Policy Statement
Godiva Group of Practice’s has signed up to the Minor Surgery Scheme outlined in the Primary Medical Services (Directed Enhanced Services) Directions 2023 (please see document). This Directed Enhanced Service has been established to support the local population so that they can more easily access surgical procedures that can be undertaken within the community. Throughout this document, ‘minor surgery’ and ‘joint injections’ are simply referred to as ‘minor surgery’ but can relate to either procedure.
Service Delivery Specification
1.1 General Requirement Specification
The aim of this agreement is to ensure that practices have the opportunity to provide a wider range of minor surgery procedures within a primary care setting.
This Enhanced Service sets out the process for practices to:
- Undertake minor surgical procedures for patients from their own practice
- Monitor minor surgical activity
- Must record in the patient’s record: (a) details of the minor surgery provided to the patient and (b) the consent of the patient to that surgery
To access the consent form please use template within patient record “Minor OP – Consent Form”.
2.2 – Eligibility for Minor Surgery
Minor surgery at the practice is generally available for conditions such as:
- Removal of cysts, skin tags, and small lumps
- Incision and drainage of abscesses
- Joint injections for pain relief
Before any procedure, a clinician will assess your condition to determine whether minor surgery is suitable for you or if a referral to a specialist is necessary.
2.3 – Duties and Responsibilities
Dr P Bahalkar is the nominated clinician who is the lead for minor surgery within this organisation and they are responsible for ensuring that the organisation’s minor surgery and joint injection standards meet national and local policy/guidance or best practice.
2.4 – Pre-Procedure Guidelines
Consultation: Before surgery, you will have a consultation with your clinician. They will explain the procedure, the risks involved, and what to expect.
Consent: You will need to sign a consent form before the procedure. This confirms that you understand the risks and benefits and agree to proceed.
Medical History: Ensure you inform your clinician of any existing medical conditions, medications, or allergies.
Fasting: In most cases, fasting is not required for minor surgery. However, your clinician will inform you if specific preparation is needed.
2.5 – The Procedure
Minor surgeries are typically done under local anaesthesia, meaning you will be awake but the area being treated will be numbed.
Procedures usually take between 15 to 45 minutes, depending on the complexity.
A sterile environment will be maintained to minimise infection risk.
2.6 – Post-Procedure Care
Wound Care: After surgery, you will receive instructions on how to care for your wound, including cleaning and dressing.
Pain Relief: Over-the-counter painkillers, such as paracetamol, can help manage any discomfort. Avoid aspirin unless advised, as it may increase bleeding.
Follow-up: You may need a follow-up appointment to monitor healing or remove stitches if applicable.
Signs of Complications: Watch for signs of infection (redness, swelling, warmth, or discharge). Contact the practice if you experience fever or excessive pain.
Governance
3.1 – Record Keeping
A full record of the procedure should be made in the patient’s electronic record and should include:
- A SNOMED CT coded entry of the operation undertaken
- Anaesthetic used
- Any medication used
- Suture material – type, needle used, make, batch numbers and expiry dates
3.2 – Audit
Full records of all procedures should be maintained in such a way that aggregated data and details of individual patients are readily accessible. The Practices should regularly audit and peer review minor surgery work. Possible topics for audit include:
- Clinical outcomes
- Rates of infection
- Unexpected or incomplete excision of lesions which following histological examination are found to be malignant
3.3 – Training
Clinicians providing this Enhanced Service will have had sufficient surgical training either by previous experience in general surgery or through a relevant post-graduate qualification, for example:
- Certificate of Competence in Minor Surgery from a Vocational Training Scheme
- Higher degree or diploma in a surgical specialty
- Evidence of completion of an approved course of training in minor surgery