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Minor surgery DES (England)

A summary of what is involved in the minor surgery DES for England.

Purpose
To provide in primary care the maximum range of minor surgery.

Applies
Indefinitely.

Wales and Northern Ireland have their own schemes

Payment

  • Level 1: £43.51 per procedure (for example, joint injections, aspirations of bursae and effusions of major joints.
  • Level 2: £87.01 per procedure (cutting surgery)
What it involves
  • Provision of satisfactory facilities at practice premises.
  • Healthcare professionals performing or assisting with minor surgery have the necessary experience.
  • There are appropriate sterilisation and infection control arrangements.
  • Obtaining written consent from the patient (or person giving consent on their behalf) and taking reasonable steps to ensure the consent form is included permanently in the medical record.
  • Ensuring all tissue removed by surgery is sent for histological testing unless there are acceptable reasons for not doing so.
  • Details of the patient’s monitoring as part of the DES is included permanently in the medical record. If the patient is not registered at the practice, this information must be sent to the patient’s registered practice.
  • Review and audit of the service provided.

Problem areas
Working out if the service will be profitable. If providing a minor surgery service as local enhanced service rather than a DES, negotiating a fair payment rate.

Top tips

  • Cost out the expenses involved carefully, taking into account GP, nurse and administration staff  time. Calculate equipment costs including disposable instruments, sutures and so on.
  • Check which items can be prescribed on an FP10 for personal administration and which will therefore generate a dispensing payment.
  • Examining referred patients and immediately performing the procedure is more efficient than two appointments.
  • Make clear to referring practices they must provide very clear details about the patient's problem.
  • Inform the referring practices without delay about the procedure you have performed.
  • Ensure referred patients are told after a procedure what they should do about follow-up care (eg sutures removal).
  • Set up a system for telling patients about their histology results.

More details
Read a case study on how one practice has approached the minor surgery DES.

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