The Surgical Care Practitioner: A Feasible Alternative. Results of A Prospective 4-Year Audit at St Mary's Hospital Trust, London

Abstract

Surgical care practitioners (SCPs) are an expanding group of professionals, drawn from nursing and the allied health professions. Amongst other functions, SCPs can provide a range of surgical procedures including a 'minor surgical' service. The aim of this study was to audit the volume and outcomes related to the SCP service at St Mary's since its inception. All prospectively collected data regarding SCP-managed patients between 2001 and 2005 were retrospectively audited. Volume, case mix, waiting times, complications and patient satisfaction were recorded and evaluated. In this 4-year period, the SCP performed 381 minor operative cases (year 1 to year 4: 32, 74, 114 and 161 cases, respectively). These included excision of lipomas, sebaceous cysts and suspicious naevi under local anaesthesia and 7 similar cases under general anaesthetic. There were 11 minor postoperative complications which included 7 wound infections which were all resolved with a short course of oral antibiotics, 2 seromas of which one needed aspiration under local anaesthetic and one minor wound dehiscence which was re-sutured the same day. Overall, 71% were seen within 1 month of referral, 16% within 1-2 months, 3% within 3 months and 10% within 6 months. In addition, 59% were seen and treated within 20 min of their appointed time, 15% within 30-60 min and 24% within 1-2 h. The 3-month patient perspective audit carried out between May and July 2004 included 59 completed patient questionnaires following surgery; 100% were totally satisfied with the care that they received; 98% were happy to see the SCP and 98% documented that they would recommend the SCP to others. The 4-year period of using an SCP at St Mary's shows that it is feasible and safe for minor operative procedures, that it contributes positively to waiting times and is acceptable to patients.