Hampshire Hospitals NHS Foundation Trust is an NHS foundation trust providing services in Hampshire and parts of west Berkshire. It was established in January 2012 as the result of the integration of Basingstoke and North Hampshire NHS Foundation Trust and Winchester and Eastleigh Healthcare Trust. It runs Andover War Memorial Hospital, Basingstoke and North Hampshire Hospital and Royal Hampshire County Hospital. (RHCH) The Trust also runs a private hospital on the same site as BNHH - the Candover Clinic.
To develop and retrospectively validate an artificial intelligence-based decision support system (AI-DSS) for optimising prostate biopsy decisions and improving benefit-to-harm ratios. This retrospective, multicentre, multiscanner study used data from 1022 patients. An AI-DSS integrating PI-RADS scores, automated prostate-specific antigen density (PSAd), and deep-learning imaging risk scores was developed on 770 cases and validated on an independent cohort of 252 men from six UK centres. The AI-DSS performance was benchmarked against the real-world clinical decisions (reference standard) using grade selectivity, biopsy efficiency, and selective biopsy avoidance as outcome measures. Biopsy-proven detection of grade group (GG) ≥ 2 disease was the reference standard. In the validation cohort of 252 patients (mean age, 67.3 years), 137 underwent biopsy and 79 (31
BACKGROUND AND OBJECTIVE:Long-term outcome data for focal therapy using high-intensity focused ultrasound (HIFU) or cryotherapy for nonmetastatic prostate cancer are needed. We report 10-yr cancer control outcomes. METHODS:Patients with nonmetastatic prostate cancer who underwent primary focal HIFU or cryotherapy and had at least 6 mo follow-up were identified from the UK HIFU Evaluation and Assessment of Treatment (HEAT) and International Cryotherapy Evaluation (ICE) prospectively maintained registries. The intervention included up to two focal ablative sessions. The primary outcome was cancer-specific mortality. Secondary outcomes were all-cause mortality, metastasis, local retreatment, radical treatment, and androgen-deprivation therapy (ADT) use. KEY FINDINGS AND LIMITATIONS:A total of 3477 patients (HIFU: n = 2897; cryotherapy: n = 580) were included from 14 UK centres (2004-2024). A total of 48%, 23%, and 25% had European Association of Urology (EAU) 2025-version favourable intermediate-, unfavourable-intermediate-, and high-risk disease, respectively. Ten-yr cancer-specific mortality was 0.13% (95% confidence interval [CI] = 0.027-0.45%). Ten-yr all-cause mortality and metastases were 12% (95% CI = 8.8-15%) and 3.3% (95% CI = 2.1-4.9%), respectively. Ten-yr ADT use was 14% (95% CI = 11-17%). Ten-yr local retreatment and radical treatment were 33% (95% CI = 30-37%) and 30% (95% CI = 27-34%), respectively, on an intention-to-treat basis. In a post hoc per-protocol analysis, undertaken to estimate outcomes under stricter adherence to the two focal ablative session protocol, patients who underwent radical treatment despite being potentially eligible for a further focal ablative session were censored at the time of radical treatment; 10-yr local retreatment and radical treatment were 13% (95% CI = 11-16%) and 8.9% (95% CI = 6.9-11%), respectively. The observational study design is the main limitation. CONCLUSIONS AND CLINICAL IMPLICATIONS:Focal therapy using up to two sessions of focal HIFU or cryotherapy could be considered as a first-line treatment for well-selected patients of nonmetastatic prostate cancer alongside radical treatment. Future research priorities should include the development of a dedicated prognostic risk calculator, further prospective assessment of focal therapy for high-risk disease, and improvements in the detection and management of locally recurrent disease.
Job planning is a mandatory part of the national terms and conditions for National Health Service (NHS) consultants. Gastroenterology and hepatology services are experiencing increasing demand, workforce pressures and evolving models of care. This document aims to provide detailed guidance for consultant gastroenterologist job planning aligned with national standards and current NHS service requirements. Guidance was developed by the British Society of Gastroenterology Job Planning Advisory Group, informed by national policy, Royal College of Physicians recommendations and expert consensus. Key areas addressed include direct clinical care, supporting professional activities, outpatient services, endoscopy, inpatient care, emergency and on-call commitments and single point of access services. Recommendations are provided to support equitable and sustainable job planning. In conclusion effective job planning is essential to deliver safe, high-quality patient care while supporting workforce sustainability. A structured, transparent and collaborative approach is required.
Background:Antimicrobial susceptibility tests (AST) are vital to guide antibiotic selection to treat bacterial infections, including urinary tract infections (UTI). Current laboratory AST takes at least 2 days. Direct testing of urine samples could speed up testing, with rapid reporting aiding timely treatment. Method:A scoping review was conducted to identify studies assessing the accuracy of direct-from-urine AST, and map the breadth of evidence. Studies that measured overall categorical agreement (CA) compared to a reference method were selected, and the reported accuracy, the type of AST method and study methodology assessed. Results:In total, 33 studies were identified that met the inclusion criteria (1976-2024). These reported overall CA for direct-from-urine AST ranging from 78.7% to 100% compared to a reference method. These studies varied in the AST method used; in urine sample collection, origin and processing; in the antibiotics evaluated; in study design and data analysis. The most common AST method evaluated was direct-from-urine disc diffusion. Most studies reported accuracy only for samples containing a single Gram-negative organism. Conclusion:Although increasing numbers of studies report the accuracy of direct-from-urine AST, heterogeneity prevented systematic comparison of methods or detailed meta-analysis. Many studies reported overall accuracy >90% CA for urine samples containing a single Gram-negative organism across several direct-from-urine AST methods, offering potential time saving compared with current methods. However, as single organism samples represent only a subset of urines taken from UTI patients, additional studies-that include analysis of samples containing mixed cultures and Gram-positive isolates-are still required.
Many European surgeons lack access to high-volume trauma training. A Trauma Traveling Fellowship, supported by the European Society of Trauma and Emergency Surgery (ESTES), could broaden educational and clinical exposure to trauma care, but feasibility and implementation factors are unclear. The aims of this survey are to assess the aspirations, expectations, and perceived challenges of prospective fellows and host centres for an ESTES Trauma Traveling Fellowship. A cross-sectional, web-based survey was distributed to all ESTES members, capturing demographics, fellowship aspirations, perceived barriers, and host centre capacities. The survey incorporated Likert scales, free-text responses, and was guided by the Consolidated Framework for Implementation Research (CFIR) and the Reach, Effectiveness, Adoption, Implementation, and Maintenance / Practical Robust Implementation and Sustainability Model (RE-AIM/PRISM). Of 903 invited, 210 responses (23.3
