Agenda item

(To receive a report from United Lincolnshire Hospitals NHS Trust (ULHT), which provides the Committee with an update of the implementation of the new model for urology in Lincolnshire’s Hospitals.  Andrew Simpson, Consultant Urologist ULHT 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 Andrew Simpson, Consultant Urologist to present the item to the Committee.  Simon Evans, Chief Operating Officer ULHT, was also in attendance for this item.

Whilst guiding the Committee through the report,  some reference was made to the challenges facing urology services in early 2021; the 12 week consultation period; the update provided to the Committee at its 16 February 2022 meeting regarding the reconfigured service; the case for change; evaluation of performance, it was noted that from patient feedback, the main area of concern highlighted had related to communication and access to appointments, with no concerns being raised relating to the service reconfiguration itself;  public/patient engagement; and staff engagement; the elimination of cancellations, and the number of re-admissions had reduced; and the challenges of reducing the backlog. 

The Committee was advised that prior to the implementation of the new model, there had been a high reliance on agency medics.  As a result of investment into the service and the new model of working it was expected that there would be a cost improvement of approximately £160,000.

Paragraph 7 on page 161 of the report highlighted the key risks and issues to the continued success of the programme, which included the retention of middle grade doctors, compliance with the new service model and the establishment of a urology-trauma hub.

In conclusion, the Committee was advised that the model had now become embedded and accepted within the Trust as a safe and effective means of delivering urology services. There had been performance improvements, but these had been impacted by the significant urgent and emergency care pressures the Trust continued to experience.

To ensure that performance remained on track, the urology department, along with information services, were monitoring and tracking the key expected benefits via a dedicated dashboard.

It was also highlighted that a lessons learned exercise had been carried out by the project team to ensure knowledge transfer was shared across the Trust.

Appendix A to the report presented provided a copy of the Quality Impact Assessment for the Urology Services reconfiguration for the Committee to consider.

During consideration of this item, the Committee raised the following points:

·       One member extended his congratulations to staff within the urology services for providing an excellent service;

·       Transport concerns were raised for patients attending Pilgrim Hospital, Boston and then being transferred to Lincoln.  The Committee noted that there was three levels of patients accessing Pilgrim Hospital, the first level were those requiring minor intervention; the second level were those with significant problems for example an obstruction, they would receive their imagery and diagnostics at Boston, and such patients would then be transferred to Lincoln; the third level, would be patients who were critical, and for these patients there was a critical care team in attendance at Boston and an on call consultant, in this situation the patient would be dealt with at Boston;

·       That no screening programme existed for prostate cancer.  One member gave his personal experience of trying to set up a screening programme.  The ULHT representative agreed to look into this matter outside of the meeting; and

·       If the risks identified on page 161 of the report were to intensify how the service would be impacted. The Committee was advised that regarding recruitment and retention, the service was seeing a good level of application for vacancies, it was felt that this would remain a low risk.  Regarding service compliance, it was reported if emergency department staff continued to be trained to deal with lower level presentation, the risk remained low. The only concern expressed was not having a dedicated assessment area, to ensure patient flow and timely treatment was provided, and as such this remained a significant risk.  The Committee noted that this matter had been raised at the Trust’s Capital Resource Group.

The Chairman on behalf of the Committee extended thanks to the presenter.

RESOLVED

1.      That the information presented on the urology services, including the significant reduction in same-day cancellations for non-clinical reasons be noted.

2.      That no further specific update on urology service be received, unless any performance concerns merited the Committee’s consideration.