The impact of the Inquiry on the Urology Department has been very significant. The Inquiry recommends that the Urology Service be provided with ongoing specific medical and operational leadership support from Senior Management, the Board and the Department. This will allow for stabilisation and help to rebuild the confidence of patients, the public and staff. The Inquiry considers that using the Urology Service to test improvement initiatives, for example in the area of data and information, might be of benefit to the wider Trust. Moreover, it may help boost morale in the service by allowing it to present as a proactive high-quality service at the forefront of developments for urology services in Northern Ireland. The Inquiry recommends that in providing that support, senior management, the Board and Department should consider the following:
• The recruitment of a stable consultant workforce is a priority. The Department must develop a clear strategic plan for urology services at the Trust and in Northern Ireland more generally. The problems in recruitment in urology should be considered more broadly as part of the general problems with recruiting consultant medical staff in Northern Ireland. The Inquiry considers that there is merit in setting up a specific project relating to the recruitment and retention of medical staff as part of workforce planning functions in the Department. While we recognise that there are problems relating to this in many areas across the UK, some Trusts have been successful in recruiting and retaining the expertise required. Novel solutions tailored to the situation are required. The Department and Trust should learn from what has succeeded elsewhere.
• The urology team and medical leaders should be given the time and resource to continue to participate in and contribute to Northern Ireland wide working groups to develop plans for the delivery of services. This support should include the implementation of the Getting it Right First Time (GIRFT) review.
• Methods for communicating with patients on waiting lists should be tested in the Trust's Urology Service. A working group should be set up to advise on how the following areas can be addressed:
a. The new encompass system allows greater information to be provided to patients however patients require explanations and information that is not necessarily on the system. Possible ways of improving how patients can access information relating to appointments, investigations and procedures and/or access advice relating to their condition should be tested in urology before being rolled out across the Trust and regionally.
b. In addition, some patients may deteriorate and come to harm while on waiting lists. Methods of assessing and mitigating this through reprioritisation should be tested in the Urology Service at the Trust and then considered on a regional basis.
• Data sets of information for meetings should also be tested in the Urology Department alongside the improved support for audit already in place. This could then be used as a model for other services.