The Minor Surgery Service is open to referrals. Following a prolonged period of suspension due to COVID-19, the service will be addressing the existing waiting list in strict date order. Please ensure that patients are aware that there may be a longer waiting time until the backlog is addressed.

Please be advised that this service is not for suspected cancers and that these patients should continue to be referred under the dermatology pathway.

Practices should refer patients with symptomatic benign skin lesions to the Minor Surgery team on NHS e-Referral Service, who will contact them directly and book them in. EBICS applications for minor surgery will be returned to the referring GP, with the suggestion that the referral be sent to Minor Surgery team if the condition/injury meets the eligibility criteria listed below.

Two practices are registered to provide Minor Surgery Directed Enhanced Service (DES) to other practices' registered populations: 

• Brondesbury Medical Centre
• Swiss Cottage Surgery.

Follow up will be by the patient's own GP (e.g. for removal of sutures).

Eligibility Criteria

Inclusions

• invasive procedures, including incisions and excisions:
  • lesions that are symptomatic and/or inflamed on more than one occasion at the time of consultations
  • toes with chronic or recurrent in-growing nails or nail deformity requiring surgical removal of part or all of the nail, along with nail bed ablation, where appropriate
  • surgical drainage of abscesses (excluding perianal, Bartholin's and pilonidal abscesses), if an appointment via CHI RSS is available within 24 hours; if it isn't, refer patient to secondary care urgently
• aspirations for diagnostic or therapeutic indications (e.g. ganglion)
• while referrals for injections are accepted (muscles, tendons, joints), the preferred route is via MSK.

Exclusions

• cryotherapy will not be offered
• children aged <12 years (12 to 18-year-olds will be assessed individually)
• lesions more than 5cm in size (can apply for EBICS if eligible)
• suspected melanoma and squamous cell carcinoma (follow 2WW referral pathway)
• basal cell carcinoma and keratoacanthoma (refer routinely or via 2WW if rapidly enlarging)
• removal of clinically benign moles on cosmetic grounds (see EBICS policy)
• treatment of skin lesions that require using cryotherapy, curettage or cautery
• removal of sutures
• labia lesions (please refer to gynaecology)
• keloid scars (see EBICS policy).

EXCEPTIONAL

• lesions on the eye lids or eye folds may be better suited for secondary care ophthalmology depending on proximity (please include a photo or diagram).

How to Refer