go with the flow: the changing pathways in urology cats
DESCRIPTION
Urology Clinical Assessment & Treatment Service UROLOGY CATS. Go with the flow: the changing pathways in Urology CATS. “There comes a time in life when the doctor stops feeling yer bollocks, and starts feeling up yer arse.” (B Connolly, CBE). Urology CATS- Objective. - PowerPoint PPT PresentationTRANSCRIPT
Go with the flow: the changing Go with the flow: the changing pathways in Urology CATSpathways in Urology CATS
Urology Clinical Assessment & Treatment Service
UROLOGY CATS
“There comes a time in life when the doctor stops feeling yer bollocks, and starts feeling up yer arse.” (B Connolly, CBE)
Urology CATS- ObjectiveUrology CATS- Objective
Primary care led service with integral Primary care led service with integral Consultant support and leadershipConsultant support and leadership
Commissioned by STAHCOM to manage Commissioned by STAHCOM to manage all urology referrals within St Albans & all urology referrals within St Albans & HarpendenHarpenden
Aim to retain at least 65% of cases in Aim to retain at least 65% of cases in primary careprimary care
Improve care pathways for patientsImprove care pathways for patients
ClinicsClinics
Based at The Elms Medical Practice, Based at The Elms Medical Practice, HarpendenHarpenden
Paper triage Paper triage Clinics: Wed, Thurs, Fri Clinics: Wed, Thurs, Fri Consultant and GPSI clinics Consultant and GPSI clinics Referrals: post, fax or electronic by e-mailReferrals: post, fax or electronic by e-mail Patients offered appt within 2 to 3 weeksPatients offered appt within 2 to 3 weeks
Clinical team- GPSIClinical team- GPSI Julian Smith Julian Smith
GP at The Elms Medical PracticeGP at The Elms Medical Practice Clinical LeadClinical Lead Responsible for running the service and reporting to the PCTResponsible for running the service and reporting to the PCT
Dr Dylan PhillipsDr Dylan Phillips Contract LeadContract Lead
TrainingTraining Diploma in Urology (Middlesex University)Diploma in Urology (Middlesex University) Clinic based Clinic based WorkshopsWorkshops Ongoing assessments and examinationsOngoing assessments and examinations
Clinical Team- ConsultantsClinical Team- Consultants
Mr Jim AdsheadMr Jim Adshead Special interest in prostate disorders, UTIs, stone Special interest in prostate disorders, UTIs, stone
disease, renal disease, paediatric (East & North disease, renal disease, paediatric (East & North Hertfordshire NHS Trust)Hertfordshire NHS Trust)
Mr Asher AlamMr Asher Alam Special interest in reconstructive, oncology, female Special interest in reconstructive, oncology, female
urology (Luton & Dunstable Hospital NHS Foundation urology (Luton & Dunstable Hospital NHS Foundation Trust)Trust)
Mr Manoah PancharatnamMr Manoah Pancharatnam Special interest in prostatic disease, andrology, Special interest in prostatic disease, andrology,
paediatric urology (West Herts Hospitals NHS Trust)paediatric urology (West Herts Hospitals NHS Trust)
Clinical Referrals/ PathwaysClinical Referrals/ Pathways LUTS (BPH) LUTS (BPH)
Prior to clinicPrior to clinic• PSA (GP)PSA (GP)• U&Es (GP)U&Es (GP)• MSU (GP)MSU (GP)• IPSSIPSS• Bladder chartBladder chart• Flow rate with bladder scan (Nurse led, at The Elms Medical Flow rate with bladder scan (Nurse led, at The Elms Medical
Practice)Practice) During/after clinicDuring/after clinic
• Urological assessmentUrological assessment• Treatment optionsTreatment options• Follow up in CATS or may need further investigation in Follow up in CATS or may need further investigation in
secondary caresecondary care
Direct referral options into secondary careDirect referral options into secondary care
Clinical Referrals/ PathwaysClinical Referrals/ Pathways StonesStones
Prior to clinicPrior to clinic• Blood tests (calcium, urate etc)Blood tests (calcium, urate etc)• Renal ultrasound scan if clinically indicated from triageRenal ultrasound scan if clinically indicated from triage
During or after clinicDuring or after clinic• Urological assessmentUrological assessment• Low dose CT KUB or CT urogramLow dose CT KUB or CT urogram
Direct referral to secondary care for lithotripsyDirect referral to secondary care for lithotripsy
Clinical Referrals/ PathwaysClinical Referrals/ Pathways
ScrotologyScrotology Prior to clinicPrior to clinic
• Small parts ultrasound scan if clinically indicated from triageSmall parts ultrasound scan if clinically indicated from triage During clinicDuring clinic
• Ultrasound scan (from mid October 2008)Ultrasound scan (from mid October 2008)• AspirationAspiration
Clinical Referrals/ PathwayClinical Referrals/ Pathway
OtherOther Minor ops under LAMinor ops under LA Discussion about current surgical optionsDiscussion about current surgical options
Secondary Care ReferralsSecondary Care Referrals Via Patient Choice Team (STARDOC)Via Patient Choice Team (STARDOC) Direct booking access onto theatre lists - e.g. day Direct booking access onto theatre lists - e.g. day
case cystoscopy, TRUS biopsycase cystoscopy, TRUS biopsy
Benefits of this ServiceBenefits of this Service
For PatientsFor Patients Improved waiting timesImproved waiting times USS prior or at same appt by consultant/GPSI if USS prior or at same appt by consultant/GPSI if
neededneeded Improved care pathwaysImproved care pathways Patient choice re secondary care providerPatient choice re secondary care provider Continuity of care Continuity of care
For CommisionersFor Commisioners Vertical integration with secondary careVertical integration with secondary care Post op f/u retained in CATS Post op f/u retained in CATS
Patient Satisfaction SurveyPatient Satisfaction Survey
100% 100% very satisfiedvery satisfied with the service with the service
FutureFuture
Increase pathways and further Increase pathways and further connections connections
Provide more services within clinicsProvide more services within clinics CystoscopyCystoscopy