National Urology Unit Service Audit Form

National Urology Unit Service Audit Form
Please select the region in which you work
Please select the hospital trust for which you work
Please enter your name
Please enter your email

Outline the type of day-case surgery facilities available to your trust, and what is performed there.

Rows	BOO surgery	URS	TURBT	Peno-scrotal surgery	Other
Dedicated DCU NOT at acute hospital site	3	4	5	6	7
Dedicated DCU that IS at acute hospital site	10	11	12	13	14
Day surgery performed in main operating theatres	17	18	19	20	21

For day-case patients, do you offer the following?
Rows YES No
Nurse-led discharge
Discharge from a dedicated day-case ward
Do you treat patients using the following?
Rows YES No
Independent sector facilities
Ring fenced surgical capacity for long-waiters/priority conditions

Are the following BOO services available for your patients?

Rows	YES	NO
One stop clinic assessment including diagnostics (i.e. consultation, flows, TRUS volume measurement, cystoscopy)
Service led by consultant with sub-specialty interest
Dedicated LUTS clinic
Dedicated outpatient catheter service
Remote catheter removal service (avoiding hospital visit)
A routinely provided point of contact to discuss post-operative catheter problems?

Are the following stone services available at your trust?

Rows	YES	NO
A sub-specialist stone team
A dedicated stone nurse/allied health professional
A regular dedicated stone MDT
An imaging meeting separate to the cancer MDT
LASER proof emergency theatre

And are these stone services available at your trust?

Rows	YES	NO	Sometimes
Consistent CT access within 24 hours for patients with suspected ureteric colic
Consistent access to ureteroscopy within two weeks of emergency admission with ureteric colic
LASER available in emergency theatre
Routine radiographer access for emergency cases

Do you have a 24-hour interventional radiology service for nephrostomy insertion at your site?

Does your department have the following?

Rows	YES	NO
A functioning advice and guidance (A&G) service
Job-planned A&G and triage time
All outpatient referrals triaged by a consultant
A community catheter and continence service
Consultant passporting for cross-site working
Trainee passporting for cross-site working

Is there a urology hot clinic available for patients presenting acutely?
Urology Investigation Units (UIU)
These are dedicated diagnosis and treatment sites for the delivery of outpatient urology care.
Does your trust have currently have a Urology Investigation Unit (UIU)?
If your trust does not have a UIU, have attempts been made to establish one?
If your trust does have a UIU, where is it located?

Which of the following services are available at your UIU?

Rows	YES	NO	Available, but not through dedicated UIU	Comments
Flexible cystoscopy
Biopsy and diathermy
Biopsy and TULA
Intra-detrusor botulinum toxin
Stent removal
LA stent insertion/change
TWOC services
Local anaesthetic transperineal prostate biopsies
Local anaesthetic transrectal prostate biopsies
Transrectal ultrasound prostate volume measurement
Uroflowmetry
Urodynamics
Peno-scrotal surgery under LA
Peno-scrotal surgery under GA/sedation
Bladder outlet obstruction procedures (specify type)
Other…

Please indicate any particular SUCCESS FACTORS encountered whilst establishing your UIU

Rows	YES	NO	N/A	Comments
Managerial support
Executive support
Clinician buy-in
Nursing staff buy-in
Suitable location available
Finance
Geograhy
Staffing
Project management support
Other factors (please specify)

Please indicate any particular BARRIERS encountered whislt establishing/attempting to establish your UIU

Rows	YES	NO	N/A	Comments
Lack of managerial support
Lack of executive support
Lack of clinician buy-in
Lack of nursing staff buy-in
Suitable location not available
Finance
Geograhy
Lack of staffing
Lack of project management support
Other factors (please specify)

Please indicate any unintended consequences encountered by your service as a result of establishing your UIU

Rows	YES	NO	N/A	Comments
Adverse patient experience
Longer waiting times
Adverse financial outcome
Adverse effect on other aspects of the urology service
Inefficiency
Inability to staff the UIU
Other (specify)

Urology Area Networks
These are regional collaborations between hospitals in which patients are referred bi-directionally in order to receive sub-specialist or emergency care.
Does your UAN have managerial/administrative staff with dedicated time allocated to the role?

Please indicate which of your services are integrated into a Urology Area Network (UAN).

Rows	Fully integrated	Part integrated	No aspects within a UAN
Bladder outflow obstruction
Upper tract stones
Andrology
Female and functional
On call for urgent and emergency care

Please indicate how the following BLADDER OUTFLOW OBSTRUCTION operations are offered by your trust / urology area network (UAN).

Rows	Performed locally for local patients ONLY	Performed locally for local patients AND UAN referrals	Performed locally for local patients AND referrals WITHIN and OUTSIDE UAN	NOT performed locally, referred elsewhere WITHIN UAN	NOT performed locally, referred elsewhere OUTSIDE of UAN	Treatment not offered
Bipolar TURP
Monopolar TURP
HoLEP/ThuLEP
Green light ablation
Steam ablation (rezum)
Prostatic urethral lift (urolift)
Prostate artery embolisation

Please indicate how the following UPPER URINARY TRACT STONE operations are offered by your trust / urology area network (UAN).

Rows	Performed locally for local patients ONLY	Performed locally for local patients AND UAN referrals	Performed locally for local patients AND referrals WITHIN and OUTSIDE UAN	NOT performed locally, referred elsewhere WITHIN UAN	NOT performed locally, referred elsewhere OUTSIDE of UAN	Treatment not offered
ESWL
Rigid URS and laser
Flexible URS and laser
PCNL
Mini/super-mini PCNL
Percutaneous nephrostomy

Please indicate how the following BLADDER CANCER operations are offered by your trust / urology area network (UAN).

Rows	Performed locally for local patients ONLY	Performed locally for local patients AND UAN referrals	Performed locally for local patients AND referrals WITHIN and OUTSIDE UAN	NOT performed locally, referred elsewhere WITHIN UAN	NOT performed locally, referred elsewhere OUTSIDE of UAN	Treatment not offered
Day case TURBT by default
Dedicated TURBT operating list
Flexible cystoscopy and LASER ablation/ resection (TULA)
Heated mitomycin C
Single postoperative mitomycin C instillation IN THEATRE

If flexible cystoscopy and transurethral laser ablation (TULA) for bladder tumours performed at your trust, where is it delivered?

Please indicate how the following ANDROLOGY operations are offered by your trust / urology area network (UAN).

Rows	Performed locally for local patients ONLY	Performed locally for local patients AND UAN referrals	Performed locally for local patients AND referrals WITHIN and OUTSIDE UAN	NOT performed locally, referred elsewhere WITHIN UAN	NOT performed locally, referred elsewhere OUTSIDE of UAN	Treatment not offered
Penectomy
Urethroplasty
Peyronie's surgery
Penile prosthesis
Artificial urinary sphincter

Please indicate how the following FEMALE / FUNCTIONAL / NEUROLOGICAL operations are offered by your trust / urology area network (UAN).

Rows	Performed locally for local patients ONLY	Performed locally for local patients AND UAN referrals	Performed locally for local patients AND referrals WITHIN and OUTSIDE UAN	NOT performed locally, referred elsewhere WITHIN UAN	NOT performed locally, referred elsewhere OUTSIDE of UAN	Treatment not offered
Autologous fascial sling
Transvaginal tape
Urethral bulking
Colposuspension
Ileocystoplasty
Bladder fistula surgery

Please indicate any particular SUCCESS FACTORS encountered whilst establishing your urology area network (UAN). [LEAVE BLANK IF NO UAN]

Rows	YES	NO	UNSURE	Comments
Managerial support
Executive support
Clinician buy-in
Nursing staff buy-in
Inter-trust collaboration at managerial/executive level
Inter-trust collaboration at clinician/nursing level
Finance
Geograhy
Staffing
Theatre capacity
Project management support
Other factors (please comment)

Please indicate any particular BARRIERS encountered whilst establishing/attempting to establish your urology area network (UAN). [LEAVE BLANK IF NO UAN]

Rows	YES	NO	UNSURE	Comments
Lack of managerial support
Lack of executive support
Lack of clinician buy-in
Lack of nursing staff buy-in
Inter-trust collaboration at managerial/executive level
Inter-trust collaboration at clinician/nursing level
Insufficient numbers to maintain on-call
Finance
Geograhy
Staffing
Theatre capacity
INPATIENT BED CAPACITY
Lack of third party support
Pressure of clinical work
Lack of project management support
Other factors (please specify)

Please indicate any UNINTENDED CONSEQUENCES encountered by your service as a result of urology area network (UAN) working. [LEAVE BLANK IF NO UAN]

Rows	YES	NO	UNSURE	Comments
Loss of subspecialty practice
Adverse patient experience
Long waiting times
Increased pressure on theatre capacity and facility
Adverse financial outcome
Loss to follow up
Adverse effect on other aspects of the urology service
Inefficiency
Bed pressures at receiving emergency site
Loss of training opportunities
Other (specify)

High Volume Low Complexity (HVLC) Surgical Hubs
These are dedicated sites serving more than one hospital which are focussed on delivering routine low complexity surgery efficiently.
Does your trust host or feed in to a High Volume Low Complexity (HVLC) surgical hub?
Indicate any treatments that your patients receive through a HVLC hub.
Rows YES NO Comments
Bladder outflow obstruction surgery
TURBT
Ureteroscopy
Minor peno-scrotal surgery
Others (specify)
Use of specific technologies

Please indicate which of the following surgical technologies you use at your own unit

Rows	YES	NO	Comment
Olympus bipolar resection set (TURiS) for TURP
Storz bipolar resection set for TURP
Other bipolar resection set for TURP(specify)
Olympus bipolar resection set (TURiS) for TURBT
Storz bipolar resection set for TURBT
Other bipolar resection set for TURBT (specify)
Holmium laser for prostates
Thulium laser for prostates
Green light laser for prostates
Holmium laser for stones
Thulium laser for stones

GIRFT guidance and use of data

Have you accessed and used the following GIRFT guidance documents and, if so, how helpful were they? (4 = extremely helpful, 1 = not at all helpful)

Rows	YES	NO	Rating
2018 GIRFT National Report
Urology: the path to recovery – a manual for developing services post COVID-19 pandemic
Urology: the path to recovery – a strategic framework
Urology outpatient transformation
Improving bladder cancer management
Improving management of bladder outlet obstruction
Improving acute urinary tract stone management

To your knowledge, who from the following list access Model Hospital data at your trust?
Rows YES NO UNSURE
Executive team
Managers
Head of surgery
Clinical lead
Consultants
Urology trainees
Nursing team
Other
Have you collected any patient reported outcome or experience measures relating to GIRFT recommended interventions?
If you would you be willing to share any patient reported data for dissemination and learning, please leave your email address here.
Should be Empty:

Select theme:

Rows	YES	No
Independent sector facilities
Ring fenced surgical capacity for long-waiters/priority conditions

Rows	YES	NO	Comments
Bladder outflow obstruction surgery
TURBT
Ureteroscopy
Minor peno-scrotal surgery
Others (specify)

Rows	YES	NO	UNSURE
Executive team
Managers
Head of surgery
Clinical lead
Consultants
Urology trainees
Nursing team
Other

Rows	YES	No
Nurse-led discharge
Discharge from a dedicated day-case ward

National Urology Unit Service Audit Form

Urology Investigation Units (UIU)

Urology Area Networks

High Volume Low Complexity (HVLC) Surgical Hubs

Use of specific technologies

GIRFT guidance and use of data