title: The surgical care practitioner: a feasible alternative. Results of a prospective 4-year audit at St Mary's Hospital Trust, London.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Biosurgical and Surgical Technology, Imperial College London, St Mary's Hospital, London, UK.
authors.forename: Shirley
authors.initials: S
authors.lastname: Martin
authors.forename: Sanjay
authors.initials: S
authors.lastname: Purkayastha
authors.forename: Rachel
authors.initials: R
authors.lastname: Massey
authors.forename: Paraskevas
authors.initials: P
authors.lastname: Paraskeva
authors.forename: Paris
authors.initials: P
authors.lastname: Tekkis
authors.forename: Roger
authors.initials: R
authors.lastname: Kneebone
authors.forename: Ara
authors.initials: A
authors.lastname: Darzi
mesh_terms: D003953:Diagnosis-Related Groups; D005240:Feasibility Studies; D006801:Humans; D008131:London; D008485:Medical Audit; D008505:Medical Staff, Hospital / Q000706:statistics & numerical data*; D013511:Minor Surgical Procedures / Q000706:statistics & numerical data*; D009369:Neoplasms / Q000601:surgery; D017060:Patient Satisfaction; D011446:Prospective Studies; D012189:Retrospective Studies; D012871:Skin Diseases / Q000601:surgery; D016896:Treatment Outcome