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diagnosis of COVID-19. There was no increase in complications or readmissions within 30 days of the procedure. The most common issues at home were catheter discomfort and constipation with low mean VAS pain score and low nausea reported. The overall patient satisfaction rating was very high at 4.8/5 and the cost saving for the hospital was £225 per patient. The study, published in the World Journal
of Urology, found that day case procedure is a viable, safe and efficient pathway for appropriately selected and counselled patients undergoing RARP.1 Between April 2022 and November 2023, 179 patients underwent day case RARP with a success rate of 89% and a 30 day readmission rate of 0.8% versus 2.4%. Between November 2022 and November 2023, the Trust achieved a £225 saving per patient and total savings of £28,350 per year. “The move to routine same-day discharge has been a ‘game-changer’ at the Trust,” explains Mr Abou-Chedid. “Across the UK, we have all seen pictures of patients lined up in corridors in A&E because of bed shortages – with Trusts declaring critical incidents. Day case surgery has the ability to free up beds. By moving to day case surgery, hundreds of patients have now gone home on the same day allowing their beds to be used by patients that need them. “This is not just good for the hospital; patients
say they prefer day case surgery – they can recover in the comfort of their own home surrounded by their loved ones rather than stay in hospital, and patients often find it hard to sleep on the wards. Day case RARP is safe, and our findings show that 97% of patients would recommend this approach for a family member.” Patients, such as father-of-three, Mr Naisby,
have welcomed the initiative: “When my surgeon mentioned that I could be discharged the same day I had the procedure, I must admit I was excited.” Mr Naisby was referred to Royal Surrey after undergoing a PSA test. He underwent the procedure at 9am and, by 8pm, was recovering at home in Guildford, Surrey. “There was no pressure on me to go home at all and the team were at pains to explain that if I didn’t feel comfortable, they would find me a bed on a ward,” he said. “They also provided me
New Prostate Cancer UK Champion
Suzanne Langley, Brachytherapy Nurse Specialist, has become the latest clinician in Royal Surrey’s Stokes Centre for Urology to be appointed a Prostate Cancer UK Champion. Suzanne was encouraged to join the cancer charity’s leadership programme, which runs for 18 months, by colleagues in the Prostate Cancer team, Mr Abou-Chedid and Clinical Nurse Specialist Maria Innes who were appointed to previous cohorts. As part of her application to join the
programme, Suzanne put forward a project idea focused on simplifying the process of treating patients with urethral strictures. Urethral strictures are a build-up of scar tissue in the urethra, which is the tube that empties urine from the bladder, and they are sometimes a side effect of radiotherapy or brachytherapy treatment. “Although the strictures only affect around 5 per cent of our prostate cancer patients, they do cause urinary discomfort and distress,” Suzanne explained. “My project aims to set up a one-stop clinic where our patients come for assessment
with emergency numbers, which gave me great trust that I had a support system in place should I need it. I am really glad I went home and was able to recover in my own surroundings and I cannot praise the team enough.”
High intensity theatre (HIT) days To tackle the increasing demand and reduce waiting times for cancer patients, the Trust has also introduced ‘high intensity theatre days’ (HIT days), to help cope with pressures. In 2023, the urology team organised two HIT days – these involved four separate teams of surgeons and theatre staff focusing on carrying out a number of RARPs to safely complete a week’s worth of patients in one day. “HIT days have been undertaken on a couple
of occasions - it is our silver bullet when we have a backlog of patients on the waiting list. Initially, we undertook a HIT day with nine patients, and then went on to undertake a
When we beat the world record, everyone celebrated and sent the news to their families. They were really proud to be part of the team and of our achievements. We got the waiting list
down by an impressive 25%! Wissam Abou Chedid, a Consultant Surgeon
28
www.clinicalservicesjournal.com I July 2024
and if we think that they have a stricture, while they’re with us at that appointment, I can pass a scope into their bladder and dilate it to relieve the discomfort from the strictures. Therefore, the patient’s assessment and treatment can be delivered in the one visit, rather than the patient coming back for two or maybe three appointments. We’re very keen to come up with ideas to help make life as easy as possible for our cancer patients and so I’m excited about this project and about learning more from other experts in the field.”
record-breaking 12 patients in one day,” Mr Abou-Chedid commented. Matthew Perry, Consultant Urological
Surgeon, said: “It is testament to the fantastic team that we have that we have been able to achieve this feat. It has involved an incredible amount of planning from many different departments. Mr Abou-Chedid added: “Our motivation
centres solely on improving the experience of our patients. We significantly reduced our waiting list and 12 men who were anxiously awaiting surgery received the care they needed. No cases were rushed and the operations themselves took the same amount of time; we were just able to reduce the turnaround time between each patient.” One of the patients who benefitted from the
high intensity theatre list was David Retter, from Winchester, Hampshire. David was previously diagnosed with an aggressive form of prostate cancer after undergoing a PSA test. “I was expecting that I would have a long
wait, but it has all happened really quickly. When you hear those words that you have cancer it is scary, but the speed that it has been dealt with has just been incredible. It is exciting to be part of something out of the ordinary,” he commented. Mr Abou-Chedid explained that the HIT days have created a sense of pride and camaraderie:
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