Urology services at Guy's and St Thomas' NHS
Foundation Trust have been transformed. The redesign responded to a
variety of issues including overcrowded clinics, complicated
diagnostic procedures and long waiting times for appointments.
The concept of a one-stop clinic in purpose-built premises has
successfully brought together every aspect of urological diagnosis
and outpatient services under one roof. Consultation and diagnosis
rooms are placed around a central island, meaning patients stay
within the unit while stopping off at various points to give a
sample, have an examination, or see a consultant.
Direct patient consultation led to new features such as discrete
booths for handing over urine samples, improved washroom
facilities, and the appointment of a clinic coordinator to ensure
all paperwork and tests are carried out before the patient sees a
consultant, reducing the need for repeat appointments.
Multidisciplinary disease-specific clinics were also introduced,
while the role of clinical nurse specialists was expanded to help
improve the care of patients with long-term diseases. Opportunities
for teaching and research were also improved, to benefit the wider
NHS.
The results are compelling, and serve as a prime example of
innovative best practise in the NHS. In 2004 there were 53 queues
to access the service: now there is one. Waiting times for new
referrals, prior to the project, were an initial 15-17 weeks with
80 new patients seen a week. Following the opening of the new unit
in 2008, capacity increased to 120 new patients a week, with 90 per
cent of new referrals seen within two weeks and 80 per cent
receiving a diagnosis on the day. In the first two years of the new
centre's operation alone, overall outpatient activity increased by
123 per cent.
The service is evaluated on an ongoing basis through a mixture
of staff and patient surveys and the collection of data on factors
such as patient waiting times, and the number of visits required
before diagnosis.
This innovative project is an exemplar of how the Charity can
empower healthcare professionals and patients to work together to
radically improve clinical services and the patient experience, as
well as reducing inefficiencies within the NHS.
Consultant urologist Tim O'Brien who led the reconfiguration
said: "All in all it has been a success. The vision was to create a
truly patient focused service, with minimal queues for
appointments, more efficient hospital services and quicker
diagnosis. Four years on, the clinic continues to work well: the
model is sound."