Community Based Minor Skin Surgery Service
Service Quality Performance Report

April 2020 – March 2021


The community minor surgery service is provided by Dr Martin White, GPER in minor surgery, who is mentored and supported by Mr Graham Putnam and Dr Christy Chou, Consultant Maxillofacial and Plastic Surgeons. Dr David Brigham and Deborah Bradley and Jackie Shearer (both nurse specialists) also run regular clinics.

The service is provided from Maryport Community Hospital, London Road Community Clinic, Carlisle and Keswick Hospital.

Over the last 12 months during the COVID pandemic there have been a number of different clinical safeguards and protocols introduced to enhance the safety of both patients and staff. Referrals during this period have fluctuated month to month, but CMS has continued to provide a high quality service to patients ensuring a continued responsive, flexible service is on offer to meet patient demand and need.

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.


The community Minor Surgery service has seen a total of 1,392 patients in this reporting period. This figure includes 91 assessments and 93 surgical follow ups.

 15 patients did not attend for their appointment.

Type of surgery performed from basic excision to maxillofacial procedure

Conditions Treated

All SCC and melanoma were referred to MDT for review.

100% lesions excised are sent for histology.

Post-Operative Complications

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

Patient Satisfaction

Patient surveys are sent out in the first week of each quarter for those patients who had surgery 4 weeks prior 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.
  • 98% patients said they were given a clear explanation of their condition and treatment
  • 100% patients said they were involved as much as they wanted to be in their care and treatment.
  • 96% patients said they had enough time to ask questions or raise concerns.

Patients are also given the opportunity to give feedback via ‘iwantgreatcare’ or our website

82 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

  • Excellent from start to finish!
  • Too early to say if the surgery was successful, or what the final outcome is. All good so far though.
  • Very comfortable and professional service.
  • The staff at the practice were excellent. The doctor and nurses who provided the surgery were informative and friendly. The procedure went well and I was made to feel comfortable.
  • Wonderful service – thank you to everyone in the clinic.
  • Local anaesthetic was not sufficient initially but as I could feel the incision however as soon as I mentioned it the level was topped up and I felt no further discomfort. The whole experience was very efficient – in and out in 20 minutes – brilliant.
  • The treatment I received from the Doctor and all the staff at Cumbria Medical Services was excellent.
  • I had no problems with the operation of the lesion. Thank you all.
  • I was very impressed with the attention and care from both Orchard House Surgery and Maryport Cottage Hospital. The wound has healed and I’m sure the red mark will fade. Much appreciation for a good service.
  • Extremely quick, efficient procedure. I expected to be travelling over 40 miles for a short consultation and was delighted when Dr Chou said he could do the surgery there and then. The wound has healed well and very little evidence on my face that surgery has taken place.
  • The whole process from identification to removal was swift, efficient and effective.
  • It might be worth sending a follow up survey further down the line to ask about any medium to long term issues arising from the procedure.
  • Very pleased with everything.
  • Spot on! Couldn’t fault anything. Thanks!
  • I could not fault any part of the procedure.
  • The service was excellent. I could not want more. Thank you.
  • The staff were both professional and kind and put me at my ease as I was unsure what to expect.
  • Super service you can be proud of it.
  • Staff very competent and friendly.
  • Extremely quick, efficient procedure. I expected to be travelling over 40 miles for a short consultation and was delighted when Dr Chou said he could surgery the surgery there and then. The wound has healed well.
  • The whole process from identification to removal was swift, efficient and effective.
  • Very efficient and professional service from start to finish. Particularly appreciate flexibility of appointment time to fit busy professional life and time taken by dermatologist.
  • Perfectly satisfied with my treatment.
  • Completely satisfied, an excellent operation and result. Thank you all.
  • Very friendly, professional, put me totally at ease, I was so nervous.
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