National re-audit of urology outpatient practice in the UK

Summary 

Introduction

In 2002 a National structure audit was conducted to assess UK urologists’ compliance with BAUS guidelines on outpatient provision. Given the recent change in government emphasis on waiting targets, and the possible impact of MMC and EWTD on trainees, we re-audited the contemporary urological clinic-based workload and service provision.

Methods

All 649 UK consultant urologists were asked to complete a postal questionnaire. This provided outpatient clinic information on medical staff, clinic frequency, numbers of new and follow-up patients seen, and geographical region. Data was compared to 2002.

Results

Usable questionnaire return rate was 65%. Median clinics/week were 1.87 (1–5) seeing a mean of 11.2 (1–32) new and 21.5 (1–80) follow-ups. Since 2002 consultant appointments have increased by 20%, SpR clinic attendance has decreased by 10%, with ‘consultant-only’ clinics increasing from 15% to 20.7%. Compliance with BAUS standards remains very low (18% vs. 21% (2002)) with the average consultant team ‘over-performing’ by a factor of 1.4. There were wide inter- and intra-regional variations.

Conclusion

Despite growth in consultant numbers since 2002, very few urological teams are able to meet the BAUS clinic guidelines. A trend has been demonstrated in clinic towards a consultant-led service with less support from doctors-in-training.

Keywords: Re-audit, Urology outpatient practice, Service provision, BAUS guidelines