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PRACTICE COMMENT

'We must make commissioners realise continence care is vital'

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Janice Reid explains why it is so important that people with continence problems have access to the care and support they need, and why continence needs to be moved up in the political agenda

Recent figures estimate that around 14 million people living in the UK are affected by bladder dysfunction, with a further six million reported as having difficulty with bowel control. The impact of incontinence on quality of life for individuals across the lifespan, including physical and emotional health, is well recognised. Despite evidence confirming that high-quality continence services are an essential part of healthcare, there are significant variations in service provision across the UK and inequality of care experienced by patients. This can only improve if the profile of continence continues to be moved up the political agenda.

Incontinence has gained greater recognition in the UK healthcare agenda in recent years but increasing competition for scarce resources, together with reorganisation of services and commissioning processes, means persistent efforts are required to maintain and increase the level of awareness and support. Incontinence will continue to present a major challenge to individuals, commissioners and providers of health and social care now and for the foreseeable future.

The cost of continence care is undoubtedly high, be it measured in healthcare or financial terms. If specialist services are to cater to the needs of all people with continence problems, there is a resource problem - particularly in light of current financial pressure, which has resulted in a withdrawal of continence services in some areas of the country. This was a hot topic of conversation at a recent conference where the role of the specialist nurse in continence care was debated. It was clear we can no longer rest on our laurels but must capitalise on the best-practice evidence available to support our unique role and prove to commissioners we can deliver high-quality and cost-effective continence care.

By developing structured patient assessment and clinical management plans, ensuring the optimal use of available resources and having a sound awareness of government policies, continence nurse specialists are well placed to enhance and streamline care. Working in partnership with multi-professional colleagues, patients and their families, while having the knowledge and skills to critically appraise evidence and guidelines, will also ensure best practice in the management of continence problems.

The Association for Continence Advice has maintained its position as the only organisation aimed at supporting multidisciplinary professionals in their work with continence. It plays a crucial role in leading professional development and skill sharing through the work of local branches and regional and national study days.

Along with other interested parties, the ACA has been involved in the All Party Parliamentary Group for Continence Care, working to raise the profile of this area of healthcare within government. It is vital that people with continence problems have access to the appropriate care and support so they can be treated and managed effectively and with dignity.

Janice Reid is chair of the Association for Continence Advice.

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  • 2 Comments

Readers' comments (2)

  • Today, outside my local shopping centre, I met a lady who uses a walking trolley with a seat because of weak knees and a replacement hip. She asked me for help to untie a knot in a plastic bag with sweets. She has severe tremor in both hands as soon as she tries to hold anything.
    This lady lives on her own and has frequent, isolated needs for assistance - buttons and poppers, breaking raw eggs, opening her post. She is desperate to hold on to her independence and avoid going into a care home. She knows what domiciliary help is available and is near to asking for some. Her main terror is of incontinence - of having a schedule of care to which her body does not conform and of being left, wet and or soiled.
    Control of our bowels and bladders, and of our cleanliness, is central to our sense of self, of dignity. It is not just continence care, but the preparation of people for the need for continence care that needs to be addressed.

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  • michael stone

    It is easy to see how this really 'damages' a person's 'quality of life', but because it isn't 'life-threatening', it would tend to get pushed to the back of the queue, during budget allocations.

    And I dare say that the people who suffer from these problems, are not too likely to be 'shouting about it' either: so it won't be a 'high profile' issue, unlike some other health problems.

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