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Clinical leads for GIRFT urology

The clinical leads for the GIRFT urology workstream have recently been working on the programme of re-visiting trusts.

Mr Kieran O’Flynn, Consultant Urological Surgeon at Salford Royal NHS Foundation Trust (left), and Mr John McGrath, Consultant Urologist at Royal Devon and Exeter NHS Foundation Trust (right), have replaced Simon Harrison as GIRFT’s joint clinical leads for urology.

Simon continues to be involved in the programme and to offer advice after publishing GIRFT’s first national report on urology in July 2018, together with a handbook (see below) containing both a guide to setting up urology area networks (UANs) and good practice case studies to share with trusts.

Click here to read the most recent GIRFT publication in the March 2022 edition of the Journal of Clinical Urology (JCU): "To what extent have key recommendations from the "Getting It Right First Time" programme for urology in England been implemented?"

What are the plans for GIRFT urology?

Mr Kieran O’Flynn and Mr John McGrath will now be leading GIRFT’s re-visits to trusts, presenting refreshed urology data and looking at the progress of recommendations since the 2018 national report.

Professor Tim Briggs, chair of the GIRFT programme and National Director of Clinical Improvement for the NHS, said:

Kieran and John are both hugely respected in the world of urology, and I am delighted to have them on board with GIRFT as we move into the second phase of our work to help improve urological services.

"The recommendations in Simon Harrison’s national report have been instrumental in driving significant changes for the better in units across England, but there is always more we can do. I look forward to seeing further innovation and improvement as our re-visit process gets under way …"

Mr Kieran O’Flynn, Past President of the British Association of Urology Surgeons (BAUS), said:

I’m delighted to be joining the GIRFT team with John McGrath.

"Simon Harrison’s excellent report signposted many of the challenges facing the specialty. With a workforce shortfall in urology and with the rising urological requirements of an ageing population, there is a pressing need to develop the urological workforce, while ensuring that standards are maintained.

"The GIRFT report identified significant national variation in the management of common conditions, and I look forward to helping support the progress of urology area networks, enabling the development of specialist care and improving core services in elective and emergency care …"

Mr John McGrath, Clinical Director of the South-West NHS Genomic Medicine Centre, said:

The GIRFT programme has enormous potential to deliver further improvements in urological care for patients across England by building on the strong platform that Simon Harrison and his team have already established.

"I am looking forward to supporting the ongoing development of UANs as well as accelerating the spread of best practice in areas such as day case surgery.

"Specialist nurses are right at the centre of high quality urological care and we have a great opportunity to working alongside the British Association of Urological Nurses to look at how we develop these roles further …"


Handbook of good practice in urology

Mr Simon Harrison, former GIRFT Lead for Urology, circulated the following information for BAUS members in January 2020: 

Following on from the GIRFT National Specialty Report on Urology, the GIRFT team have published a handbook of good practice in urology, "Gettging It Right In Urology"This contains:

  • Guidance on how Urology Departments and Trusts might go about establishing collaborative working arrangements within a Urology Area Network.  It is hoped that most Urologists will, by now, be aware of which other Urology Units they are likely to be networking with.
  • A set of 23 case studies, produced by Urology Departments from around the country, that describe innovative ways of working and delivering services.  These examples of such practice came to light during the GIRFT visits to Trust Urology Departments.  There are doubtless many other examples which remain largely out of sight to the Urology community. 
"It is hoped that the portfolio of case studies will increase over time; BAUS members are encouraged to contact the GIRFT Urology team with further examples of innovation that would be of wider interest.  It should be noted that GIRFT has not formally evaluated the practices that the case studies describe - clinicians are urged to judge whether adopting similar protocols and procedures would be expected to be of benefit to their own department.  This is information-sharing, rather than a policy-directive ..."

Download the handbook "Getting it Right in Urology" - first published in December 2019

Other GIRFT publications

The 2018 National Report presented 18 recommendations to improve the care pathway for patients, including rolling out dedicated urological investigation units (UIUs) to support greater emphasis on outpatient services and increased day surgery procedures, extending the role of specialist nurses to lead on outpatient work, and establishing Urology Area Networks (UANs) from clusters of adjacent urology departments providing comprehensive coverage of services.

Following on from the work of Simon Harrison, the "Getting it Right in Urology" case study handbook above was sent to all trusts, offering examples of the good work and innovations seen during the national review as well as information on how to set up a UAN.

Additional information from GIRFT

Urology Area Networks (UANs) & new ways of working

Everyone now realises that there will be no quick return to the pre-COVID-19 ways of working, and that some changes in practice will be permanent. The Getting It Right First Time programme team was asked by NHSE/I to collate examples of new ways of working that have been successful and could be adopted across the country. 

Online data collection for this survey by NHSE/I has now closed but, if you have information about successful Urology Area Networks that you wish to share, you can still email this to Kieran O'Flynn or John McGrath. The information required includes:

  • name of hospital Trust;
  • nature of the innovation and how it changes the patient pathway;
  • impact of the change in terms of population health outcome, safety, efficiency, productivity;
  • what is needed to sustain this change in practice; and
  • have there been any problems with the change?

Kieran & John will collate these changes and share the information (but not your name or e-mail address) with BAUS and NHSE/I.


GIRFT webinars on this website

Upcoming webinars under the banner of GIRFT and the National Clinical Improvement Programme can be found here on the e-Learning page.

Recordings of past webinars are available here on the Webinar Archive page.

You can find the webinar schedule & recordings under the
"Clinical Quality (GIRFT) & Audit" tab of the pages above


Urology delivery guides (published on the GIRFT website, Jan 2022)

These guides have been published by GIRFT, in partnership with BAUS, BAUN & BADS, and are available from the GIRFT website by clicking the links below. 

  • Acute stones - this guide highlighting examples of services which perform best and have overcome difficulties to improve care for patients;
  • Bladder cancer - this guide provides information about ensuring timely provision of effective treatents that can, in some cases, limit recurrence, halt progression or even cure;
  • Bladder outlet obstruction - urology has seen an increase in the range of treatment options, thereby improving outcomes but also increasing the complexity of both patient decision-making and treatment management; and
  • Outpatient transformation - this guide addresses both the ongoing COIVID-19 pandemic and the threat of global warming, incuding how the NHS uses technology to improve patient care and to facilitate delivery of the net zero ambition of the NHS.

Additional urology resources, including disease-specific pathways & metrics,
are also available in the Urology area of the GIRFT Best Practice Library