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Objective: To analyse the litigation trends and the reasons for claims within the specialty of Urology, within the UK National Health Service (NHS), over a 16‐year period. Materials and Methods: Data were requested from NHS Resolution under the Freedom of Information Act 2000. This included the total number of claims in Urology, the number of these that were successful (settled or closed), and the costs in damages paid out per financial year between 2006 and 2022. A breakdown of the successful claims by their primary cause was also collected. These were coded into the categories: 'non‐operative', 'intraoperative', 'postoperative', and 'other'. Results: A total of 4124 litigation claims were made between 2006 and 2022 and 60.9% (2511/4124) of these claims were successful. In all, £145 million (British pounds) was paid out in damages. The number of successful claims increased 2.9‐fold from the start to end of this 16‐year period, and the costs in damages paid out increased 10‐fold. Regarding primary causes for the successful claims, failure or delay in treatment (20.9%, 525/2511), failure or delay in diagnosis (14.5%, 364/2511), and intraoperative problems (9.1%, 229/2511) accounted for the highest proportion. Overall, non‐operative causes for successful claims accounted for 73.3% (1840/2511), intraoperative for 20.1% (504/2511), and postoperative for 3.9% (98/2511). Conclusions: The number of successful urological litigation claims, and their associated costs is rising. The majority are due to non‐operative causes, which may be partially explained by NHS waiting lists alongside the effects of the coronavirus disease 2019 (COVID‐19) pandemic. [ABSTRACT FROM AUTHOR]

Objectives: To present the number and outcomes of urological referrals to the General Medical Council (GMC) and provide a breakdown of the doctors' demographics. Methods: Data were requested and collected from the GMC under the Freedom of Information Act 2000 for all complaints about urologists between 2007 and 2021 (14‐year period). Results: Between 2007 and 2021 a total of 635 urologists were referred to the GMC, totalling 734 referrals (1.15 referrals/doctor). Of these, 50% (364) were closed following a provisional enquiry (PE; 1 month) and another 43% were investigated but no action was taken. Action was taken for only 7% of urologists (49); these urologists were given advice, required to do extra training, suspended from practice, or erased from the medical register. Compared to the current urology workforce, a marginally higher proportion of those referred were international medical graduates or from diverse backgrounds. Conclusion: For urologists unfairly referred to the GMC it is reassuring to know that half of cases are closed at a PE. Of those investigated, only 7% of urologists were given sactions, suspension or given extra training. Reassuringly, our data demonstrate a robust process of GMC investigation, with most doctors going back into work following suitable complaints and, over the last 14 years, only nine urologists received sanctions, two of whom were erased from the medical register. There were only marginal differences when comparing our data to the current urologist population with regard to race and location of primary medical qualification. Conversely, the male‐to‐female split was more heavily weighted towards males being referred to the GMC. [ABSTRACT FROM AUTHOR]

Objective: To look into the urology litigation trends and successful claims in the National Health Service (NHS) over the last 20 years. Methods: We requested data from NHS Resolutions to investigate current litigation numbers, costs and causes for claims. Data collected included the number of claims dating from 1996 to 2019, the total sum of damages paid out each year for urology and the causes for the claims dating from 2009 to 2019. Data from NHS Resolutions were analysed, stratified and categorized by the authors from this information, which was provided as two separate documents. Results: The total cost of damages between 1997 and 2017 was £74.5m (range: £241 325–£7.8m per year). While the number of successful claims was 1653 (range 7–168 per year), the total number of claims was 3341 (range 31–347 per year) and, over time, this has increased almost sevenfold. The cost of damages has increased roughly in line with the number of claims. Over the last 10 years, non‐operative‐related claims accounted for 984 claims, of which the largest subset was for 'the failure to diagnose and/or treat' (n = 639, 65%), with 88 (9%) successful consent‐related claims. There were 226 intra‐operative‐related claims. Of these, wrong‐site surgery, a never‐event, accounted for eight claims and there were six successful claims for failing to supervise juniors. A total of 1129 claims were postoperative claims, with retained foreign body or instrument accounting for 71 (6%) of these. Conclusions: The number and cost of litigation claims have increased year on year. There is a need for continual improvement in patient care, surgical training, counselling, informed consent and early management of complications. The evidence reviewed in this paper suggests that the best approach to this is the combination of rigid adherence to and re‐enforcement of common surgical guidelines and implementation of the national 'Getting it right first time' initiative. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the knowledge and current radiation safety practice among health care professionals undertaking fluoroscopic procedures in urology. Materials and Methods: A 14-question survey was disseminated to multidisciplinary urology theater staff. Questions included demographic data, usual radiation safety practice, and knowledge. The questions were selected based on guidelines from the International Commission of Radiological Protection and Health and Safety Executive. The survey was disseminated through regional collaborators and social media. Results: The survey received a total of 309 completed responses, including 272 from the United Kingdom. Responses from the United Kingdom multidisciplinary team included 164 (60.3%) urologic surgeons, 68 (25.0%) theater nurses, 27 (9.9%) from the anesthetic team, and 13 (4.7%) radiographers. Results from the United Kingdom demonstrated use of lead aprons and thyroid shields as 99.3% and 52.2%, respectively. Lead glasses and lead glove use were 7.4% and 0.7%, respectively. Lack of availability was cited as a reason for noncompliance with shielding guidelines in 208 (76.5%) of the respondents. No form of training in radiation safety was reported by 120 (44.1%) respondents. However, there was no association between answering knowledge questions correctly and having completed some form of radiation safety training (p = 0.41). There was an association between dosimeter use and those who had received radiation safety training (p = 0.02). Consultant urologists were also more likely to use a dosimeter than training grade urologists (p = 0.035). Conclusion: Suboptimal compliance with radiation safety guidelines is prevalent in contemporary urologic practice, and presents a significant occupational health concern. Availability of protective equipment needs to be urgently addressed. [ABSTRACT FROM AUTHOR]