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Evidence Based Interventions

Introduction to the urology clinical guidance

The EBI programme is an initiative led by the Academy of Medical Royal Colleges to improve the quality of care. The programme is supported by five partners: NHS England, NHS Confederation, the Patients Association, the National Institute for Health and Care Excellence (NICE) and Getting it Right First Time (GiRFT). It was developed in 2018 to help ensure a national approach to quality improvement and to reduce variation across the healthcare system.

The key principles are to:

  • Improve the quality of care for everyone
  • Reduce the risk of harm to patients
  • Minimise unwarranted variation in service provision
  • Ensure finite resources are used most effectively for the benefit of patients and the wider NHS.

The programme reviews, with a panel of expert clinicians, existing interventions where the evidence indicates that they are inappropriate for some patients in some circumstances where specific criteria are not met. Best clinical practice guidance is then produced based on this work.

New urology guidance for 2024

The EBI programme has published three new urology recommendations. These were developed with expert clinicians from the British Association of Urological Surgeons (BAUS), the Primary Care Urology Society, Integrated Care Boards (ICBs) from England and patient representatives from the Academy’s Patient and Lay Committee. Expert opinion has also been sought from other specialist societies, specialist charities and patient representative groups. Their feedback has been considered, and where appropriate, incorporated into the final recommendations.

PSA testing for men 80 years and over

AIM: to maximise shared decision making between men who are aged 80 or older and primary care clinicians in relation to the investigation and diagnosis of prostate cancer. By developing a clear understanding of the potential outcomes to PSA testing for this group it will begin to address the harm associated with overdiagnosis, overtreatment and the wide variance in care delivery across the country. It also provides clarity and guidance to primary care providers on when it is appropriate to refer concerned patients aged over 80 to secondary specialist care following a PSA test. 

Click here  to view the guidance.


Investigation and onward referral of women with recurrent urinary tract infections (rUTIs)

AIM: to reduce variation in care experienced by women with recurrent urinary tract infections (rUTI) by providing guidance for primary care clinicians on when to refer individuals to specialist urology. These recommendations aim to limit harm to patients by reducing harmful and invasive investigative procedures when other alternatives are more appropriate and effective and can be conducted before specialist referral. 

Click here to view the guidance.


Transurethral resection of bladder tumour (TURBT) - single post instillation of mitomycin C (SPI-MMC)

AIM: to target improvements in how care is delivered to patients with bladder cancer, to reduce cancer recurrence, improve patient experience and reduce unwarranted variation by setting out best practice. 

Click here to view the guidance.


Other urology EBI interventions