Lyn Kirkwood, RGN.
President, British Association of Urology Nurses, and Clinical Nurse Specialist, Weston General Hospital, Weston-super-Mare...
Nurse-led clinics are not a new concept, and many acute trusts run well-established clinics to diagnose and treat patients with lower urinary tract symptoms (LUTS).
I have been involved with setting up and running nurse-led clinics in my trust for over 18 years. My experience has shown that the benefit lies in providing a quick diagnosis and assessment for men with lower urinary tract symptoms, which improves a patient's experience and potential treatment outcomes.
The NHS Modernisation Agency has also recognised the need for nurse-led clinics, with the launch of its Action on Urology initiative. Around half of the 15 pilot sites involved will investigate the benefits of hospital- and community-based nurse-led clinics in delivering quality diagnoses and treatment standards.
The British Association of Urological Nurses (BAUN) has its own guidelines to develop nurse-led clinics for the assessment of men with lower urinary tract symptoms, which aim to increase the number of clinics and standardise the quality of care delivered. Good practice exists in many centres but there is a huge variation in service standards across the UK. There is also a lack of uniformity in terms of role description, clinical grade and the expertise of the nurses responsible for assessing men with these symptoms.
Many areas of health care continue to move towards a holistic multiprofessional approach, urology is no exception. Numerous factors including government legislation, demographic trends and an increasing demand from the public for improved patient care strengthen the need for developing services such as nurse-led clinics.
Formal guidelines from a recognised professional body such as BAUN are crucial to encourage the development of these clinics and ensure that the growing need is met.
About four out of five men presenting with LUTS have benign prostatic hyperplasia (BPH) - one of the most common conditions affecting middle-aged men. Up to 50% of them develop the condition by the age of 60, and 90% by the age of 80.
The UK's elderly population is growing, which means the condition is likely to be present in an increasing number of men.
The BAUN guidelines are timely and coincide with the British Association of Urological Surgeons' (BAUS) guidelines, to be published soon.
These revised guidelines for GPs, nurses and patients facilitate moving assessment and medical treatment of patients with BPH into primary care. While the BAUS guidelines focus on the medical management of LUTS, the BAUN provides a framework to assess practical aspects such as identifying service need and the resources and training required.
Nurses have a key part to play in diagnosis, treatment and referral using an agreed protocol. The BAUN guidelines are a comprehensive resource to help them.
The Modernisation Agency's Action on Urology programme aims to improve access to and quality of care for patients. The 15 pilot sites will incorporate cancer and non-cancer work (see www.modern.nhs.uk).