Agenda item

(To receive a report from United Lincolnshire Hospitals NHS Trust, which provides the Committee with an update of the implementation of the new model for urology in Lincolnshire’s hospitals.  Dr Colin Farquharson, Medical Director and Mr Andrew Simpson, Consultant Urologist will be in attendance for this item)

Consideration was given to a report from United Lincolnshire Hospitals NHS Trust (ULHT), which provided the Committee with an update of the implementation of the new model for urology in Lincolnshire’s hospitals.

The Chairman invited the following representatives from ULHT: Dr Colin Farquharson, Medical Director and Mr Andrew Simpson, Consultant Urologist, to remotely present the item to the Committee.

The Committee was reminded of the challenges facing urology services across Lincolnshire’s hospitals, the public engagement exercise to consult upon the proposed changes, and the subsequent approval by the ULHT Board on 2 August 2021 to the proposed changes.

The Committee were advised of the model of service; the case for change; the benefits of the reconfigured service to date; non-elective performance, it was noted that non-elective admissions were now significantly lower than they were Trust-wide before the re-configuration, and that this trend would be monitored; average length of stay on the urology non-elective pathway; the quality impact assessment; patient feedback, it was noted that to date although patient survey responses had been low, no negative feedback or formal complaints had been received; public/patient engagement in the process; staff engagement; finance; and key risks and issues.

In conclusion, the Committee was advised that the expected benefits of the model and its wider impact were continuing to be being monitored.

During discussion, the Committee raised the following points:

·       The reluctance of some patients to engage with services due to Covid-19.  Confirmation was given that Covid-19 had clearly affected the willingness and ability of some people to engage with services.  Confirmation was given that so far in February there had been no cancellations due to elective bed pressures, despite considerable emergency activity at hospital sites;

·       Level of response received from the consultation and the themes of concern had been highlighted.  It was reported that the level of response from patient feedback had been limited (3 responses).  Confirmation was given that there had not been any concerns raised apart from one isolated complaint.  There was recognition that further feedback from patients and staff was necessary.  It was highlighted that from 50 staff, 20 responses had been received.  The Committee was advised that the feedback exercise would be repeated;

·       When would there be evidence of reduced cancellations of elective appointments and improvements to cancer care.  The Committee was advised that there was an expectation to see reduced cancellations due to the split between emergency and elective care, which at present was not supported by the present data, and as a result this information would be reported to a future meeting of the Committee.  Regarding cancer care, the Committee was advised that there had been a reduction in the most urgent cases, but the service was still struggling with its cancer performance figures.  It was highlighted that the introduction of robotic surgery would reduce reliance from other providers to deliver the most complex cases; and

·       Whether the urology/trauma assessment hub had progressed any further and if not, when was it likely to be put in place.  A suggestion was made that a further report be considered by the Committee in three to four months’ time, when further information was available.

The Chairman on behalf of the Committee extended thanks to the ULHT presenters.

RESOLVED

1.      That the report and presentation on the urology service, provided by United Lincolnshire Hospitals Trust be noted, and that the Committee welcomes

a.      The reduced expenditure on agency expenditure for medical staff;

b.      The plans to recruit a tenth consultant; and

c.       The use of robotic surgery.

2.      That further progress be made in other areas such as reduction in the number of cancelled appointments, and improvements to the 28-day cancer performance.

3.      That a further update on urology services be received in four months’ time.