The GP Care Urology Service has now seen over 200 patients since commencing service delivery in November 2007, has received consistent favourable feedback from both patients and GPs and has delivered significant cost savings against PBC budgets. As a result of this solid performance, in July 2008 South Gloucestershire PCT both extended the duration of the contract and widened the number of practices to which this Service is available from 5 to 13, covering over 110,000 patients.
The 8 additional practices are all in the Severnvale area of South Gloucestershire and additional capacity is already available for roll-out to the rest of the South Gloucestershire PCT.
In July 2008 the Urology Service saw over 40 individual patients at this consultant led, rapid access ‘one-stop-shop’ diagnostic and assessment clinic in Clifton, Bristol.
This primary care service addresses the following urological areas:
- Common urological complaints - performance of specific tests previously only available after referral into secondary care (‘immediate’ ultra sensitive PSA, urinalysis, uroflow and bladder scan studies);
- Haematuria - including flexible cystoscopy and ultrasound scans;
- Prostate assessment service - including PSA, IPSS, prostatic scan;
- Lower Urinary Tract Symptoms (LUTS); and
- Review of recurring patients - consultant-led appraisal and management plan of patients who have recurrently attended Trust clinics over months, perhaps years but no decision has been taken to either treat or discharge.
This service is a comprehensive diagnostic and assessment service with onward referrals to secondary care required only for surgical follow-up or complex imaging such as X-rays, MRI or CT scans. Links are in place and work well with the existing Trusts to transfer patients quickly and seamlessly when cancer is diagnosed.
Waiting times from referral receipt to actual appointment continue to average less than 14 days and are currently running at circa 10 days whilst DNAs are minimal as a result of professional administrative support with proactive appointment confirmations and reminders.
Key elements of positive feedback from both patients and GPs includes: being seen within 2 weeks of referral; having a full 30 minute appointment with any necessary tests including cystoscopy being carried out in this one appointment; appointments running to time; consultant involvement; patients leaving the appointment with a report in their hand and knowing that their GP will receive a copy on the same day; plentiful adjacent parking; and a small clinic environment with comfortable sofas, coffee, carpets and curtains with patients being greeted by a receptionist who is expecting them. All these things represent good patient care and yet appear to contrast considerably with the patient experience in some other settings.
Would you like your patients to be able to access this new service? Use your commissioning groups to influence your PCT to make the service available locally.
