Access to Plastic Surgery Survey

Access to reconstructive plastic surgery can be limited by financial, workforce, facilities and training challenges as well as capacity and geographical factors.

Improving equity begins with understanding these limitations. We would be grateful if you could share your experience and opinion by answering the following 9 questions (Answers will be kept anonymous).

Many Thanks

Jo Skillman and Haneen Abed (Plastic Surgeons at UHCW)

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* 1. Which region do you work in?

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* 2. Do you offer the following procedures in YOUR unit?

	Often (> 20 cases / year)	Sometimes (10 - 19 cases per year)	Rarely (<10 cases per year)	Never	Other
Wide local excision and oncoplastic type 1 procedure	Wide local excision and oncoplastic type 1 procedure Often (> 20 cases / year)	Wide local excision and oncoplastic type 1 procedure Sometimes (10 - 19 cases per year)	Wide local excision and oncoplastic type 1 procedure Rarely (<10 cases per year)	Wide local excision and oncoplastic type 1 procedure Never	Wide local excision and oncoplastic type 1 procedure Other
Therapeutic mammaplasty	Therapeutic mammaplasty Often (> 20 cases / year)	Therapeutic mammaplasty Sometimes (10 - 19 cases per year)	Therapeutic mammaplasty Rarely (<10 cases per year)	Therapeutic mammaplasty Never	Therapeutic mammaplasty Other
Chest wall perforator flaps	Chest wall perforator flaps Often (> 20 cases / year)	Chest wall perforator flaps Sometimes (10 - 19 cases per year)	Chest wall perforator flaps Rarely (<10 cases per year)	Chest wall perforator flaps Never	Chest wall perforator flaps Other
Implant reconstruction	Implant reconstruction Often (> 20 cases / year)	Implant reconstruction Sometimes (10 - 19 cases per year)	Implant reconstruction Rarely (<10 cases per year)	Implant reconstruction Never	Implant reconstruction Other
Lipomodelling	Lipomodelling Often (> 20 cases / year)	Lipomodelling Sometimes (10 - 19 cases per year)	Lipomodelling Rarely (<10 cases per year)	Lipomodelling Never	Lipomodelling Other
LD reconstruction	LD reconstruction Often (> 20 cases / year)	LD reconstruction Sometimes (10 - 19 cases per year)	LD reconstruction Rarely (<10 cases per year)	LD reconstruction Never	LD reconstruction Other
DIEP reconstruction	DIEP reconstruction Often (> 20 cases / year)	DIEP reconstruction Sometimes (10 - 19 cases per year)	DIEP reconstruction Rarely (<10 cases per year)	DIEP reconstruction Never	DIEP reconstruction Other
Surgical prevention or treatment of lymphoedema	Surgical prevention or treatment of lymphoedema Often (> 20 cases / year)	Surgical prevention or treatment of lymphoedema Sometimes (10 - 19 cases per year)	Surgical prevention or treatment of lymphoedema Rarely (<10 cases per year)	Surgical prevention or treatment of lymphoedema Never	Surgical prevention or treatment of lymphoedema Other

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* 3. Do you have referral pathways in place for patients requiring the following procedures?

	yes	no
Unilateral Immediate autologous reconstruction	Unilateral Immediate autologous reconstruction yes	Unilateral Immediate autologous reconstruction no
Unilateral delayed autologous reconstruction	Unilateral delayed autologous reconstruction yes	Unilateral delayed autologous reconstruction no
Bilateral autologous reconstruction (including risk reducing patients)	Bilateral autologous reconstruction (including risk reducing patients) yes	Bilateral autologous reconstruction (including risk reducing patients) no

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* 4. How easy do you feel it is to access a plastic surgery opinion for your patients?

Other (please specify)

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* 5. Does a plastic surgeon attend your MDT?

A plastic surgeon attends the regular breast MDT where all patients are discussed

A plastic surgeon attends the oncoplastic MDT

No, there is no plastic surgery input to our MDT

Would you like a different amount of involvement from your plastic surgery colleagues?

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* 6. In your opinion, what would be the easiest and most effective way to increase capacity for autologous reconstruction?

	Increasing numbers coming through your unit	Increasing the number of women done in the private sector as NHS patients	Increasing the number of plastic surgeons	Increasing the number of NHS units providing autologous reconstruction	Shared plastic surgeon consultant appointment between breast and plastic surgery unit	Other (please add comment below)
Straightforward, effective and feasible	Straightforward, effective and feasible Increasing numbers coming through your unit	Straightforward, effective and feasible Increasing the number of women done in the private sector as NHS patients	Straightforward, effective and feasible Increasing the number of plastic surgeons	Straightforward, effective and feasible Increasing the number of NHS units providing autologous reconstruction	Straightforward, effective and feasible Shared plastic surgeon consultant appointment between breast and plastic surgery unit	Straightforward, effective and feasible Other (please add comment below)
Probably achieveable	Probably achieveable Increasing numbers coming through your unit	Probably achieveable Increasing the number of women done in the private sector as NHS patients	Probably achieveable Increasing the number of plastic surgeons	Probably achieveable Increasing the number of NHS units providing autologous reconstruction	Probably achieveable Shared plastic surgeon consultant appointment between breast and plastic surgery unit	Probably achieveable Other (please add comment below)
Possible	Possible Increasing numbers coming through your unit	Possible Increasing the number of women done in the private sector as NHS patients	Possible Increasing the number of plastic surgeons	Possible Increasing the number of NHS units providing autologous reconstruction	Possible Shared plastic surgeon consultant appointment between breast and plastic surgery unit	Possible Other (please add comment below)
Unrealistic	Unrealistic Increasing numbers coming through your unit	Unrealistic Increasing the number of women done in the private sector as NHS patients	Unrealistic Increasing the number of plastic surgeons	Unrealistic Increasing the number of NHS units providing autologous reconstruction	Unrealistic Shared plastic surgeon consultant appointment between breast and plastic surgery unit	Unrealistic Other (please add comment below)

Comments

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* 7. How many patients have developed breast cancer whilst on the waiting list for risk reducing mastectomy and autologous reconstruction?

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* 8. Do patients on the waiting list have access to psychological support, either through a counsellor or breast care nurse?

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* 9. Thank you for contributing to this survey. If you have any comments, please include them here. If you would like feedback on the results of the survey, please include your email address.