Community Based Minor Skin Surgery Service
Service Quality Performance Report

April 2023 – March 2024

Introduction

The community minor surgery service is provided by Dr Martin White, GPwER in minor surgery, who is mentored and supported by Mr Graham Putnam, Consultant Maxillofacial. Dr David Brigham GPwER in minor surgery and Deborah Bradley, Advanced Operating Practitioner, also assist with running clinics each month.

The service is provided from Maryport Community Hospital, Carlisle Healthcare South, Cockermouth Community Hospital and Keswick Hospital.

Bookings are via NHS E-Referral service following GP referral, though the majority of patients are assessed first in the community dermatology service before being listed for their procedure.

A photograph of the lesion is taken in the dermatology clinic and attached to the patient records where appropriate, and triaged by Dr White who allocates the time required for surgery and the clinician to perform the operation.

Any benign lesions have to meet evidence based criteria before listing for surgery:

  • Well documented evidence of significant pain
  • Recurrent infection
  • Subject to recurrent unavoidable trauma leading to bleeding
  • Uncertain diagnosis, to rule out or confirm malignancy

Patients are given a comprehensive preoperative patient information leaflet detailing what to expect on the day, medication, potential risks and consent procedure.

Following skin graft surgery, patients are provided with an advice sheet on wound care with information also provided for the practice nurse on the removal of sutures. Where appropriate, the patients return to clinic for the removal of their sutures

Waiting Times

The average waiting time from referral to assessment is 4-6 weeks and the average waiting time from assessment to procedure is 4-6 weeks. All patients in this reporting period were assessed and treated within 18 weeks of referral.

Activity

The community Minor Surgery service has seen a total of1,615 patients in this reporting period. These included 1,431 procedures, 25 assessments and 163 surgical follow up appointments.

There were a further 22 appointments which resulted in a DNA.

Type of surgery performed from basic excision to maxillofacial procedure

Conditions Treated

Some of the conditions treated include:

All SCC and melanoma were referred to MDT for review.

100% lesions excised are sent for histology.

Post-Operative Complications

  • 11 patient recorded as having a post-operative infection requiring antibiotics
  • 3 patients recorded having excessive bleeding post-surgery

Patient Satisfaction

A sample of patients are forwarded a link to a patient survey on Survey Monkey at the start of each quarter questioning them on a range of subjects including the booking arrangements, clinic facilities, doctor and nurse manner, and overall satisfaction.

  • 100% patients said they were treated with courtesy throughout from reception to clinician.
  • 97% patients said they were given a clear explanation of their condition and treatment
  • 97% patients said they were involved as much as they wanted to be in their care and treatment.
  • 99% patients said they were extremely likely or likely to recommend the service to their family and friends.

Patients are also given the opportunity to give feedback via ‘iwantgreatcare’ or our website www.cumbriamedicalservices.co.uk

100 surveys have been returned for this reporting period to date. Using the Family and Friends test the results show how patients are likely to recommend CMS:

Patient comments included

  • ‘Everything was top notch’
  • ‘I felt very relaxed and was treated with care’
  • ‘A beautiful new facility with kind and friendly staff’
  • ‘My first time at the new centre, parking very good, directions to appropriate area very good.’
  • ‘Everything was extremely smooth, I was in and out in no time at all and all the staff were really welcoming and friendly, excellent service and very pleased with the outcome’
  • “I was extremely pleased with the procedure itself and my own Drs surgery are amazed at how good the scar is looking. My own Dr struggled to find it. Thank you Dr White. A job well done and quickly”
  • “I had excellent service. My appointment was at 0900 and was taken immediately. I had fantastic treatment, Dr White and his staff were wonderful. I felt nervous beforehand but I was immediately put at ease.”
  • “Really Good experience all round”
  • “Every bit of my appointment was explained without any problem, Dr Chaudhri is a true gentleman he tells you what you need to know and why he is doing it, excellent service.”
  • “I thought the whole organisation was efficient and professional.”
  • ‘’Excellent overall service which I would recommend to anyone who requires it.Every element from first appt right through to procedure was first class and can’t speak highly enough of the service and care provided’’
  • ‘’I have a fear of needles .so for the anaesthetic I was very nervous .but was reassured by the nurses and surgeon all the way through the procedure’’
  • ‘’Very professional service from the ladies who dealt with me. They were also very approachable. Thank you’’
  • ‘’The 2 medical professionals who looked after me were lovely and really put me at my ease. They kept checking that I was OK and made the whole experience a lot better than I feared it would be’’
  • ‘’Absolutely amazing treatment. Made to feel at total ease. Such professional service. Lovely environment made easier by the consultant and nurse. Please send my thanks to an amazing team’’
  • ‘’Both Dr & nurse were excellent and explained step by step what they were doing throughout the procedure. Post operation information sheet also excellent’’
  • “I had concerns about my facial operation, as it was a second incision but Mr Putman put me at ease by explaining the procedure”
  • “Staff are very professional and very knowledgeable. Can’t fault the Doctors”
  • “I was very pleased with my treatment, the staff were very reassuring and polite. I was called on time and the procedure only lasted about 15 minutes. I was advised how to look after the wound”
  • “The service and treatment on the whole was excellent, it was just unfortunate that infection set in needing medical intervention, thanks to all”
  • “The entire staff were very professional. I was treated with respect and care”
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