We as a group (East Midlands general surgery registrars) do not think that the general surgical registrars should be providing acute urological cover at QMC due to the following reasons

1) Management, including assessment, investigation, decision making and operative competence would require an ISCP-approved Case Based Discussion at Level 4 and at least 3 PBAs from 3 different consultants at Level 4. Unfortunately, none of the current registrars on the training program fulfil this requirement and we therefore cannot, manage a condition which is outwith any of our competencies with immediate effect and any referrals hence with are to be made to the competent clinicians i-e the urologist.

2) General surgery registrars cannot be expected to manage a condition that is outwith their Specialty Advisory Committee's syllabus without the relevant competencies in dealing with acute testicular torsions.

3) It effects and puts at risk safe provision of safe and timely service for the acutely ill the general surgical patients

4) There is no responsible consultant on site for the missed diagnosis or complications which may occur during the procedure?

5) Testicular torsions from Mansfield (more than 20 miles away) can travel to NCH to be seen by urologist, but we fail to understand why testicular torsions from QMC cannot travel less than 5 miles to see the urologist (which will take less then 20 minutes for them to see specialist in the condition)?