President's Mar 2021 Newsletter

Those of you who read your emails from BAUS will know that on 31 March 2021, the contract with Dendrite closes and the BAUS system for surgeon-entered data on major surgery will be no longer.

The process over the last 6-10 years reflects well on the organisation and on UK urologists. A lot of interesting data has been submitted, abstracts have been presented, and papers written. It has certainly been an engine for driving up standards. The decision to move to a new approach really arose out of a feeling that collecting more and more data of this type without meaningful follow-up was of limited further value. In short, are we going to learn anything more from 60,000 nephrectomies without follow-up than we would have from 50,000 without follow-up?  The feeling of successive groups of Trustees and the Audit Steering Group was “probably not”.

Furthermore, the audit process, through Dendrite, meant that large numbers of urologists in the UK did not, in fact, have their practice in any audit  at all – this did not feel appropriate.  Finally, the collection and storage of patient identifiable data at BAUS creates a number of challenges from an information governance perspective. Coincident with this was a realisation that the work of NCIP through GIRFT provided an opportunity to perform high quality audit through routinely collected data. The presentations and pilots from NCIP were very impressive and pointed to a situation where all members of BAUS would have the majority of their work recorded. Andrew Dickinson and the Audit Steering Group have been dogged in their pursuit of this goal, and were rewarded this month with the news that urology will be the vanguard specialty in this approach to surgical audit. This is good news, and an ambitious roll out plan is underway. The plan is to have all units in England registered and working by the end of the year. It is a system for England only, but plans for the devolved nations will be worked out.  

Some urologists are disappointed by the switch, but the decisions have been made in the best interests of the whole organisation, and I think the new approach should be viewed as an opportunity. If it can be made to work, it will give high quality data, without the laborious process of data entry by Consultants, and with follow up. It will also cover a far wider range of procedures than the limited ones on Dendrite.  

All the data that has been entered over the last few years remains ours (i.e. yours) and is accessible for members. Final summary documents are in preparation, so that the collective lessons from the exercise can be learnt, and these will be collated into a series of ‘standards in …’ documents.  Any questions about the old or the new systems should be directed to Louisa Hermans at BAUS.

Anyone interested in the new approach can also listen to a podcast on the subject which can be found on the BAUS website.

The virtual congress that took place from 9 to 11 Nov 2020 was a huge success and so, with the pandemic continuing well into 2021, it was a straightforward decision for Trustees to decide to run the 2021 BAUS summer meeting as a virtual event. Asif Muneer, Harry Heald, Ian Pearce and the new recruits to the BAUS team, Annabelle Masham and Athene Madden, have been pulling together an excellent programme.

The theme will be "Global Urology" with a series of headline, joint sessions with our international partners around the globe. Once again, we are able to bring the congress to members at a hugely discounted rate, so we will be expecting record numbers of registrants once again.  

The numbers were astonishing in the Autumn (1818 delegates a BAUS congress is a rec o4rd; multiple sessions with over 400 delegates; an industry satellite with 480 delegates and so on). It is probably a good moment to remind you that all the content remains watchable for a year on the Launch platform using your unique meeting login. If you are having difficulty in accessing the platform again, or wish to register, please email the Events Team.  At a time when the Royal College of Surgeons of England launches its diversity review, with a flagship programme on "Parenting in surgery", why not watch the superb BSoT session on the subject from November!

Social distancing rules are set to be relaxed on the opening day of the congress - 21 June 2021 - so, if we are permitted to meet, why not arrange a small get-together for your colleagues at work on that Monday evening. A relaxed day at virtual BAUS followed by an outdoor soirée with your friends might make for a very enjoyable Midsummer's evening. The BAUS President will be doing the same in Epsom ...

The BAUS webinar programme continues to deliver outstanding learning opportunities which are free to members. You can link to the programme of webinars that are set to take place over the spring by clicking here, and to the webinars (BAUS member only) that are in the digital archive on the website.  

The programme will continue in 2021 and plans relating to the various programmes are currently being discussed.

This project has been a hugely enjoyable part of my first year as BAUS President.

A huge personal “thank-you” is due to Nitin Shrotri who has driven the group forward with incredible energy and commitment. The two webinars have been inspiring events, full of incredibly rich stories from urologists who have navigated this route. A session at the summer meeting will climax a very successful first year for the group.  

If you are interested in the programme of mentoring that is being established (or if your interest is in mentoring in general), you might want to register for Tim Terry’s "Introduction to mentoring" webinar on 7 April 2021.

The BAUS SAS project team have really driven this contentious area forward at great pace. Interestingly,  the lot of SAS doctors was a key recommendation in the RCSEng diversity review written by Helena Kennedy, so we are ahead of the game!

Anyone interested in contributing to this project should click here to email the SAS Doctors at BAUS or take a look at the SAS webpages on the BAUS website.

Trustees

In January 2021, we appointed Lisa Dodgshon as the first non-urological trustee of BAUS. Her background is in communications, sponsorship, pharma & marketing: she established and ran her own company, Succinct Communications, for a number of years. Sher has already made a difference to Trustees, and we look forward to both to her continued contributions and to the appointment of more non-urological trustees in the future. 

BAUS Honorary Secretary and Honorary Treasurer

The closing date for nominations for these positions is Thursday 1 April at 12:00hr. If you’ve wondered whether to stand, then do!! Both are positions with great influence within the organisation, and I think the switch to virtual committee meetings makes the jobs far more feasible for urologists, wherever you may reside. 

BAUS Workforce Lead 

Steve Payne has kindly agreed to lead the BAUS Workforce Report until 2024. This work gives us vital information in planning urological services and in understanding better where the pressure points will be.

He has recently produced a report on the ageing urologist, which sets out the challenges of being a surgeon over the age of 55. This is in keeping with the BAUS view that all elements of the workforce need to be supported in imaginative ways.  The report will be published on the BAUS website shortly.

TUF Clinical Trials Unit 

This project has moved forward at pace. For those new to this, you should know that The Urology Foundation (TUF) has sponsored the development of a partnership between TUF, BAUS and the Centre for Healthcare Randomised Trials (CHaRT) unit in Aberdeen, with the express intention of bringing forward outstanding multicentre trials in urological surgery.

Graeme MacLennan and James N’Dow from CHaRT, Caroline Moore the RCS England / BAUS specialty lead for urology research, Grant Stewart, Chairman of the TUF Science & Education Committee, and myself have met monthly. The highlight of the first six months of work will be a Dragon’s Den of research trial proposals at the virtual congress in June 2021.

The key is ideas. If you have them, put them forward through sections, or contact us ... I’d delighted if you contact me. We are open to all ideas and we want them to come from new sources. If you are interested in the project, do register for the explanatory webinar on 15 April 2021 at 19:00hr. 

A strong theme of the Presidential Q&A at the virtual congress was the urological landscape post-Covid, and how urologists might navigate this successfully. Unsurprisingly, this has been a huge theme of the NHS recovery team which regularly asks the BAUS President for input on your behalf.

The development of networks and the sharing of best practice are recurring themes.  In that vein, I would point you towards two resources.  One is the GIRFT programme which is focussing on four subjects ( BPH, TURBT, stones, and outpatients) and the other is our clinical leads network at BAUS.

The clinical leads network, under the chairmanship of Mark Lynch, is meeting virtually on Wed 31 March 2021 at 19:00hr, so why not register if you are leading a team through the tail-end of the pandemic. 

I point members towards some projects in development that may well have an impact on on the organisation beyond 2021. BAUS Trustees have given the go-ahead for exploration of two exciting new themes.

The first is a joint project with IBUS to develop a framework for bringing IBUS under the umbrella of BAUS. IBUS has links all over the globe, as of course does BAUS, and we feel the synergy could be very effective across two main areas: 

1. the creation of a more robust structure to the international links of BAUS, perhaps through a BAUS International forum. This might allow the development of shared programmes which were not dependent on the BAUS President, and had a realistic framework within which to grow. The potential for this exchange of knowledge seems almost limitless; and
2. to support international medical graduates (IMGs) more effectivel, after they arrive in the UK and as they start to navigate the steeplechase that is urology in the NHS.

The second project relates to the digital side of BAUS and, in particular, whether a BAUS App should be developed. Potential advantages of this mjight be:

• to allow the new streams of new digital content to be shared more effectively;
• to act as a catalyst for new digital educational initiatives;
• to act as a channel for new sponsorship; and
• to be a better tool for BAUS comms.

The highly mobile lives of urologists would seem to make "urology on the move" a valid goal.  A working party is being established to look into this in more detail as scope, cost, logistics and functionality need to be developed. Potentially, thoug, an exciting development - watch this space ...

A third point to highlight, of course, relates to the report of the Royal College of Surgeons of England into Diversity. I’m sure most members will have read it, or at least read its conclusions. Whilst much of the report relates to the internal workings of the RCS Eng, there is much that goes way beyond this, into the culture of surgery in general. The President and Vice-President of BAUS have had an introductory discussion, as we look to formulating our working response at BAUS. The report has not yet been discussed at Council or Trustees, so further detail on this is not available at the time of writing. Clearly its an important area for us to get right.