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The Community-Based Surgery Audit (CBSA) has been established to enable practitioners of community-based surgery to collect evidence on the quality of the surgery they undertake.
It aims to
- build a mechanism that measures the quality and quantity of community-based surgery undertaken in the UK
- support practitioners of surgery in community settings in monitoring and improving the quality of the service they provide by providing feedback on their practice and results and allowing comparison with their peers
- allow individual practitioners to collect data to support re-accreditation, appraisal, revalidation, and local contracting
- allow high-level analysis and reporting of data submitted by all participating practitioners to give an overview of community-based surgery practice.
What does it measure?
The audit is concerned with operative procedures on patients aged 18 years or older, carried out under local anaesthesia in a community setting and likely to involve the removal of material for histological analysis, plus partial and complete avulsion (removal) of toenails. This will encompass all dermatological surgery (removal of skin lesions), including some more technically challenging excisions including flaps and grafts under local anaesthesia. It does not currently include vasectomy, carpal tunnel, trigger finger or ganglion surgery.
- If the surgery takes place within a hospital setting under acute trust governance then it should be excluded.
- If the surgery is undertaken in the community, by a primary care surgeon, even if the surgeon is working under acute trust governance (i.e. as a model 2 practitioner) then that would be included. The audit makes provision for such extended roles.
The data set includes information on patient details, clinical details of lesions treated, surgery undertaken, results of histological analysis, and the occurrence of any complications. It has been designed to allow assessment of the timeliness of treatment, accuracy in diagnosis, surgical technique, patient outcomes, and other indicators of the quality of clinical practice.
How is the data collected?
The audit system is based on a secure web-based portal through which participants can submit information on individual cases they have treated. The data is held on secure servers operated by the Health and Social Care Information Centre (HSCIC).
Who manages the project?
The audit has been developed by the RCGP's Clinical Innovation and Research Centre (CIRC) in collaboration with HSCIC.
Pilot progress to date
The pilot began in 2013 with a limited release phase during which a number of practitioners who had expressed an interest in early involvement used and tested the system. The system has been updated based on their experience and feedback and the audit has now progressed to a national pilot. All practitioners of community-based surgery, regardless of how much surgery they undertake, are now encouraged to participate. With sufficient levels of participation and data collection over the 2014/2015 period, the aim is to secure further funds to continue the audit beyond the pilot stage.