1. An account from the West
An Scéal Aniar
An account from the West
Hinckley 2015

2. …What’s the craic in Ireland?
Hinckley 2015

3. Ireland in perspective:
Republic of Ireland = ± Manchester M people, 2,888 GPs 43% eligible for ‘NHS’, 57% private, 50% have private health insurance 11% GNI spend on healthcare= €13 billion (-) 2.7 Doctors/ 1000 population (v) GP spend = €0.45 billion (3.5%)(all fees allowances supports to practice, 2013) 20% practices single handed GP training last 4 years Average GP income c € 200K
Hinckley 2015

4. Surface surgery/procedures as a business:
NOT!
Private € 252 Public € 25
(156,000 €3.9M)(PCRS 2013)
Hinckley 2015

5. 1.The Community Surgical Pilot
PCSA key actions 2015
1.The Community Surgical Pilot
2 Community-based surgical audit
3.Core Curriculum chapter on procedures for GP Training
4. An RCT of GP vs Hospital Care of NMSC
Hinckley 2015

6. 1.The Community Surgical Pilot
20 practices nationally
6 months of weekly 3 hour clinic
2000 public patients treated for a grant of c € 800/clinic
TO REPORT SCOPE, VOLUME, COMPLICATIONS, SATISFACTION
TO TEST
CREDENTIALING STANDARD, INTER-REFERRALS
….? €m NEXT YEAR?
Hinckley 2015

7. 1.The Community Surgical Pilot
Credentialing
Country
Accreditation process
Training course
AAFP (USA) no No
RACGP
Yes
RNZCGP
RCGP
GPwSI
yes
RCCGP (Can)
ICGP
DSAM (Den)
CMG/SFTG/SFMC (Fr)
SEMFyC
(1)SCCA (Skin Cancer College of Australasia)
(2)Australian College of Rural and Remote Medicine
NHG (Netherlands)
SIMG (Italy)
Hinckley 2015

8. 2 Community-based surgical audit
Hinckley 2015

9. 2 Community-based surgical audit
MediForm
Hinckley 2015

10. 2 Community-based surgical audit
Data Extraction & Analysis by Irish PC Research Network
Hinckley 2015

11. 2 Community-based surgical audit
Data Extraction & Analysis by Irish PC Research Network

12. 3 Core Curriculum Chapter for GP Training
Hinckley 2015

13. 3 Core Curriculum Chapter for GP Training
Hinckley 2015

14. 4. An RCT of GP vs Hospital Care of NMSC
Hinckley 2015

15. 4. An RCT of GP vs Hospital Care of NMSC
Survey of PCSA members April 2014
Access to hospital services for skin cancer.
(no of respondents)
Hinckley 2015

16. 4. An RCT of GP vs Hospital Care of NMSC
% Respondents
Hinckley 2015

17. 4. An RCT of GP vs Hospital Care of NMSC
% respondents
Hinckley 2015

18. 4. An RCT of GP vs Hospital Care of NMSC
20 practices
214 patients
Non-inferiority design
80% power to detect difference in lateral excision margin of > 0.5mm at 95% confidence level
Adequacy of Excision NMSC
Complications
Scar Patient Satisfaction Clinico-pathological correlation Delay
Cost
Hinckley 2015

19. PCSA 4th Annual Scientific Meeting Clontarf Castle Hotel, Dublin
Sept 25th & 26th 2015
Hinckley 2015