Healthcare workers unwillingly supplying inappropriate incontinence supplies to patients, resulting in negative health effects, hospital delays, and escalating expenses for the NHS.

Healthcare workers unwillingly supplying inappropriate incontinence supplies to patients, resulting in negative health effects, hospital delays, and escalating expenses for the NHS.

The National Health Service (NHS) is grappling with significant challenges in the realm of continence care, as highlighted by a recent survey and numerous reports. The issues at hand revolve around training, product choice, and their impact on patient health and NHS budgets.

Training and Implementation Gaps

NHS England's 2018 guidance on "Excellence in Continence Care" has yet to be fully implemented as of 2025. A substantial lack of comprehensive training across healthcare professionals persists, particularly in key areas such as midwifery, dementia, cancer care, and health visiting teams. This training deficit affects the ability to provide effective continence care across all patient groups, from infancy to old age. A stronger mandate and enhanced training programs are needed to improve care quality and reduce crises such as emergency admissions related to unmanaged constipation or incontinence.

Product Choice and Access Issues

Many patients experience difficulties accessing appropriate continence products. Reports of rationing—for example, limiting to four pads per day—can lead to trauma, poverty from out-of-pocket product costs, and reduced quality of life for those dependent on continence support. Some regions have had very limited continence services until recently, exacerbating disparities in care.

Impact on Patient Health

The insufficient focus on continence care leads to avoidable complications such as severe constipation, infections, skin damage, and mental health issues related to incontinence. These problems affect millions—around 14 million people in the UK suffer from continence or incontinence issues, but the exact scale is unclear as NHS data on continence status is not routinely recorded at entry points to care. Mental health consequences and quality of life impairments are increasingly recognized as linked to poor continence care.

Financial and Budget Implications

While specific budget figures are not detailed, there is evidence of pressure on NHS resources due to crisis interventions and hospital admissions that might be prevented with better continence care in community settings. Families also face financial burdens due to the cost of continence products when services are inadequate or products are rationed. Additionally, NHS Continuing Healthcare funding frameworks support care for complex needs including continence but come with complex eligibility criteria and challenges for patients to access them fully.

Initiatives and Awareness Efforts

World Continence Week 2025 (June 16–22) highlighted themes such as shared decision-making, mental health impacts, and sustainability in continence care. Programs like the PROCON Project aim to boost innovation and training in nursing homes to improve continence care delivery.

In a report by Chris Whitehouse, a political consultant and expert on medical technology policy and regulation, the impact of poor training, management, and choice of product on patients with incontinence and NHS budgets was discussed.

Despite repeated warnings from trade associations and manufacturers, NICE has admitted that no assessments of the costs of the projects were made. The approach of the project was the antithesis of the collaborative approach to dealings with industry that NICE claims to be committed to.

Essity, a leading continence product supplier, reports that poor continence care and choice of inappropriate product can lead to patient dignity issues, unpleasant health outcomes, and increased costs in NHS staff time and resources.

Looking Ahead

The MedTech Directorate of the Department of Health and Social Care has been developing Standard Guidance on assessing "value" rather than "item price" for roll-out across the NHS in England from early 2026. However, NHS Supply Chain appears to have been developing its own rival methodology, causing confusion and concern across the MedTech sector.

As the NHS continues to grapple with these challenges, it is clear that enhanced training, better service implementation, greater product availability, and robust data collection are crucial to improving outcomes and reducing costs associated with unmanaged continence conditions.

1. The National Health Service (NHS) is currently facing complex challenges in the field of continence care, as shown by recent surveys and numerous reports.
2. In 2018, NHS England issued guidance on "Excellence in Continence Care," but it remains unimplemented as of 2025.
3. Ongoing training deficits across healthcare professionals, particularly in midwifery, dementia, cancer care, and health visiting teams, hinder effective continence care for various age groups.
4. Inadequate training impacts the quality of care and contributes to crises like emergency admissions due to unmanaged constipation or incontinence.
5. Many patients encounter difficulties accessing suitable continence products, with reports of rationing leading to trauma, financial strain, and reduced quality of life.
6. Limited continence services in certain regions exacerbate existing disparities in care and access.
7. Neglecting continence care results in unnecessary complications such as severe constipation, infections, skin damage, and mental health issues related to incontinence.
8. Around 14 million people in the UK suffer from continence or incontinence issues, yet data on continence status is not regularly recorded at care entry points.
9. Unmanaged continence conditions can lead to mental health consequences and significant quality-of-life impairments.
10. The insufficient focus on continence care places pressure on NHS resources due to hospital admissions that could potentially be prevented through better care in community settings.
11. Families burdened by the costs of continence products, particularly when services are subpar or products are rationed, face financial hardships.
12. NHS Continuing Healthcare funding frameworks support care for complex needs including continence, but accessing these resources may be challenging due to complex eligibility criteria.
13. World Continence Week 2025 emphasized topics such as shared decision-making, mental health impacts, and sustainability in continence care.
14. Programs like the PROCON Project aim to enhance innovation and training in nursing homes to boost continence care delivery.
15. According to a report by Chris Whitehouse, a political consultant and expert on medical technology policy and regulation, poor training, management, and product choice negatively affect patients with incontinence and NHS budgets.
16. Despite repeated warnings from trade associations and manufacturers, NICE has acknowledged that no cost assessments were made for ongoing projects.
17. Essity, a leading continence product supplier, states that inappropriate continence care and product selection can result in issues related to patient dignity, unfavorable health outcomes, and increased costs in NHS staff time and resources.
18. The MedTech Directorate of the Department of Health and Social Care is working on Standard Guidance for evaluating "value" instead of "item price" for NHS implementation across England starting in early 2026.
19. However, NHS Supply Chain is developing its own alternative methodology, creating confusion and concern within the MedTech sector.
20. To improve outcomes and reduce costs associated with unmanaged continence conditions, it is essential to focus on enhanced training, better service implementation, increased product availability, and accurate data collection.
21. The healthcare industry must prioritize science-based advancements and invest in medical devices, therapies, and treatments that cater to various medical conditions, including chronic diseases, respiratory conditions, digestive health, and eye health.
22. Science can also play a crucial role in addressing other health concerns, such as hearing loss, skin care, mental health, men's health, and sexual health.
23. The rise of artificial intelligence and technology has made it possible to develop breakthroughs in fitness and exercise, nutrition, aging, and women's health.
24. Autoimmune disorders, cancer, neurological disorders, and cardiovascular health are all areas where ongoing research and innovation could drastically impact treatment possibilities and patient outcomes.
25. Improved health and wellness, workplace-wellness, and lifestyle choices are considered vital for addressing the challenges posed by chronic diseases and maintaining overall well-being.
26. Healthcare providers and businesses must collaborate to address the challenges of data and cloud computing, gadgets, and cybersecurity within the industry.
27. Personal finance, banking, and insurance play crucial roles in enabling patients to access affordable treatments, therapies, and resources for managing their health conditions.
28. As we move forward, fostering a holistic approach to health, wellness, and finance—that encompasses food and drink, fashion and beauty, home and garden, travel, entertainment, relationships, pets, and parenting—is essential for creating a more sustainable and inclusive healthcare system.

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