City and Hackney Community Minor Surgery

The service is an alternative to hospital-based treatments offering a one stop service for appropriate minor skin surgical procedures. This aims to minimise the need for follow-up and only when appropriate, onward referral to secondary care.

The service is to provide a community minor surgery pathway for patients registered with GP Practices in City and Hackney from assessment to treatment in line with the acceptance and exclusion criteria and service requirements.

Services required:

• Enhanced Minor Skin Surgery (in line with the national Directed Enhanced Service DES). This includes excision and incision procedures
• Cryotherapy/Cautery for GP practices that have opted out of the GMS/PMS additional service of minor surgery

The service will be provided locally in City and Hackney from a primary care clinical site location(s) for City and Hackney GP registered patients. This model will provide local, accessible, and integrated services that are aligned with providers within the health and social care economy.

Procedures include treatments for the following:

• Capsulitis
• Bursitis
• Entheosopathies / tendinitis
• Tenosynovitis
• Compression
• Aspiration indications: diagnostic or therapeutic and where such treatment will be likely to improve clinical outcomes
• Pigmented and vascular lesions, where histology is required (excluding suspected melanomas)
• Lesions with atypical behaviour, such as bleed or change in colour, where histology is required. These might include for example, papilloma, dermatofibroma or seborrhoeic keratosis.
• Lesions that are symptomatic and/or have been inflamed on more than one occasion at the time of consultation
• Epidermoid cysts in that are symptomatic and/or have been inflamed on more than one occasion at the time of consultation
• Keratoacanthoma
• Surgical drainage of abscesses and haematomas where this is deemed best treatment
• Removal of foreign bodies only where local anaesthetic and incision is required as part of procedure
• Low-risk Basel Cell Carcinomas (BCCs), as defined in current NICE Guidance on Cancer Services. For BCCs which do not meet the low-risk criteria or where there is any diagnostic doubt, a referral should be made as per NICE guidelines.
• Keloid scars in cases where the scar interferes with function or causes pain or itchiness which is persistent and unrelieved by standard medication for over one year,

Activity: approximately 500 procedures, 300 cryotherapies and 160 consultations

Budget: approximately £120k per year Additional information: The process being followed is a Most Suitable Provider Process under the Provider Selection Regime 2023.