BSDS: a national registry for skin cancer surgery

Client: The British Society for Dermatological Surgery (est. 1983)
Sector: Healthcare — national clinical body
What we did: The British Skin Surgery Registry & British Mohs Micrographic Surgery Registry — designed and built by Flare Software, in national use for over five years

The British Society for Dermatological Surgery is the UK's professional body for skin surgery. When your members are consultant surgeons removing skin cancers, the questions that matter are national ones: how are patients doing two years on? How does each unit compare? Are minimum standards being met everywhere?

Answering those questions takes a national registry. BSDS asked Flare to build it.

What we built

A national clinical registry and reporting system built on Claris FileMaker, used by consultant dermatological surgeons across the UK:

  • A surgeon's logbook — each surgeon records their skin surgery and Mohs micrographic surgery cases: procedure, surgical team (primary, assisting and reconstructing surgeons), unit and outcomes
  • A reporting suite — any combination of unit, surgeon, procedure and date range, output as on-screen charts, summary tables or data exports
  • Three-level benchmarking — the feature that matters most: a surgeon can see their own outcomes (such as cancer outcome at two years, including local recurrence) side by side with their unit's results and the national picture. Sixteen thousand cases and counting, distilled into one honest chart.
  • Minimum Mandatory Standards reporting — automated auditing of case records against the national standards for Mohs surgery, including unit-by-unit comparison
Registry chart comparing a surgeon's indications for Mohs surgery with their unit and the national picture
Three-level benchmarking in action: one surgeon's caseload against their unit and the national picture (example data, identifying details removed).

Built for clinical data

A system holding surgical case data has to take confidentiality seriously, so it was designed in from the start: every user logs in through a managed portal with department-level access control, data access is logged, and the export tools include a purpose-built anonymised export so researchers and auditors get the numbers without the identities.

The outcome

The registry has been running for over five years and now holds more than 16,000 reported cases. When a BSDS surgeon needs their numbers — for appraisal, audit or research — they're a filter and a click away.

Peri-operative complications report comparing surgeon, unit and national rates
Outcome reporting: peri-operative complication rates, benchmarked nationally (example data).
Statistical summary table of pre- and post-operative diameters across surgeon, unit and national cases
Statistical summaries — min, mean and max — for any measure, at any level (example data).

"The BSDS needed a platform for collecting useful everyday surgical data so that Mohs surgeons could study their practice, benchmark, and constantly improve. There is a skin cancer epidemic, so these doctors are extremely busy — we couldn't bog them down with cumbersome, laggy, click-heavy generic software. We needed something quick and easy to use and totally bespoke to our complex practice, capturing large numbers of data points over multiple time points, and producing reports that mean something to doctors so they can act on them and improve patient care. And we needed a system that didn't take ten years to launch, or stand still waiting for IT to make small edits while doctors lost confidence in it. The solution was the trusted, secure but agile FileMaker platform, and partnering with Flare Software. They have a great understanding of what we need, including security and user optimisation, and always work with us highly professionally and efficiently. I have total confidence in Flare Software."

— Dr Adam Bray, Consultant Dermatologist and Mohs Surgeon, Bristol · President, British Society for Dermatological Surgery · British Mohs Surgery Logbook Lead

Technologies used

Claris FileMaker (multi-file architecture: central registry, user portal and reporting module), charting and statistical summaries, anonymised data export, synchronised data updates.

Got data that needs to become answers?

Registries, audits, benchmarking, outcomes — if your organisation collects important data and struggles to get answers out of it, that's exactly the kind of problem we enjoy.

Get in touch or call us on 0330 113 0958.