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Gold, incentives and meh

College weighs in on row over safety of GP minor surgery

By Lilian Anekwe

The RCGP has weighed into the growing row over GP minor surgery with a warning that the health service would ‘grind to a halt' if GPs stopped performing operations.

The college has fired off joint letters with the GPC to a series of professional bodies – including the Royal College of Surgeons and the British Association of Dermatologists – strongly rebutting criticism of the quality of GP surgery.

But even as the letters were being sent out a new report added to the controversy by claiming GPs failed to recognise one third of the malignant skin lesions sent for histological analysis.

Professor Steve Field, chair of the RCGP, told Pulse: ‘We're unhappy with the NICE guidance on skin cancer and so is the BMA. Organisations like the British Association of Dermatologists would rather GPs didn't perform minor surgery at all, but that's just not realistic.

‘If GPs were not doing it the health service would just grind to a halt because of all the referrals that would choke up hospital services.'

His comments came as observational data, drawn from a randomised controlled trial of 586 patients seen either by 65 GPs or 60 dermatologists or surgeons in a minor surgery hospital unit, found only 45% of the 490 lesions diagnosed by GPs were confirmed by histology – a level of agreement the researchers described as ‘moderate at best'.

The sensitivity of GPs for the detection of malignant lesions was 66.7%, and 63.6% for the correct diagnosis of individuals affected with malignancy.

Writing in the British Journal of Cancer, Professor John Primrose, professor of surgery at the University of Southampton, said the research was a ‘health warning around the assumption that shifting services from secondary care to primary care carries only benefit'.

Professor Steve Field: unhappy with Nice guidance on skin cancer Professor Steve Field: unhappy with Nice guidance on skin cancer

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