The enhanced service for minor surgery is locally-specified so will vary from practice to practice and between areas.
If your practice is providing the minor surgery enhanced service, each financial year NHS England or your CCG (whichever is commissioning the service) should clarify which minor surgery procedures you are able to undertake and for which categories of patients and the payment that you will receive.
Minor surgery procedures that may be undertaken by GP practices are set out in the Directed Enhanced Services Directions and include:
- injections for muscles, tendons and joints
- invasive procedures, including incisions and excisions
- injections for varicose veins and piles.
Practice requirements under the ES
Practices providing this enhanced service must take all reasonable steps to provide suitable information to patients about the procedure they are undergoing.
Practices must obtain written consent to the surgical procedure before it is carried out. Where consent is obtained from someone else on the patient's behalf that person's relationship to the patient must be recorded on the form.
Consent forms must be included in patients' medical records.
All tissue removed by surgical procedure should be sent for histological examination unless there are reasons for not doing so.
Any healthcare professional involved in performing or assisting in minor surgery must have the necessary skills, training and experience for that particular procedure and have resuscitation skills.
The practice must have appropriate arrangements for infection control and decontamination in premises where surgical procedures are undertaken.
The commissioner may stipulate the use of sterile packes from the local central sterile service department, disposable sterile instruments or approved sterilisation procedures. The commissioner may also stipulate the use of particular infection control policies in relation to handling used instruments, excised specimens and the disposal of clinical waste.
The practice must ensure that all records relating to minor surgery are maintained so that aggregated data and details of patients are readily accessible and to facilitate regular audit and peer review by commissioners.
The practice must provide commissioners with any information it requests for the purposes of monitoring the practice's performance under the ES.
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