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Optimising surgery in Irish primary care
Tralee in general and the Rose Hotel were an excellent venue for this conference. It was perhaps fitting that the meeting was in Dr David Buckley’s home town as this was his sixth and final year organising the PCSA Annual Scientific Meeting. With rail and air links, as well as a nearby motorway, Kerry was near enough to be convenient, but far enough to be a very different and charming setting for a major medical meeting.
The PCSA was founded in 2012 as a representative group for GPs and other community-based operators who seek to promote procedural work outside of the hospital setting. The organisation has had a strong emphasis on developing quality standards and providing educational opportunities for trainee and established GPs. Office-based surgeons and nurses are also members of the association.
This year’s meeting continued the successful format of previous years. In particular, we retained the emphasis of hands-on simulated training, small group workshops and seminars to promote knowledge and skills acquisition across the range of topics encompassed in procedural practice. The dual stream approach of sessions for the relative novice and for the more experienced, allowed the best match for delegates to their learning needs. As in previous meetings, the practical sessions were complemented by plenary lectures, which addressed both specific topics as well as the moving points of procedural practice in general.
Under this heading, the meeting this year provided specific talks about the UK experience with community surgical audit as well as a comprehensive review of genital pathologies. For the broader perspective, in contrast, Prof Paul Ridgway, Associate Professor of Surgery at Trinity College Dublin, gave a tour d’horizon of the future of ‘see and treat’ surgical services within the Irish healthcare system.
This year’s meeting also continued the extended masterclass concept: Friday morning and early afternoon was dedicated to an in-depth seminar on the theory and practice of cryosurgery with such eminent speakers as Dr Paola Pasquali from Spain, Dr Buckley and Prof Colm O’Mahony, Consultant Physician in Genito-Urinary Medicine, from Chester, UK.
Those delegates who chose to attend the masterclass could elect two practical workshops on Friday afternoon focusing on the treatment of benign and malignant conditions using cryosurgical and combined cryosurgical/surgical/immunological techniques.
The regular Friday afternoon and full day Saturday format of the PCSA Scientific Meeting proper, covered topics such as setting up a skin surgery service in general practice, dermatological diagnosis, theoretical and practical sessions on wound healing, suturing, excisions, the excision of cysts and lipomas and vasectomy. Sessions for advanced learners included reviews of melanoma, head and neck skin cancers and dermoscopy.
Ross Ardill prize
As ever, the Ross Ardill prize for research or audit in community surgery drew a range of valuable papers, covering the spectrum of procedural work from joint injection to skin cancer, ENT procedures and vasectomy.
The prize, judged by a panel chaired by Association of Surgeons in Primary Care President Prof Vijay Kumar, was awarded to Dr Richard Look Tong for a two-year review of vasectomy audit data from Irish general practice (oral); and Dr Fawad Anwar for a one-year review of intra-articular joint injections (poster).
A lively commercial exhibition enhanced the meeting with demonstrations of dermatological products, updates on medicines, the latest in surgical supplies and showcases for video consulting and electronic inter-referral between GPs.
AGM and new Council
The PCSA AGM was held on Saturday, 30 September. This well attended meeting saw the election of Dr Tony O’Sullivan (Irishtown, Dublin) as the new Chair and Dr Cormac O’Dubhghaill (Cork city) as the new Secretary. Dr Shastri Persad takes over as Treasurer and Dr Buckley becomes PRO. Dr Frank O’Leary and Dr Sylvia McKenna left the committee with a vote of gratitude for their hard work over several years. Dr Emer Byrnes (Cavan) joins the committee as member at large, while Dr Niall Hurley (Dublin) takes over in charge of educational mentorship. Dr Ciaran McCabe (north-east) joins the committee to represent the GP trainee interest.
The AGM heard of the ongoing work in the area of the National Community-based Surgical Audit, the efforts to deliver an extension of the pilot community surgery accreditation project, and active work around a new arrangement for the management and referral of non-melanoma skin cancers agreed with the National Cancer Control Programme. The resolution of the difficulty over Code 23 with Laya Healthcare was a welcome item of news announced at the meeting. Laya has revised its schedule of benefits to include a new code, Code 22, to cover the excision of benign skin lesions in a primary care setting, with a condition of this benefit being that all lesions excised are sent for histological investigation.
About 150 delegates attended this PCSA meeting and went away eager to enhance community surgical provision and looking forward to reconvening for our seventh meeting in Galway on 21 and 22 September next year.