Minor Surgery

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The minor surgery directed enhanced service (DES) provides an opportunity for primary care to deliver appropriate minor surgery. The Minor Surgery Service Specification identifies the qualifications and training required of clinicians, as well as standards for facilities and equipment.

Practices can offer up to three levels of minor surgery, depending on the types of procedures clinicians are accredited to perform.

  • Level 1: Injections and aspirations
  • Level 2: Some invasive procedures, including incisions, excisions
  • Level 3: Removal of low risk Basal Cell Carcinomas (BCCs)

Practices also have the option to offer minor surgery services to other practices patients and to non-registered Islington patients. Four Islington practices are registered to provide this service to other practices' registered populations: 

  1. The Junction Medical Centre
  2. Ritchie Street Group Practice
  3. The Village Practice

A description of minor surgery procedures provided by these local practices is provided to help you select a practice to refer to.

Eligibility criteria


Invasive procedures, including incisions and excisions:

  • lesions that are symptomatic and/or inflamed on more than one occasion at the time of consultations
  • toes with chronic or recurrent in-growing nails or nail deformity requiring surgical removal of part or all of the nail, along with nail bed ablation, where appropriate
  • surgical drainage of abscesses (excluding perianal, Bartholin's and pilonidal abscesses), if an appointment via CCAS is available within 24 hours; if it isn't, refer patient to secondary care
  • aspirations for diagnostic or therapeutic indications (e.g. Ganglion)
  • while we accept referrals for injections (muscles, tendons, joints), the preferred route is via MSK


  • children aged <12 years (12–18-year-olds will be assessed individually)
  • lesions more than 5cm in size (can apply for EBICS, if eligible)
  • suspected melanoma and squamous cell carcinona (follow 2WW referral pathway)
  • basal cell carcinoma and keratoacanthoma (refer routinely or via 2WW if rapidly enlarging)

Following procedures not normally funded:

  • removal of clinically benign moles on cosmetic grounds
  • treatment of skin lesions that require using cryotherapy, curettage or cautery
  • removal of sutures

How to refer

The following clinicians can refer to this service: GPs


Referral methods: Email

Before making a referral, you will need to check which practices you can refer to and which level of procedure (1, 2 or 3) each practice will accept. It is important not to refer a patient for a procedure that the accepting practice cannot treat. (See downloads for service pathway and FAQs)

For each patient, you will need to:

  • Check that the procedure you want to refer is valid under the DES.
  • Check to see whether the procedure is level 1; level 2; or level 3 ( see guidance above and the more detailed guidance available on the referral website) 
  • Identify an Islington practice that will accept referrals of procedures at the relevant level. 
  • Complete a referral form containing all relevant information about the referral (see downloads).
  • Email the referral form from your nhs.net account to the appropriate accepting practice


Ritchie Street Health Centre
The Junction Medical Centre
The Village Practice