WIREDGOV

The National Institute for Health and Clinical Excellence (NICE) has today announced that it will convene a guidance development group to formally review the recommendations relating to the diagnosis and removal of ‘low risk’ basal cell carcinomas (BCCs) in primary care in its guidance Improving Outcomes in Cancer for people with skin tumours including melanoma (2003).

Early in 2009 NICE was made aware of difficulties arising from the implementation of one aspect of its guidance. These were particularly in relation to the arrangements under which GPs could remove ‘low risk’ BCCs and how services for skin cancer patients were being commissioned. Some GPs believed that the requirements, especially attendance at hospital multidisciplinary team meetings, were unnecessarily onerous and in some areas it was believed that there was a threat to GP minor surgery in general. As a result of these concerns, NICE held a meeting in April 2009, chaired by the National Cancer Director, Professor Mike Richards and including representatives of some of the key stakeholder groups involved in implementing the NICE guidance including the Royal College of General Practitioners (RCGP), British Medical Association and British Association of Dermatology (BAD). A number of important issues were clarified at this meeting but NICE feels that further formal review is needed.