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Community Urology Service - GP Care (DRAFT)

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Overview

The Specialist Community Urology Service, GP Care, will provide a rapid access, one stop assessment and diagnostic service for routine urological conditions, delivered in non-hospital settings linked to the six GP Localities.

In general terms, most routine urology conditions can be referred to GP Care subject to the exclusions given below.

GP Care also provide the Urology Advice & Guidance service for BNSSG

Before Referral

Check specific guidelines on Remedy pages prior to consideration of referral.
Check Funding policies which may apply to certain conditions and must be adhered to (otherwise referrals may be returned by the Referral Service or GPcare)
Consider use of Urology Advice and Guidance.
Check inclusion and exclusion criteria as below.

Inclusion criteria

Adults (aged 18 years and older), registered with a GP Practice in BNSSG
The urology services that can be provided by the Specialist Community Urology Service are listed below. This list may be subject to change as additional treatments may be provided in a community setting in future. Please see individual Remedy pages for advice on referral criteria and work up/ management in primary care prior to consideration of referral:
- Non-visible haematuria
- Lower urinary tract symptoms (LUTS)
- Recurrent UTI
- Haemospermia (if under 55) - normally managed in primary care - referral rarely required unless underlying conditions suspected.
- Management of scrotal lumps (non-cancer) - funding policies apply.
- Testicular pain
- Erectile dysfunction - if criteria are met.
- External genitalia problems (non-operative) - see Penile problems page and Female Genetalia Surgery page. - funding policies apply.
- Peyronie’s disease (non-operative)
- Loin pain, possible Renal calculus (non-operative), monitoring of small non-obstructive stones in pelvis and ureter
- Prostatitis
- Urodynamics (although complex Urodynamics to stay at Southmead) and Uroflometry (flow test)
Not currently available (as of November 2023) buy may become so in future:
- To work towards providing active surveillance after diagnosis of low risk (Gleason Grade group 1) prostate cancer
- To work towards providing flexible cystoscopy surveillance of low risk non-muscle invasive bladder cancer

Exclusion criteria

The following patients are excluded from the service:-

Patients requiring an appointment under the two week wait rules. All USC (2ww) referrals will be dealt with by North Bristol Trust and Weston Area Health Trust
Patients with routine continence problems, these patients should be seen by the Community Bladder and Bowel service
Patients requiring a general anaesthetic for flexi cystoscopy - refer to secondary care via eRS.
Patients unable to transfer themselves on and off a bed without assistance. Patients may use their own portable hoist if able to do so with assistance from their own carer
Paediatric referrals - Patients aged under 16 refer to paediatric urology pages . Patients aged 16 and 17 to adult urology.

GP Care do not provide the following services:

Botox
Circumcisions
Vasectomy
Diagnosed stones - refer to secondary care. See Renal calculus page.
Re-inserting Catheters

GP Care do not carry out any surgery but can direct list into secondary care if surgery is needed..

Referral

Refer via eRS ensuring referral criteria are followed and funding policies are adhered to where relevant.

Contact for queries: 0333 332 2102

Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

Information provided through Remedy is continually updated so please be aware any printed copies may quickly become out of date.