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GPs hit back over minor surgery claims

By Emma Wilkinson

GP researchers have delivered a powerful riposte to a recent NHS study which branded minor surgery carried out in primary care as ‘unsafe'.

A seven-year analysis of malignant melanoma excision found no evidence that GPs were any worse than specialists at performing operations.

Of almost 600 melanomas removed in North Wales between 1993 and 2001, one in six were done by GPs – either because they had the skills and experience to do so or because the lesion was initially not thought to be malignant.

There was no difference in quality of excision between general practice and hospital and those who had melanomas removed in primary care were more likely to get a quick diagnosis, the study found.

It comes just a few weeks after a Health Technology Assessment found operations conducted in primary care were of poorer quality, and were less cost-effective, than those done in hospital.

Study leader Dr Richard Neal, a senior lecturer in primary care at the University and a GP in Flintshire, said it was becoming increasingly common for people to attend the GP surgery asking for moles to be removed.

‘The message is if you excise by accident, you need to make sure you refer the patients on to the hospital but you probably haven't done the patient any disservice whatsoever.

‘This is good evidence from a large number of cases and there was nothing to suggest they are managed in any poorer quality way in general practice.'

Dr Neal said he had followed the recent controversy with interest and he had been ‘delighted' with the results of his research.

GPC chair Dr Laurence Buckman said NICE had responded to his written request for clarity on their skin cancer guidance, which some PCTs were implementing in a ‘draconian' way but the answer was unsatisfactory and he would be pushing them further.

‘I do feel GPs have been demonised over this and we will be looking at this new study closely.'

Minor surgery row: research shows GPs no worse than specialists Minor surgery row: research shows GPs no worse than specialists

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