A clinic set up at the James Paget to investigate those with blood in their urine (Haematuria) is helping patients to be seen more quickly and providing a faster route to treatment for those who need it.
The One-Stop Haematuria Clinic was re-launched in May as the hospital continues work to enhance services for patients with suspected cancer symptoms. This is a new and improved version of the previous clinic as patients can now be seen in the new purpose-built Urology Treatment Suite.
Some of our team in the Urology Treatment Suite
While urgent cancer work continued throughout the past 18 months, initiatives such as one-stop clinics are providing a way forward across a number of services, to provide faster diagnosis, reduce the number of hospital visits patients need to make, and streamline the way services are provided.
Once patients are referred by their GP they are triaged by our Urology nurse specialists and, if they are suitable for the pathway, they will be given an appointment at the One-Stop Haematuria Clinic, held in our Day Care Unit on Friday mornings. The clinic aims to carry out a consultation, ultrasound imaging (US KUB) and camera inspection of the bladder, known as flexible cystoscopy, all in one appointment.
There are currently six appointments per week with patients usually seeing consultant radiologist Dr Vinod Shenoy for their ultrasound scan first, followed by Urologist Mr Lokesh Suraparaju for their consultation and cytoscopy.
Consultant Urologist Mr Adam Nelson, lead clinician for the clinic and bladder cancer service, said this meant initial investigations are started promptly.
“A major advantage of this clinic for everyone is it’s a single appointment. Most patients come in quite quickly after referral and they know it will be a longer appointment rather than three separate visits. It means that, if we do all the tests and find nothing, they can be reassured and discharged very quickly or, should we find something like a bladder tumour, we can arrange further tests and initial treatment promptly. If the patient subsequently has to progress to further treatment, such as a larger operation or radiotherapy, we can get them to this stage much more efficiently.
“The clinic speeds up the pathway, particularly for those with suspected bladder cancer, who will need a number of tests. This does take good teamwork and we have fantastic support from Radiology, our nurse specialists, our operational team and senior staff.”
Some of our team, left to right - Urology specialist nurse Siji Blinto, Consultant Urologist Mr Adam Nelson, Business Support Manager Arnold Rayavarapu and Urology specialist nurse Jincy Bilgy
Urology specialist nurses Siji Blinto, Jincy Bilgy and Wendy Keenan triage referrals that come in via GPs and then liaise with individual patients.
Siji says; “Previously patients would have seen a consultant and then had to be booked in for other tests and often this would take several weeks to arrange. With the one-stop clinic, as soon as we get a referral we gather all the information together and then contact the patient to check their details.
“We then find them a suitable date to come into the clinic as soon as possible. This means there is less waiting for patients and, should they need further treatment, it may lead to a better outcome.
“The new Urology Treatment Suite in our Day Care Unit and the One-Stop Haematuria Clinic is not just a step in the right direction for our urology patients and cancer services, it is a huge leap forward towards safe, effective and inclusive care.
“This clinic allows us to increase efficiency, improve patient flow and reduce waiting list pressures. Ultimately faster cancer diagnosis and excellent patient experience should come to reality through this project.
“As a well-established and motivated team, the urology department is looking forward and committed to make a significant and positive difference in our patients journey.”
Jincy said; “We’re already getting lots of positive feedback from patients about how it’s quicker than they expected. Often the not knowing can be difficult, so getting a faster diagnosis, means that some can be reassured more quickly and others can be treated more quickly.”
Staff nurses Julie Pulford and Claire Higgins work in the new Urology Treatment Suite on the Day Care Unit and are there to provide support to patients during the clinic.
Claire, who has a background in oncology and haematology nursing, says; “We start by testing a patient’s urine for any signs of infection and then complete the paperwork needed. We’ll then take them into another room where there will be three members of staff – usually a nurse, a health care assistant and a doctor – for the examination. We are all here to reassure and explain what will happen, talking through what we are doing, providing information and answering any questions they may have.”
Julie, who previously worked in the Urology team in our Endoscopy department, says; “The clinic enables us to do a proper examination to check the bladder, and Dr Suraparaju will look at scans and past medical history and do an in depth assessment, covering everything. It is like a puzzle and all the separate elements come together to give us a picture. In many cases we are able to reassure people or give them the information they need. For some we may need to book them in for further tests or a CT scan but we are here to provide support and advice throughout.”
Our Radiology Department have been crucial in providing services and expertise, with a significant amount of work going in to co-ordinate staff and equipment for the clinic, to create capacity and accommodate both initial and follow up tests.
Macmillan Cancer Lead Nurse Julie Buckenham, Consultant Radiologist Dr Vinod Shenoy and Cancer Services Manager Lorraine Burrage.
Lorraine Burrage, Cancer Services Manager at the James Paget, said; “We and our patients are already seeing the benefits as this is streamlining the process and leading to faster diagnosis. We want to be able to offer this to as many patients as possible and ensure individuals receive their diagnosis within 28-days.”
In addition to those mentioned above, the team involved in the project include Deputy Divisional operations Director Jonathan Harrowven, Consultants Mr Suresh Gupta, Mr Suresh Kothandaraman, Mr David Manson-Bahr, Mr Natarajan Sezhian, Urology Locum Registrar Mr Sanjay Banka, deputy lead nurse Sarah Burroughs, Macmillan Cancer Lead Nurse Julie Buckenham, Business Support Manager Arnold Rayavarapu, Project Manager Katrina Strak, Multi-Disciplinary Team Co-ordinator Nicky Page, Patient Pathway Co-ordinator Sharon Medland, our Clinical Urology fellows, the consultant’s secretaries, appointment session staff, Urology nurses Lucinda Perry and Catherine Linstead, Day Care Sisters Beverly Gray and Kelly Goffin and their team, and Sister Louise Wilkin and her team in Surgery OPD, who all contribute towards the safe and effective running of the clinic.