Post COVID the Neuro-Urology department experienced a significant reduction in medical staffing. Urology Consultants reduced from 3 part- time to 1 (lost of 1.3 WTE) Remaining Consultant has Long Covid and had to reduce from 0.6WTE to 0.2WTE. Failure to recruit new consultant for > 1year. 
New patients referrals were breaching, outpatient medical appointments was >2000 patients waiting to be seen, diagnostics ie video-urodynamics 600 patients waiting, sexual function medical clinic reduced to once a week with > 6 month waiting time.

Seconded a Band 5 Nurse 0.8 WTE for 1 year to back fill the current Band 6 CNS to backfill the CNS Band 7 to take on medical outpatient clinics as a Consultant Nurse
Upskilled current CNS and SHCA team
New urology inpatient referrals seen and plan agreed with urology medics
Weekly Bladder and Bowel Ward Round by CNS
Referred patients to external specialists ie hematuria clinic 2 week protocol, removal of renal and bladder stones, urgent colonoscopy for surveillance under the 2 weeks protocol
Non-Medical prescribing for inpatients and outpatients – done by Band 7
Diagnostics requests done by Band 7 
New patients RTT seen by Band 7
New Nurse Flexi-cystoscopy list supported by new urology Consultant once recruited
Validation of theatre, diagnostics and outpatient flexi-cystoscopy lists 
Secured funding through the COVID recovery allocation to work weekends and longer days to reduce diagnostic waiting times 
Spinal Cord Injury Consultants to be our medical clinical support due to reduction of onsite Urology Medics

Results: from April 2022 to April 2023
Medical Outpatient clinic - 1320 seen 
Sexual Function clinic – 308 seen 
New Patients – 100% compliant with RTT
VCMG – complaint with new patient, reduced list from 600 to 100 by extra lists and validation
CMG – extra 88 appointments created now compliant 
Flow rates – compliant with and up to date
Flexible Cystoscopy outpatient procedure – 480 procedures completed now compliant 
Main theatre validation and diverting patient to outpatient procedure 550 patients
Pelvic Floor Physio appointment increased to x1 per week from 0.5.

We are a Team of highly experienced Nurse Specialists, Senior Healthcare Assistant, Clinical Scientist and Pelvic Floor Specialist Physiotherapist. 
By up-skilling our workforce and working within agreed safe parameters we have made a significant impact on reducing waiting times for patients. Validation of waiting lists is crucial to stay a program like this. 
Positive patient feedback and satisfaction has been received of our service

Clinical Nurse Specialists, Clinical Scientists, and Allied Healthcare Professionals can utilise their extensive skills and knowledge to develop expert care of spinal cord injured patients for bladder, bowel and sexual function. 
The success of this quality improvement service has led to successful business cases for a Lead CNS for Neuro-Urology, a new CNS for Neuro-Urology/Sarcoma, recruitment of a Band 6 CNS and increased hours for the current Band 6 CNS. 
We were nominated for Continence Team of the year  2023 with the Nursing Times and got to final 
We were nominated for Clinical Team of the Year 2024 at our local awards