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Successful Haematuria Pilot at Roscommon University Hospital forms part of National Urology Strategy

Roscommon University Hospital was delighted to host the launch of the new urology model of care for Ireland on Friday 06 September.

The HSE’s national clinical programme for surgery is developing models of care for a number of surgical specialties. The latest is for Urology and this model of care looks at the range of activity delivered and areas where there are gaps in the service. It aims to maximise the surgical workforce to deliver urology care not just in hospitals but in primary care centres along with access to radiology tests, while ensuring appropriate clinical governance to support a safe and high quality service.

Roscommon University Hospital (RUH) played an important role in the development of the new model of care by being the pilot site for a Rapid Access Haematuria Service, which is one of the key initiatives under the new model of care.

The Rapid Access Haematuria Service in RUH began as a pilot in December 2018 as a One Stop Clinic for patients who have symptoms of blood in the urine, known as haematuria, with procedures and investigations carried out within a target of 28 days.

The service is being led by Mr Eamonn Rogers, Consultant Urologist at Galway and Roscommon University Hospitals who is also the national clinical lead for Urology. He said, “When urine infections are excluded, blood in the urine or haematuria is a serious medical condition and strongly associated with an underlying malignancy. It is similar to a breast lump, raised PSA (which may be an indicator for prostate cancer) or bleeding from the bowel.

“The Rapid Access Haematuria Service in RUH allows us to quickly assess the urinary tract by carrying out imaging of the kidneys and a cystoscopy of the bladder. Having both of these diagnostic tests available at the same time, in the same place is more efficient and convenient for patients and allows us to determine a treatment plan as quickly as possible.

“If a GP has a concern about a patient who has blood in their urine, they send a letter of referral to a Consultant Urologist to ask for the symptoms to be investigated. Since the Rapid Access Haematuria Service was started, the Urologists from the hospitals throughout the Saolta Group have had the option to send their patients to RUH for rapid assessment.

“In the first six months the new service received referrals for 325 patients with an average waiting time of 26 days for treatment. All of this was achieved by holding a single clinical day every week. Over 70% of patients were discharged back to their GP to care for their symptoms and just over 9% were sent for further investigation for cancer. The rest of the patients were referred to specialist Urology or Nephrology services in their local hospital after assessment in RUH.

“We have proven that this way of seeing and treating patients with haematuria works. Roscommon University Hospital’s experience shows how smaller hospitals play a key role in supporting larger hospitals in a hospital group and Saolta will now lead the way for other hospital groups to follow.”

Mary Garvey, General Manager RUH added, “The success of the pilot in RUH demonstrated that the proposed model of care, when implemented across the country, will improve the access for patients to the services. I would like to thank Mr. Eamon Rogers and all the staff in the hospital for their commitment to the project and for delivering a high quality service to the patients who travelled from across the west and northwest of Ireland to attend our Rapid Access Haematuria Service. We are delighted with the patient feedback of their experience in RUH. This project is an excellent example of a group of hospitals working together, and I would like to acknowledge the support of our colleagues in the other hospitals in the Saolta Group. I would also like to thank the National Clinical Programme in Surgery, the National Clinical Programme for Radiology, the National Cancer Control Programme and the Acute Strategy and Planning Department who collaborated with us to develop this ‘One Stop’ Rapid Access Service. We are proud to have been selected as the pilot site under the Urology model of care and to have successfully implemented it.”

Ann Cosgrove, Chief Operations Officer, Saolta University Health Care Group commented, “The Roscommon University Hospital pilot and the participation of all other hospitals in Saolta Group including Letterkenny, Sligo, Mayo, Portiuncula and Galway University Hospitals is significant for patients living along the Western seaboard. We have been able to demonstrate that a model of care can translate from a document to a living, working clinic that has already benefitted many patients in a relatively short space of time.

“Our population is changing and ageing and we need to take on board new ways of working, use new technology for diagnosis and treatment, deliver efficient and economically viable services while ensuring the needs of our patients are the starting point for change.

“We hope to start a second Rapid Access Haematuria Service within the Saolta Group and with two hospitals providing this service, we expect to be able to reduce the current urology outpatient waiting list by 15%, which will make a huge difference to the length of time that patients are waiting.”

The article above is specific to the following Saolta hospitals:: 
Roscommon University Hospital (RUH)