Community Based Minor Skin Surgery Service
Service Quality Performance Report

April 2022 – March 2023

Introduction

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

The service is provided from Maryport Community Hospital, Arnside House Surgery (moved to Carlisle Healthcare South in January 2023), Cockermouth Community Hospital and Keswick Hospital.

Bookings are via NHS eReferral 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 weeks and the average waiting time from assessment to procedure is 4 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 of2,048 patients in this reporting period. This included 1,738 procedures, 176 assessments and 83 surgical follow up appointments.

 There were a further 33 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

  • 2 patient recorded as having a post-operative infection requiring antibiotics
  • 1 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.

  • 98.5% patients said they were treated with courtesy throughout from reception to clinician.
  • 98.5% 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.
  • 98.5% 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

42 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

  • ‘Considering the problems with the NHS this was a first class service’
  • ‘Still swollen and stiff but now three-quarters open. Sore but informed it will take time’
  • ‘Very professional service throughout’
  • ‘Excellent treatment and efficient pleasant staff’
  • ‘From being first to be referred to the operation itself it was done efficiently and quickly. I’m very satisfied’
  • ‘Felt very well looked after and all staff were friendly.’
  • ‘I found that the treatment I got was excellent – apart being told that I could wash my hair (my operation was in my hair) and I was supposed to keep the area dry’
  • ‘Surgery part was fine. Trying to get an appointment with my Surgery to get stitches out not so good.’
  • ‘Very good’
  • ‘Excellent treatment from the team. Thank you’
  • ‘The surgeon and supporting nurses were very considerate. I was pleased to be referred so quickly to the clinic in Keswick by the dermatologist at my recent appointment at the James Cochrane Practice Kendal, after waiting 4 months for a referral appointment at Westmorland General Hospital which has only just come through for early December and is only for an examination’
  • ‘I was hugely impressed by the kindness and consideration of the team. I was also very grateful to Dr Chou for his professionalism and gentleness. Thank you. My only regret is that I live in South Lakes’
  • ‘The staff who carried out the procedure were very professional and very caring.’
  • ‘Very friendly, professional and made me feel comfortable’
  • ‘Very professional and caring group that looked after me.’
  • ‘Everyone was friendly, kind & considerate. I felt comfortable with the treatment. No waiting, clinic running to time’
  • ‘Still quite a bit of pain since I had the second visit to control the bleeding’
  • ‘Great staff and very helpful 👍 👏’
  • ‘Excellent help very happy staff making me feel ok’
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