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President's Sep 2021 Newsletter

from Tim O'Brien

The start of the academic year seems like a good moment both to reflect on the year gone, and to update members on plans for the year ahead at BAUS. For understandable reasons (too many to detail here), it’s been a year that many will simply want to forget but that’s not actually how I see it because, amidst all the hassles, worries and upheaval, opportunities have presented themselves to reshape much of what we do.

The most obvious innovation has been the delivery of two virtual congresses with excellent academic content, record numbers of delegates, great breadth of contributors, extraordinary global reach, minimal registration fees, and a healthy financial surplus which would all point to hugely successful endeavours.

Asif Muneer and Harry Heald deserve great credit for managing both events. Why not review a session that you may have enjoyed or missed?  If you don’t still have your BAUS 2020 meeting login (and you registered for the meeting) you can contact the BAUS events team who can re-send this to you (available until the end of October). 

For BAUS 2021, the meeting platform can be accessed here.  If you did not register for the meeting, you can contact the BAUS events team for more information about how to register now.  The challenge now, of course, will be to work out how to blend virtual events with face-to-face events to maximise the advantages of both.

The digital theme has been everywhere, and has made us far more efficient at BAUS with our arrangements for committees, now incorporating a significant virtual element. Two obvious benefits have accrued in 2020 - significant savings in the costs related to attendance at committee meetings, which were held virtually, and the reduction in time off work required to contribute to BAUS sub-groups, which should remove one of the barriers to getting involved. Digital education is here to stay, and the "Controversies in Urology" & "Innovations in Urology" programmes are both delivering excellent content through the year. All of it is available to members here.

BAUS now has a new home.  Anne Bishop and the team engineered the move in May to state-of-the-art facilities in the rebuilt College of Surgeons at Lincoln’s Inn Fields. It’s a lovely facility and provides a great base for the organisation moving forward. New members of staff (Annabelle Masham and Athene Madden) have been recruited to bolster the events team. BAUS Trustees have changed too, with the arrival of Gurpreet Singh, Susan Willis, Iqbal Shergill, Joe Philip and Lisa Dodgshon as new Trustees in 2021. The appointment of Lisa deserves special mention since she is the first non-urological trustee at BAUS. Her background is in business, marketing, pharma and communications, and it’s the injection of new skills into BAUS trustees that makes her arrival so exciting.

Congratulations are due to Krishna Narahari and Nikita Bhatt who were both successful at the BAUS / TUF Dragons Den in June, and their ideas will now go forward to be worked on with the team at the CHaRT centre in Aberdeen. Hopefully, both trials proposals will be strong candidates for NIHR funding. The trials proposed were to examine the role of lymphadenectomy in radical prostatectomy and the place of routine stenting of the ureter post-ureteroscopy. Personal thanks are due to everyone who put forward their ideas for consideration at the Dragons’ Den – there were some fabulous ideas that didn’t win. A year ago, a TUF/BAUS clinical trials unit was no more than a pipedream, so, the pace at which this project has moved from nascent idea to selection of initial proposals is hugely encouraging. This is not the end of this initiative, though ... it’s only the start, and more opportunities will arise for urologists to advance fresh trial ideas in 2022.

One of the brightest spots for BAUS in the last year has been the creation of a dynamic group addressing the needs of SAS doctors in urology. Thanks are due to Alvaro Bazo for forcefully making the case for action in this area, to Nitin Shrotri for bringing real urgency and drive in his role as chair of the BAUS SAS group, and to Siraj Natalwala for putting his name into the hat as SAS representative on BAUS Council. We have been way "off the pace" on this at BAUS, but that is no longer the case. Thanks to everyone who has contributed so positively in the last year. A pilot programme of mentoring for 20 SAS doctors who are BAUS members is being introduced this year, and it will be interesting to see how this develops.

Enough reflection of 2021, though … what of plans for the year ahead?

BAUS Annual Congress 2022

The virtual congresses that took place in November 2020 and June 2021 were a huge success, but it’s been a straightforward decision for trustees to decide to run the 2022 BAUS summer meeting as an in-person event in Birmingham at the ICC. Ian Pearce, Harry Heald and myself have undertaken scoping visits, and the congress centre is superb. The quality and proximity of the hotels too is excellent. I think it will be a runaway success.  

In addition to an array of top speakers, the programme will be tailored to maximise the opportunities for networking, conversation and socialising. These are the things that people tell me they have missed. The congress will start with a "Welcome back to BAUS" party on Sunday evening, 12 June, on the roof terrace of the Library of Birmingham. It’s a spectacular venue and should be a wonderful occasion at which to catch up with old friends. There will also be a crêche for the first time ever at BAUS. There will, of course, also be options for those who cannot attend congress in person, and who wish to access content remotely.

One innovation this year will be the introduction of a "poster from every unit" session on the mezzanine floor of the Exhibition Hall. We want to hear from every unit in the UK. Tell us something good you are doing: a service improvement, an organisational problem you’ve fixed, a surgical innovation, a piece of research you are most proud of, an educational initiative, a technological innovation or even tell us about a challenging case. They will not be peer-reviewed, and it will be a fabulous chance to showcase an aspect of your work. There will be awards for the best work from small, medium-sized, and large units. Why not start thinking now about the work your unit will be presenting in this special session?


Section Meetings in 2021

The BAUS Sectuon of Endourology Meeting is "face-to-face" in Nottingham on 4 & 5 October. A fantastic energy surrounding this event is expected, given that it will be the first BAUS Section meeting since lockdown. If you wish to register then you can use this link. There is also an option to register to watch the meeting via a live stream. 

The BAUS Section of Oncology Meeting in December is also planned as a face-to-face event. The original venue (The Wellcome Genomics Centre in Cambridge) is no longer able to host the meeting, due to ongoing Covid issues, so the meeting will be held at the Imperial War Museum, Duxford Airfield, Cambridgeshire. This is a spectacular setting and will surely be a meeting not to be missed. The dates of this meeting are 9 & 10 December. Booking will be available on the BAUS website shortly


BAUS Council September 2021

BAUS Council is one of the main steering groups of BAUS, and all the regions have representatives on Council. This year, we will be meeting in a new format. Replacing the three times a year train trip to London is a two-day, strategic planning event in Cambridge on 27 & 28 September. The range of subjects under discussion include research in urology, elective surgery recovery, urological training, urology in the devolved nations, widening participation at BAUS, the Kennedy report, the older urologist; supporting urologists after adverse events; competence in emergency urology, the future of congress, extending and optimising membership (including fees), and the provision of urology in smaller, geographically isolated, units. Furthermore, every member of Council will be interviewed by the digital consultants we are working with so we can gauge a direction of travel for developing our digital outputs. 

It should be a terrific couple of days, and I hope a more productive format for Council. Your regional representative will be attending so, if there is something that’s been on your mind ...


BAUS Digital Project

As mentioned above, we are currently engaged in a project examining the digital footprint of BAUS. The last 18 months have emphasised how much can be achieved with digital formats, but the question remains how best to blend them together into a coherent whole. Website, social media, podcasts, and apps all offer complementary possibilities but also risk unnecessary duplication or confusing outputs. We also need to maximise the return on set-up and running costs.

I am particularly interested in whether we should develop a BAUS app, as I think it might catalyse the development of streams of new content, lead to more effective sharing of existing content, trigger new digital educational initiatives, be a channel for new sponsorship, and it might be a better tool for BAUS comms. The highly mobile lives of urologists would seem to me to make "urology on the move" a valid goal.  

Potentially exciting developments, so watch this space ...


BAUS On-Line Learning

The BAUS webinar programme for 2020 - 21, and BAUS congress content from 2020 and 2021 is available on watch back.  I’d highly recommend all of it.  For the webinars, click here; for the congresses - if you don’t still have your BAUS 2020 meeting login (and you registered for the meeting) you can contact the BAUS events team who can re-send this to you (available until the end of October).  For BAUS 2021 – the meeting platform can be accessed here.  If you did not register for the meeting, you can contact the BAUS events team (using the link above) for more information about how to register. 

A new online programme will be delivered in 2021 - 2022. There is a range of innovative subjects being covered. Jo Cresswell and Sunjay Jain have curated this, along with a host of talented young female urologists. I think it will be worth watching.


SAS Doctors in Urology

As mentioned at the start of this newsletter, this project continues at pace. Amongst other things, in the second year, the team will be exploring the possibilities of mentoring, with a pilot programme for 20 SAS doctors who are BAUS members. Nitin Shrotri is coordinating this and anyone interested in being a mentor (or mentee) should contact him. Any other queries relating to SAS doctors should be directed to the SAS rep on BAUS Council, Siraj Natawala, or by taking a look at the SAS webpages on the BAUS website.


BAUS AGM & Membership Categories

Last year, the BAUS AGM was held in a virtual format. Attendance was excellent and, as a result, we will be repeating the format this year. The meeting is on Tuesday 9 November at 08:00 hr.

The most significant proposal this year will be the potential expansion of BAUS to include non-medically qualified members for the first time. It is a recognition that the urological team is broad, roles have blurred and, in many cases blended, and that some members of the urological team have no real professional home e.g. robotic assistants, physician' assistants, and clinical scientists. Trustees feel that this presents a real opportunity for BAUS to grow its membership and embrace the wider urological community. Not everyone will agree (!) but it is a proposal to be presented at the AGM in November.

Nick Watkin and the BAUS executives have undertaken a significant piece of work in 2021, with the expressed intention of streamlining the membership categories at BAUS. A set of clearer categories has been developed and was shared with members in August; these categories will be discussed at BAUS Council in September, then ratified and shared with the membership later in 2021 for the AGM. 


BAUS Data & Audit

Andrew Dickinson and the Audit Steering Group have been dogged in their pursuit of the goal of national funding for audit as part of the NCIP / GIRFT programme. They were rewarded earlier this year with the news that urology will be the vanguard specialty in this approach to surgical audit. Clearly this is good news and an ambitious rollout plan is underway. The plan is to have all units in England registered and working by the end of March 2022.  

A podcast, and information about the data in the portal, with plans for rollout can be found on the here on the BAUS website. BAUS also recommends that urologists take a good look at the Model Hospital (registration required) where there is a rich set of data presented, relating to a wide range of conditions; many units already use this as a basis for their service improvement efforts e.g. with respect to day surgery, length of stay, and readmission rates. See where your unit sits in comparison with others in the UK. Any questions about when individual units will go live in the new programme can be addressed to Louisa Hermans. This is a system for England only - plans for the devolved nations will need to be worked out. 

All the data that has been entered on Dendrite over the last few years remains ours (i.e. yours), and is accessible for members. Summary data from the registries for benchmarking is available on the BAUS website. John McGrath’s team in Exeter have written a number of manuscripts relating to the BAUS complex surgical operations audits for publication in the JCU.  The cystectomy paper can be accessed here - nephrectomy and prostatectomy papers will follow shortly.

Two new BAUS snapshot audits are scheduled to run in 2022: emergency ureteric injury management, and muscle-invasive bladder cancer.  The audit of management of the lower ureter in nephroureterectomy will close on 21 December 2021 so, if you have signed up to contribute to this audit, please be sure to get your data in by the deadline.


BAUS "Widening Participation" Project

This is a wide-reaching project at BAUS and embraces a number of different initiatives. One is the "poster from every unit" detailed above, another the SAS doctor project; and a third the potential opening up of BAUS to non-medically qualified members. "Developing the pipeline" at BAUS is also a priority as we try and bring new faces and voices into the BAUS firmament. One priority is to attract contributions from members across a wider geographical area into the core working groups of BAUS.  

A crucial element of this work also relates to issues highlighted in the RCS England Kennedy report. Dame Helena Kennedy gave a very eloquent address at our virtual congress in 2021, and I’d encourage members who missed it, or are unsure of why this report matters, to watch the talk via the BAUS 2021 meeting platform. Jo Cresswell is leading in this area for BAUS and, together with BAUS trustee Susan Willis, has developed a 10-point plan addressing diversity and inclusion at BAUS. Jo would be delighted to hear any feedback from members on the plan.


The New Urology Curriculum

Everyone, I am sure, is aware that a new curriculum for urology is upon us, but many may not be aware of what responsibilities this is likely to entail for them or, conversely, what opportunities it might provide for units to develop positions to fit the new requirements.

There is a page dedicated to the new curriculum on the website, including a webinar for trainers and a podcast hosted by the Chairman of the SAC, Phil Cornford.  


The BAUS Fellowship Day

Anthony Koupparis and Melissa Davies have put together a terrific programme for the inaugural BAUS Fellowship day on Friday 1 October 2021 in Bristol.

The meeting is aimed at trainees who have completed their FRCS Urol and are embarking upon, or are already engaged in, a dedicated urology fellowship. You can register here.  Registration closes at 17:00hr on Friday 24 September, and places are limited so please book quickly to avoid disappointment.  

Any urology units which currently offer fellowships are also strongly encouraged to enter the details of their fellowship programmes on the fellowship pages of the BAUS website.

As this resource develops, it should allow a much easier understanding of what is available at fellowship level in the UK for candidates, wherever they reside. As I’ve said in all of my presidential addresses to date, I think the fellowship landscape in the UK presents an incredible opportunity for high level training for urologists from the UK and abroad, and for keeping urology in the UK in the international forefront.  


Elective Surgical Recovery

Many will have read the press releases last week relating to the government’s plans for the recovery of elective surgery. I also know that many surgeons are currently in no position to even think about this subject because urgent surgery simply isn’t happening in their hospitals to any significant degree.  The numbers on waiting lists have, inevitably, become somewhat daunting. Three areas predominate - bladder outflow surgery (>30,000 waiting), circumcision and cystoscopy.

BAUS Council will be hearing more of the GIRFT programme this month. Networks and surgical hubs are to the fore. We are very interested in how the newer techniques in BPH surgery might be employed in innovative ways, and at new sites, to resolve some of these challenges. If your unit has done innovative things in elective recovery, then it might be a good idea for your clinical lead to join the BAUS Clinical Leads group. You can email Mark Lynch, and you may consider showcasing your work in the "poster from every unit" initiative at BAUS 2022. It seems timely that BAUS will be running a BPH masterclass early in 2022, kindly sponsored by Boston Scientific.


Urologists interested in any of the items in the newsletter should contact me by email.  We are always on the lookout within BAUS for urologists with novel skillsets to help us with any of the new challenges we face.

With best wishes for the season of mists and mellow fruitfulness.

Tim O’Brien, President of BAUS

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