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Continence nurse blog: Integrated care pathways

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Continence expert and Nursing Times blogger Frank Booth on why no continence specialist nurse can afford to ignore integrated care pathways

Integrated Care Pathways for anything will soon become a way of life. All services will work to them through guidelines, policies and protocols to enhance the care. In fact there is a conference in Manchester and for NHS staff it’s only£400+VAT per person for one day. At that price, it should be good.

Lord Darzi wrote in the final report on the NHS Review that ‘...change is most effective not only when it responds clearly to patients needs but also when it is driven by clinicians based on their expert knowledge of conditions and care pathways...’.

So it seems that care pathways have a respectable pedigree, but are they new?

For continence services, it certainly is not. We know that either ‘care pathways’ or ‘integrated’ appears not less than eight times in Good practice in continence services (DH 2000). It was pronounced as the way forward for continence services nine years ago.

The guidance says that 3.13 residents of each health authority should have access to integrated continence services, managed by a director of continence services who would usually be a specialist continence nurse or physiotherapist responsible for:

  • overseeing and co-ordinating the development and implementation of common policies, procedures and protocols;

  • developing and maintaining care pathways to and from primary care and specialist services;

  • ensuring users and carers are involved in all aspects of the service;

  • ensuring services are made available to all the residents in the area served;

  • working closely with other services such as social services, education services and psychological services;

  • ensuring services are made available to all patients in hospital who require them;

  • co-ordinating educational activities for continence specialists, primary health care teams and others involved in the delivery of health and social care;

  • organising service-wide review, audit and research activities particularly to ensure national targets are met;

  • promoting awareness of incontinence.

When I Googled care pathways I got 2,500,000 hits.So it really is important.

The National Electronic Library for Health contains much of the information you need but how complicated care pathways.

Taken at the most basic level and stripping away the frippery and fancy dressing up that so many things seem to be packaged in today, care pathways are quite simple.

Lord Darzi has said it all in his comment that, ‘... change is most effective not only when it responds clearly to patients needs but also when it is driven by clinicians based on their expert knowledge of conditions and care pathways...’

So specialist clinicians, continence advisors, matrons, nurse consultants or whatever name your role carries, take these words to heart: You are important. You are the experts, and you understand care pathways. Don't you?

I sincerely hope you answer yes, because they have been around for years now and many of us got heavily involved in pathways years ago.

I only hope that your managers have read Lord Darzi’s comments and report. If they haven’t, have you? Have you told them about what he said and what it means to your service? Don’t expect your managers to do it all, get in there and tell them?

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