Vasectomy Services Cardiff and Vale

provision of a community based Vasectomy Service to patients registered in a General Practice in Cardiff and the Vale of Glamorgan.

The service to be commissioned is for a total of 3 years with an option to extend for a further one year with an activity level of approximately 450 completed procedures per annum. The service must be inclusive of the following:

Post referral management

Pre operative counselling

Patient information

Consent

Sterilisation

Semen testing

Andrology service

Record keeping

Communication

Audit

Clinical governance

Complaints management

In delivering the above service elements the following criteria must be met:

In line with the Locality model of joint service planning, it is required that the Provider is able to consider delivery of clinical services from appropriate premises in each of the Localities - South and East Cardiff, North and West Cardiff and the Vale of Glamorgan Locality.

The patient should be allocated to the operating clinician whose premises are geographically closest to the patient’s postcode unless the patient agrees otherwise.

Within 2 weeks of receipt of referral the provider must write to the patient to confirm who they have been referred to and provide appropriate contact details for them to make an appointment for counselling.

The provider must ensure counselling is arranged to take place within 2 to 6 weeks of referral, subject to patient choice. If the operating clinician is unable to

If the patient is deemed to be not suitable for surgery under a local anaesthetic or for another reason is deemed as requiring treatment within secondary care, the Provider is required to make suitable arrangements for referral to Cardiff and Vale Heath Board to ensure they are placed on the waiting list fairly.

The provider must ensure the patient is competent to make a choice and there is a robust and documented consent process.

There must be a minimum wait of two weeks following counselling to allow the patient to reconsider.

Subject to agreement by the patient to proceed, the waiting time for the procedure to take place should not exceed 6 weeks from counselling.

A robust system should be put in place to reduce DNAs for all appointments in the process.

Routine histological examination of the excised portions of vas deference is not required, unless deemed clinically necessary.

Post-vasectomy semen samples should be taken by the patient to the approved testing laboratory which should be a reasonable distance from the patient’s home (preferably within Cardiff and the Vale of Glamorgan). Patients should be requested to submit 1 sample at 12 week post surgery. A routine second PVSA is not required if azoospermia is found in the first sample. A second PVSA should be undertaken in offer counselling within the timeframe the patient should be offered a referral to a surgeon with shorter waiting times.

If waiting standards cannot be met following counselling the patient should be offered a referral to an operating clinician with a shorter waiting time.

cases where azoospermia has not been achieved.

If no sample is received from the Patient with 16 weeks of the procedure the provider is required to have a process in place for reminding the patient.

The provider should have a system in place for -referral for advanced semen testing if needed.

Should histology indicate the tissue sample to be other than Vas Deferens the patient will be contacted to arrange appropriate course of action.

Provider must undertake effective succession planning/business continuity to ensure ongoing delivery of the service.