The Minor Surgery Directed Enhanced Service offers primary care minor surgical procedures, including injections and aspirations, more invasive procedures such as incisions and excisions, and removal of low-risk basal cell carcinomas.

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) refer patient to secondary care
• aspirations for diagnostic or therapeutic indications (e.g. Ganglion)
• while referrals for injections (muscles, tendons, joints) are accepted, the preferred route is via Haringey and Islington's Integrated Musculoskeletal Service.

Exclusions

• children aged <12 years (12-18-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 urgent suspected cancer skin referral pathway)
• basal cell carcinoma and keratoacanthoma (refer routinely or via urgent suspected cancer skin referral pathway if rapidly enlarging).

The following procedures are not normally funded:

• removal of clinically benign moles on cosmetic grounds
• treatment of skin lesions that require use of cryotherapy, curettage or cautery
• removal of sutures.

How to Refer