[Skip to content]

.

Regional Innovation Fund 2010/11 Project: LTC 20036

Provision and evaluation of new community based LUTS and stable prostate cancer service

Derby Hospitals NHS Foundation Trust working with the NHS in Lincolnshire 

 

This project will provide specialist nurse-led services in the community setting for patients with Stable Prostate Cancer (SPC) and Lower Urinary Tract Syndrome (LUTS) at a cost lower than tariff.
Innovative clinical decision support software will be used, which is more convenient for the patient and provides for consistent disease management.
Formal supervision is provided as part of this project. 
SPC and LUTS are long-term condition affecting men over the age of 45. Patients are typically referred by their GP to urology clinics located in hospital outpatient departments. This can be a problem particularly in rural areas as in Lincolnshire where patients may have to travel long distances to hospital. These patients usually have a need to urinate frequently and so those using public transport have particular difficulties.
Although there are clear nationally-accepted guidelines developed by the British Association of Urological Surgeons (BAUS) for the management of SPC and LUTS patients in the community, most GPs are not confident in treating patients themselves and do not have access to the special investigations needed.
Lincolnshire has the oldest average aged male population in the East Midlands, with almost 20% of the total population being men aged 50 years or older as compared to just under 17% for the East Midlands as a whole. As expected with age-related disease, Lincolnshire also has the highest incidence of SPC and LUTS and the highest incidence per 100,000 patients.
A new community-based pathway addresses this problem. This pilot project evaluates whether the pathway can be successful in rural areas of Lincolnshire, where it should be ideally suited.

 

   
The new SPC and LUTS pathway service will be piloted within the Lincolnshire South West Consortia. Some of the GP practices are remote from hospitals. Nurse-led clinics will be held in GP clinics for patients who have been diagnosed by their GP as having SPC or LUTS.
The principle objective is to manage the SPC and LUTS patients locally, to avoid unnecessary travel to hospital outpatient clinics.  The secondary objective is to measure the cost savings and evaluate the new service from the point of view of both patients and clinicians.
Patients will be involved in development of evaluation tools. Feedback will come from all patients going through service. Development of patient group to take part in workshop to develop innovation tools and to contribute to the final workshop as well as the identification of GP pathway champions is desirable to help achieve sufficient use for evaluation and to maximise savings.
 
  • Treatment closer to home with greater dignity for patients.
  • Reduction in prescribing errors
  • Longer consultation times than are currently provided in an acute setting.
  • GPs will be able to take over management of their SPC and LUTS patients in a safe manner.
  • Nurses running the service will work at a higher skill level, supported by a clinical decision support system.
   
  • Reduction in admission rates for urgent and emergency urological services.
  • Reduction in DNA rates.
  • Service will consistently advise treatment based on NICE guidelines.
  • Target a higher proportion of patients with this condition near to the patients’ home
  • Earlier and more effective community-based care
  • Reduced Carbon Footprint
  • Acute hospitals will be freed up to focus on providing higher level urological services
Potential savings of £400,000 per year are possible if the service is rolled out across the whole SHA. For this project, services will be provided at 75% to 85% of tariff resulting in a 15% to 25% savings during the project period.
LUTS Group Image
contact innovator button resized

Contact the Innovator

Mike Henley, Derbyshire Hospitals NHS Foundation Trust

Mike.henley@derbyhospitals.nhs.uk

Fred Jacobs, iQudos

Fred.jacobs@iqudos.com

 

Download case study button resized

Documents to Download

See the project featured in the East Midlands Regional Innovation Fund Projects Brochure on Page 50

East Midlands EXPO Poster