Quality standard

Quality statement 2: GPs managing low-risk basal cell carcinoma

Quality statement

GPs who manage low‑risk basal cell carcinoma maintain and audit records of their caseload.

Rationale

Low-risk basal cell carcinoma can sometimes be managed by GPs in the community, which can be more convenient for patients. Treatment in the community can also frequently be provided at a lower cost and free up capacity in hospitals. However, it is essential that this is balanced with ensuring that care offered in the community is as safe and effective as that in hospital. Maintaining and auditing records of their caseload can help in demonstrating competence.

Quality measures

The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.

Structure

Evidence of local arrangements to ensure that GPs who manage low‑risk basal cell carcinoma maintain and audit records of their caseload.

Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by healthcare professionals.

Process

Proportion of GPs managing low‑risk basal cell carcinoma who audited their caseload within the past 12 months.

Numerator – number in the denominator who audited their caseload within the past 12 months.

Denominator – number of GPs managing low‑risk basal cell carcinoma.

Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by healthcare professionals.

Outcome

a) Proportion of skin lesions excised by GPs that are subsequently confirmed as low‑risk basal cell carcinomas.

Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from patient records.

b) Patient safety incidents reported related to removal of basal cell carcinomas in primary care.

Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by provider organisations, for example from local risk management systems.

What the quality statement means for different audiences

Service providers (GP practices) ensure that GPs managing low‑risk basal cell carcinoma maintain and audit records of their caseload.

Healthcare professionals (GPs, GPs with specialist interest and GPs with extended roles) managing low‑risk basal cell carcinoma maintain and audit records of their caseload.

Commissioners (NHS England and integrated care systems) ensure that GPs who manage low‑risk basal cell carcinoma maintain and audit records of their caseload.

People who are having treatment from a GP for a type of skin cancer called low‑risk basal cell carcinoma receive treatment that is safe and effective.

Definitions of terms used in this quality statement

Low-risk basal cell carcinoma

Low-risk basal cell carcinoma is defined in the section on models of care in NICE's guidance on improving outcomes for people with skin tumours including melanoma (2010 update).

Competence in managing low-risk basal cell carcinoma

NICE's guidance on improving outcomes for people with skin tumours including melanoma (2010 update) outlines criteria for assessing competence and accrediting practitioners.