ABSTRACT
Introduction: At a time of massive service downturn and heightened public anxiety, we sought to develop, enhance and maintain an ambulatory service to provide specialist care to Urology patients throughout the Covid-19 pandemic. The aim was to divert Urology patients from attending Emergency Departments (ED) and reduce inpatient stays. To allow patients access to specialist services and reduce multiple hospital attendances where possible. Patients and Methods: Two Specialty Doctors and a Ward Manager re-opened an inactive ward with a new purpose, to respond to the growing need for an alternative route for patients who required Urology attention. An outline of emergency urology pathways were devised as a guide for ED and on-call surgical colleagues disseminated by Trust email, initially providing a guide for referral to the service. Results: Over 16 months, 1400 patients attended ambulatory appointments. 424 were diverted from attending ED, 160 hospital admissions were prevented and 382 patients removed from waiting lists for outpatients or day procedure. Patient satisfaction was excellent and wholly positive feedback collected. Conclusions: Despite particularly challenging circumstances, staff shortages and increasing pressure on the health system, we were able to rapidly put together a substantial and sustainable service. With a patient-centered approach and considerable benefits to the hospital, came great professional satisfaction. In a time of crisis came opportunity, which led to significant service development with a lot of team work and dedication.