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Dermatologists urge clampdown on GP minor surgery

By Nigel Praities

Specialists are urging the Department of Health to clamp down hard on GPs who carry out minor surgery after it emerged many PCTs were failing in their duty to implement a new accreditation system.

Trusts have a mandatory target to accredit all GPSIs by March 2009, and every three years after that – but many are set to miss the deadline and some are not even aware it exists.

The British Association of Dermatologists is in discussions with ministers over ways of injecting some urgency into the accreditation system amid ‘anxiety' that trusts are attempting to duck their responsibilities.

Dermatology is by far the most common of specialism for GPSIs, but the BAD has previously warned only a third are sufficiently trained to justify their titles.

Dr Mark Goodfield, president of the British Association of Dermatologists and a consultant dermatologist at Leeds General Infirmary, said: ‘We have had discussions with the DH about the documented failures of the system. There is data from secondary and primary care showing the quality of what goes on in skin cancer in some GP-led health services is simply not adequate.

‘The most worrying thing for GP minor surgery and skin cancer is there are individuals performing these functions who have not been through the accreditation process. The NICE guidance was a way of upping the standard, but those struggling to meet the requirements of those systems need to be re-examined.'

Professor Ram Dhillon, spokesperson for the Association of Practitioners with Special Interests and consultant surgeon at Northwick Park Hospital, Middlesex, said he had approached by a number of PCTs who had been unaware of the deadline to accredit their GPSIs. ‘I would be surprised if most PCTs are been doing anything on this. The DH has completely failed to communicate this deadline effectively and there is a question about who at PCTs has responsibility for this.'

Professor Dhillon said the Association of Practitioners with Special Interests was rushing out advice for PCTs and had already been approached by four PCTs to accredit their GPSIs before the deadline.

A Pulse investigation earlier this year revealed PCT oversight of GPSI-led services was minimal, with only 36% of PCTs saying they had conducted an official audit of GPSIs, despite an increase in the number of GPSIs from an average of eight to around 10 per PCT in the past two years.

Accreditation of GPSIs

- All new and existing GPSIs have to be accredited from March 2009 to enable them to ‘safely to take on their new roles'

- Existing GPSIs should reapply for their positions with their PCT and justify their expertise and training, provide a reference from a specialist and undergo a face-to-face interview

- PCTs have to follow-up with a service visit, regular checks and official reaccreditation every three years

Dermatologists claim GP minor surgery is too often inadequate Dermatologists claim GP minor surgery is too often inadequate

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