British Association endorses EAU Guidelines at BAUS 2015

Tue, 14 Jul 2015 • Loek Keizer

The British Association of Urological Surgeons has joined the long list of national societies who officially endorse the EAU’s Guidelines. The cooperation was finalised at BAUS 2015, the Association’s annual meeting, which was held in Manchester on 15-18 June.

“The EAU has a fantastic set of Guidelines, written by expert groups. Without a shadow of a doubt, these are the guidelines we tell our trainees to read,” Mr. Mark Speakman, BAUS President said of the endorsement. “The EAU Guidelines address day-to-day, real-life practice, and they have great breadth in terms of subject matter.”

Mr. Duncan Summerton, BAUS Hon Secretary also emphasised the EAU Guidelines’ “best clinical practice” credentials as a strength. The Guidelines were already commonly used in the United Kingdom, and endorsement largely means formalising this arrangement. BAUS is hoping to write supplementary papers to the Guidelines that will factor in the particularities of the British context.

EAU Guidelines Office Chairman Prof. James N’Dow, hailed the endorsement: “The EAU Guidelines Office is very pleased to have BAUS endorse the EAU Guidelines. British Urologists make up a large proportion of our EAU Guideline Panel membership and the vast majority of British urology residents use the Guidelines throughout their training and for their exit exams; and so this endorsement makes a lot of sense.”

“That said, we could not have achieved this major milestone without the support, leadership and commitment of a number of incredible people including Mr. Speakman, Mr. Summerton, Kieran O’Flynn, EAU Secretary General Chris Chapple and many others.”

The EAU Guidelines and BAUS

Speakman and Summerton are both clear about the practical value of the EAU Guidelines. However, in a country with a public health system and established guidelines (National Institute for Health and Care Excellence or NICE), some further work is required for a complete endorsement. This would not take the form of adapting or rewriting, but rather providing a supplementary “commentary” on the UK situation.

Speakman: “We are hoping to write some articles to engender enthusiasm among British urologists for using the EAU Guidelines. The articles can compare and contrast, show how they fit into British practice, how we can take them forward.”

Summerton: “the EAU Guidelines represent the best clinical practice. In a public health system such as ours, health economies are also an important factor. When we publish articles that address the EAU Guidelines for a British crowd, we need to include a nod to health economics, and some other slight differences of the British urological landscape. Treatment of infertility, for example, differs somewhat from the EAU’s approach. In the UK a lot of infertility practice has gone to gynaecology.”

Speakman: “We will not be telling our members to ignore NICE, but to use the EAU Guidelines. We would like to see joint EAU-BAUS-badged versions.”

With regards to the timing of this BAUS-EAU cooperation, both Speakman and Summerton joke about British stubborn insularism. “It would be nice to say that we’re only endorsing these guidelines now because we are thorough! Over time it’s dawned on us that we don’t need to reinvent the wheel. A good group, featuring several prominent British urologists has done the work, analysis and produced outstanding guidelines.”

Mr. Summerton also mentioned the pre-existing NICE guidelines as a contributing factor to a relatively late adoption of the EAU’s Guidelines, citing the need to find a way to combine or ratify the two.

BAUS 2015

The 71st annual scientific meeting of BAUS attracted 1,200 delegates, a figure the organisers were extremely pleased with. Mr. Speakman pointed out an evolution in the scientific programme of the meeting over the past few years, settling on the current four-day arrangement.

The first day was reserved for three simultaneous section meetings, addressing Academic Urology, Andrology and Genito-Urethral Surgery, and Female, Neurological and Urodynamic Urology, respectively. Other well-attended sessions in the regular scientific programme were the “as live” surgery sessions, and topics like antimicrobial resistance and urinary tract infections drew large crowds.

The scientific programme featured several contributions from EAU Board Members, with Prof. Hein Van Poppel speaking on hormone-refractory prostate cancer, and Prof. Francesco Montorsi presenting ten-year follow up on sex and the heart. In addition to chairing a session together with Prof. Montorsi, Prof. Chapple presented on female mid-urethral tapes, and Prof. James N’Dow spoke on the usage of evidence-based medicine.

While the scientific programme included international speakers, BAUS 2015 was chiefly a British meeting, catering to the UK’s 1000 registered urologists. One session in particular illustrated the unique situation of urologists in the UK and its National Health System. A session was held about the clinical and commissioning priorities of robotic surgery in the UK.

Mr. Speakman neatly summarises the situation: “Costs of robotic units are high, and implementation has not been systematic, but the result of chief executives pooling money. As it stands, we have 50 units in England, one in Wales, and none in Scotland. The debate then follows whether it’s inefficient to have a concentration of robots in one area, or if it’s better to have specialised centres.”

Collaborating with the EAU

On the topic of broader EAU-BAUS collaboration, both BAUS trustees mention the recent change in EAU leadership. Mr. Summerton points to Prof. Chris Chapple, EAU Secretary General since March 2015, as being keen to bring British endorsement to the EAU Guidelines.

Mr. Speakman was complimentary of Prof. Chapple’s predecessor, Prof. Per-Anders Abrahamsson. “EAU-BAUS cooperation is getting better and better. Per-Anders did a fantastic job, and he was a true diplomat who travelled the world, meeting other organisations. Chris Chapple was handed a playing field that was sorted out, stable and ready to go forward. I’ve known Chris for 25 years, and it will be a pleasure to keep working with him!”