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NICE skin cancer rules relaxed

By Lilian Anekwe

NICE guidance on skin cancer will relax the requirement for GPs to attend multidisciplinary team meetings in order to perform minor surgery – and introduce different levels of competency for those performing more complicated procedures.

Pulse understands that under the new guidance, due to be published this week, any GP will be able to perform minor surgery under either direct or enhanced service arrangements if they can show surgical competency, a fail-safe log of procedures, an annual audit of accuracy, and evidence that all specimens have been sent for histology.

But GPs have won concessions from NICE meaning they will no longer be required to maintain a minimum level of activity and will not have to attend a set number of multidisciplinary team meetings.

Speaking at the Association of Surgeons in Primary Care conference in London earlier this month, Dr Jonathan Botting, the RCGP's national clinical champion for minor surgery, said GPs will be able to perform minor surgery more freely, but the ability to manage low risk basal cell carcinomas will ‘depend on who you are'.

GP surgeons will be classified into three groups according to their competency, from a model 1 GPSI - able to treat the lowest risk patients - to a model 2 practitioner and a group 3 GPSI.

PCTs will be able to choose one or more of the models, and will also be able to choose to commission a community skin cancer service or commission from the independent sector.

Dr Botting, a GP in Barnes, south west London told Pulse PCTs were still restricting GP surgeons: ‘It's amazing how many PCTs are coming down heavily upon their most able skin surgeons – stopping them operating on conditions that they are best placed to operate on, many with evidence to show superior results to secondary care - just weeks before NICE publishes the widely discussed BCC guidance.'

NICE has revised its guidance on skin cancer


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