21st January 2025
The NHS Transformation Unit (TU) supported the Urology Clinical Network in Lancashire & South Cumbria (L&SC) to develop a comprehensive case for change in specialised cancer surgery and sub-speciality Urology. Our role was to provide pragmatic senior programme management support to lead the day-to-day activity required to deliver the project successfully.
The Challenge
The TU were asked to set up the Urology workstream, to provide a refreshed case for change, and to develop a set of options for a Model of Care that would enable the system to become compliant with the national standards for complex urological cancer and reduce service fragility.
Recognising that benign urology is closely connected to cancer work, sub-speciality development was included in the project’s scope to prevent disruption in centres not performing major cancer surgery.
The vision of the Urology Network was to improve workforce resilience with a single L&SC cancer team working across the Network, establish centres of excellence for sub-specialisation procedures, and ensure equity of access to a standardised level of care for the population.
Our Approach
We applied our robust clinical redesign process to the development of the case for change and proposed options for re-configuration of services.
By supporting L&SC Urology Clinical Network:
- We established sub-speciality working groups to support the development of a Model of Care for benign urology. Clinical leads from each Trust were invited to collaboratively identify opportunities for network development in the treatment of ureteric stones.
- We held positive face-to-face stakeholder engagement workshops with consultant teams and online with patient groups from across the region.
- We agreed the vision for Future Model of Care and identified the preferred way forward through engagement sessions.
- We developed a comprehensive Case for Change that provided a range of options for the delivery of major urological cancer surgeries in line with the national specification.
- We completed an Equality and Health Inequalities Impact Assessment (EHIA) to support understanding of the impact of the options.
The Outcome
The Case for Change for complex cancer and sub-speciality benign urology was completed, ready for submission to the Clinical Senate and appropriate governance routes within the Integrated Care Board and Provider Collaborative Board, and NHS England assurance processes. The Case for Change supported the Provider Collaborative Board and Urology Clinical Network in the next stage of their plans to reconfigure urological cancer surgeries in L&SC.