Simplified one-stop clinic

Abstract

Objective: The Government initiative to reduce patient waiting times for new referrals to specialist clinics has put a great amount of pressure on outpatient clinics. The objectives of this study were to identify which patients referred to the urology clinics at St Helier Hospital would be suitable for the simplified one-stop clinic model-a model which allows patients to receive appropriate investigation, consultation and treatment plans in one sitting, with care then either discharged back to the GP for follow-up, or put on the elective surgery waiting list-and to estimate the potential number of follow-up appointments that could be saved through the use of the simplified one-stop clinic model. Method: Three months of GP referrals to the general urology clinics were identified retrospectively. The simplified one-stop clinic criteria were then hypothetically applied to these referrals. The group that was suitable for the one-stop clinic was further analysed for the purpose and outcome of the first and the follow-up appointments. Results: Out of 330 referrals, 48.8% were suitable for the simplified one-stop clinic. Further analysis of this group showed that 38.5% were discharged and 27.3% were put on the elective surgery waiting list following the initial consultation. The remaining 34.2% required follow-up, because 14.3% were awaiting renal tract ultrasound, 12.4% were awaiting uroflow rate study, and 7.5% for other reasons. Conclusions: There is a potentially significant number of follow-up appointments in the general urology clinic that are wasted owing to patients waiting for simple investigations. The authors believe the simplified one-stop clinic model has the potential to provide a safe solution to reduce the burden of follow-up appointments within urology.