Urology general practitioner advice and guidance: A service evaluation of its effectiveness

Objective: This study aims to assess the effectiveness of the Urology Advice and Guidance (A&G) referral pathway within the National Health Service (NHS). It seeks to identify whether the A&G system helps to prevent unnecessary referrals to secondary care services and endeavours to see whether there is any variability in consultant responses to A&G queries, and whether this affects how patients are subsequently managed. Patients and methods: This study uses patient data collected by Cambridge University Hospitals NHS Foundation Trust over a six-month period between 2016 and 2017. The correspondence from 192 A&G referrals was analysed to extract 11 data points from each referral to help analyse the aims of the study. Results: The results showed that almost half of all A&G referrals could be avoided if general practitioners made better use of the urology guidelines made available to them. The results also demonstrated that A&G referrals were more appropriately managed when guidance was given by a consultant with subspecialty interests in line with the referral. Conclusion: The aims of this study were appropriately met, and the study outlines how improvements in the A&G service could offer both financial and clinical benefits to primary and secondary care services alike. Level of evidence: 3b