Provision of on-call urology services in the United Kingdom: Teamworking,and confidence,in providing an emergency service

Abstract

Objective:

The aim of this study was to establish an evidence base of teamworking and confidence in the provision of emergency urology in the United Kingdom.

Methods:

An online survey of members of The British Association of Urological Surgeons looked at individual’s confidence in out-of-hours support and its effect on teamworking, communication and the management of emergency urological conditions, or requiring emergency surgery. This was compared with hospital and rota types and occupational status. Confidence in support available was measured on a 5-point Likert-type scale, and on a 10-point visual analogue scale for the clinical management of emergency conditions.

Results:

In general, communication was bi-directionally good between team members out-of-hours, although this was less evident in district general hospitals. More than 30% of urologists had little confidence in the support provided by their emergency department or on-call managers. Consultants were more confident managing urological conditions than mid-grade and core trainees. However, >60% of consultants had no confidence in providing emergency skin cover, nephrectomy, the management of acute haemorrhage and urgent laparotomy if required, while only 50% were confident in managing the injured ureter.

Conclusion:

Teamworking and infrastructural support are good for out-of-hours urology. There is an imperative to reconsider training in the management of ureteric injuries at all levels.

Level of evidence:

Not applicable