Stockport NHS Foundation Trust

Stockport NHS Foundation Trust's pilot has assisted junior doctors in urology in meeting the Working Time Directive early by extending a hub and spoke patient service model.

The project considered a number of strategies around workforce design, planning and service design. Prior to the project, Stockport NHS Foundation Trust provided urological services across Stockport and the High Peak as well as Tameside, Glossop and neighbouring districts on a hub and spoke basis, serving a population of over 600,000 which has run successfully for over 10 years giving experience in patient management across sites. This project enabled the service to be extended to Macclesfield.

The project has involved partnership working with East Cheshire Trust and East Cheshire PCT and a joint working group is in place.

The unit at Stepping Hill Hospital provides a comprehensive urology service, including major pelvic cancer, endourology, laparoscopy and female urology. There is also an active research programme including evaluation of HIFU (High Intensity Focused Ultrasound), for the treatment of primary prostate cancer and radiation failure disease. In addition the unit performs radical cystectomy and open radical prostatectomies.

The main project objectives are as follows:

• The extension of urological services on a hub and spoke basis to Macclesfield District General Hospital
• Day case and outpatient services to remain at Macclesfield DGH and all inpatient and emergency services to be undertaken at Stepping Hill Hospital
• The use of specialist nurses undertaking extended roles in community settings allowing the existing medical staff to get more appropriate training at Stepping Hill Hospital and together with the supporting teams provide more effective out of hours cover
• Learning to be provided in time for the wider NHS to benefit
• Urological services across Stockport, Tameside, Macclesfield and High Peak to be WTD 2009 compliant
• Post pilot financial sustainability to be built into the project plan.

The project has started well with inpatient and emergency work transferred to Stockport. Consultants are working at Macclesfield in the outpatient department and this has strengthened services on both sites. This was facilitated by a new rota being introduced into urology and the two staff grades from Macclesfield were fully integrated into this rota. For further information on this hub and spoke urology project, contact Lynn Nutall at lynn.nuttall@stockport-tr.nwest.nhs.uk