One-Stop Clinic Utilization in Plastic Surgery: Our Local Experience and the Results of a UK-Wide National Survey

Abstract

Introduction. “See and treat” one-stop clinics (OSCs) are an advocated NHS initiative to modernise care, reducing cancer treatment waiting times. Little studied in plastic surgery, the existing evidence suggests that though they improve care, they are rarely implemented. We present our experience setting up a plastic surgery OSC for minor skin surgery and survey their use across the UK. Methods. The OSC was evaluated by 18-week wait target compliance, measures of departmental capacity, and patient satisfaction. Data was obtained from 32 of the 47 UK plastic surgery departments to investigate the prevalence of OSCs for minor skin cancer surgery. Results. The OSC improved 18-week waiting times, from a noncompliant mean of 80% to a compliant 95% average. Department capacity increased 15%. 95% of patients were highly satisfied with and preferred the OSC to a conventional service. Only 25% of UK plastic surgery units run OSCs, offering varying reasons for not doing so, 42% having not considered their use. Conclusions. OSCs are underutilised within UK plastic surgery, where a significant proportion of units have not even considered their benefit. This is despite associated improvements in waiting times, department capacity, and levels of high patient satisfaction. We offer our considerations and local experience instituting an OSC service.

Are sex disparities in COVID-19 a predictable outcome of failing men’s health provision?

“…Qualitative studies using patient questionnaires in a range of specialities have suggested high patient satisfaction with ‘one-stop’ clinics compared with traditional outpatient encounters 183 , 184 . A study investigating patient experiences with a one-stop haematuria clinic and a clinical pathway containing several visits showed high patient satisfaction (recorded through a questionnaire), reporting that 82% of the participants expressed preference for a one-stop clinic model 183 .…”

“…A study investigating patient experiences with a one-stop haematuria clinic and a clinical pathway containing several visits showed high patient satisfaction (recorded through a questionnaire), reporting that 82% of the participants expressed preference for a one-stop clinic model 183 . A separate study 184 investigated the effects of a one-stop clinic for minor skin surgery in 32 UK plastic surgery departments, reporting that the use of one-stop clinics was associated with a higher degree of patient satisfaction (95% versus 72%) than conventional pathways and improved compliance with 18-week waiting time targets (95% versus 85%).…”

Effect of a See and Treat clinic on skin cancer treatment time

“…In the face of increasing referral numbers, lengthy waiting times for skin cancer surgery have been reported . Departments with increasing workloads without commensurate increases in resources must develop innovative means of ensuring effective, cost‐efficient treatment in a timely manner.…”

“…‘See and Treat clinics’, also known as ‘one‐stop clinics’, enable specialist assessment and surgical treatment of skin cancers to occur in a single visit . Such clinics are being implemented around the world in attempts to reduce cancer treatment time . Confining assessment and treatment to a single visit benefits patients by reducing the number of appointments required.…”

Improving waiting times in the orthopaedic outpatient clinic

“…Clearly, this improves the times patients must wait and reduces the number of hospital visits. One stop clinics have already been established in gynaecology, 9 urology, 10 breast surgery, 11 plastic surgery, 12 ear nose and throat surgery, 13 gastroenterology, 14 care of the elderly 15 as well as in orthopaedic surgery. 16 17 …”