Creating a safer and better urology service

Last year, the Care Quality Commission (CQC) – the body that inspects hospitals for quality and safety – found that three-quarters of the 79 hospital trusts visited under its new inspection regime had safety problems. They warned that safety across the NHS and care sectors in England was of “significant concern”, particularly in hospitals.

The report said improving leadership was the key to tackling the problems. Mr David Behan, CQC Chief Executive said: “What we know from our report and from other research is that the leadership of an organisation sets the culture of that organisation.” Though the CQC report criticised general hospital care and did not specifically pertain to urology, TUF takes special interest in improvements to patient care and treatment.

TUF holds the philosophy that such improvements can only be accomplished through professional development and research support. In the interest of patients, TUF has decided to invest in a two-year research pilot designed to create a radical culture shift in hospitals. The pilot aims to instil a sense of responsibility for quality and safety in all professionals – from trainee urologists to senior consultants. The culture shift will encourage openness in admitting errors, analysing errors, and solving the root causes of errors to protect patients without undermining developing professionals. Working with Nick Sevdalis, Professor of Implementation Science & Patient Safety at King’s College London, and James Green, Consultant Urologist and Cancer Lead for Urology at Barts Health NHS Trust, we are supporting a training programme that will equip urology trainees with the skills to implement change from the ground up. The programme will employ leadership techniques and quality improvement processes that promote safer urology service and better patient care.

The pilot will focus on urology trainees based in London, the South East and North West of England. If the pilot proves to be successful, we hope to cover all urology trainee programmes in England. We expect significant benefits for urology patients from this programme. Not least:

  • Quality improvement skills that prioritise patient safety, ultimately resulting in better care for patients.

  • Gradual and sustainable positive change in the care processes across all urology patients treated in the participating training hospitals and those hospitals where trainees rotate.

  • A culture of continuous improvement, safety and quality of care in the NHS to ensure that urology patients receive the best possible treatment and management.

  • A higher standard of urological care across the UK. Centres of excellence will share their learning and improvements more quickly with all hospitals leading to better benchmarking of services.

James Green said: “This project will promote skills that trainees can use throughout their whole careers. The enthusiasm for this has been remarkable.”

Nick and James expect to see other fields adopt the programme if the research pilot proves successful. This landmark pilot underscores TUF’s role in fostering necessary innovation, and will hopefully create significant change in postgraduate surgical training.

This pilot was made possible through generous funding from the Schroder Foundation.

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