Quality statement 3: Referring men with upper urinary tract infections

Quality statement

Men who have symptoms of an upper urinary tract infection are referred for urological investigation.

Rationale

Upper urinary tract infections can indicate the presence of lower urinary tract abnormalities. It is important that men with symptoms of an upper urinary tract infection have urological investigations to ensure that any possible abnormalities are diagnosed and treated.

Quality measures

Structure

Evidence of local arrangements to ensure that men with symptoms of an upper urinary tract infection are referred for urological investigations.

Data source: Local data collection.

Process

Proportion of episodes of suspected upper urinary tract infection in men that are referred for urological investigations.

Numerator – the number in the denominator referred for urological investigations.

Denominator – the number of episodes of suspected upper urinary tract infection in men.

Data source: Local data collection.

What the quality statement means for service providers, healthcare professionals and commissioners

Service providers (such as hospitals, community services and GPs) ensure that they have processes in place so that men with symptoms of an upper urinary tract infection are referred for urological investigation.

Health and social care practitioners ensure that they are aware of local referral pathways for urological investigations so that men with symptoms of an upper urinary tract infection can be referred for urological investigation.

Commissioners (such as clinical commissioning groups and NHS England area teams) should seek evidence of practice from providers that men with symptoms of an upper urinary tract infection are referred for urological investigation. This can be achieved through carrying out local audits.

What the quality statement means for patients, service users and carers

Men with symptoms of an upper urinary tract infection are referred to a specialist for urological tests.

Source guidance

Definitions of terms used in this quality statement

Upper urinary tract infection

Characterised by evidence of urinary tract infection with symptoms suggestive of pyelonephritis (loin pain, flank tenderness, fever, rigors or other manifestations of systemic inflammatory response (Management of suspected bacterial urinary tract infection in adults. Scottish Intercollegiate Guidelines Network [2012]).

Urological investigations

These include urodynamic techniques such as pressure/flow cystography to detect lower urinary tract abnormalities (Management of suspected bacterial urinary tract infection in adults. Scottish Intercollegiate Guidelines Network [2012], recommendation 5.3).