Asked by: Andrew Mitchell (Conservative - Sutton Coldfield)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps he is taking to support people with bladder and bowel control conditions in Sutton Coldfield constituency.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
An Adult Bladder and Bowel (Continence) service is delivered via Birmingham Community Healthcare NHS Foundation Trust (BCHC) offering appointments for all residents in Birmingham, including in Sutton Coldfield, with a clinic facility in North Locality based at Sutton Cottage Hospital. The service offers face-to-face and virtual consultations and supports the community nursing service with patients who meet the housebound criteria with complex needs around continence management, catheter care or bowel management.
The service treats adults who are experiencing bladder problems or bowel dysfunction, with all patients receiving a high-quality clinical assessment and personalised care plan in line with best practice, and national driven guidance.
There are a range of investigations, including vaginal pelvic floor assessment, bladder ultra-sound scan or rectal examination, that are available through the service that helps to determine the best course of treatment, based on individual patient needs. Treatment may include lifestyle advice or interventions, pelvic floor exercises, bladder re-training, medication, specialist care or signposting to other appropriate services. The service also offers specialist clinics for young adults aged between 18 and 19 years old transitioning from Children's Services working in partnership BCHC’s Children's and Families Division. The service can be accessed by referral via a patient’s general practitioner (GP).
Housebound patients, including patients with psychological illness which prevent them from accessing a clinic, or following a treatment programme, will initially need to be referred to a Community Nursing service for assessment and treatment by the patient’s GP.
BCHC is currently scoping the use of containment products and ensuring they align with National Institute for Health and Care Excellence guidance recommendations. A consultation and engagement plan, quality impact and equality, human rights assessment will underpin any decisions on the future model.
The average patient waiting times for clinic appointments at Sutton Cottage is 10 weeks, but urgent referrals can be seen within two weeks.
GPs also can access secondary care specialist advice and e-refer a patient to University Hospitals Birmingham NHS Foundation Trust’s (UHB) specialist clinics for adults with incontinence, overactive bladder, stress urinary incontinence, or bladder pain.
As part of the system’s work to transform and standardise care, between October 2026 and March 2027, GPs across Birmingham and Solihull will start to have access to digital tools for clinical decision making and case management via online consulting rooms with UHB urology specialists to speed up and improve access in health and care.
Asked by: Andrew Snowden (Conservative - Fylde)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps he is taking to support people with bladder and bowel control conditions in (a) Fylde and (b) Lancashire.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
Lancashire and South Cumbria (LSC) Integrated Care Board (ICB) commissions several community bladder and bowel/continence services across Fylde and Lancashire. These services consist of specialist nurses and allied health professionals, who work collaboratively with primary care, secondary care and wider community nursing services to ensure there is comprehensive support and end to end treatment pathways for residents of Lancashire and South Cumbria.
Bladder and bowel services provide a holistic continence assessment, including routine observations, bladder scans and skin integrity checks, as well as reviewing past medical history, medication, mobility, carer support, and diet and fluid. They offer ongoing support and products for any bowel and/or bladder issues that are identified and may refer patients to specialist nurses for further support or district nurses for ongoing care. Self-care advice is always given, and independence is promoted during assessments, such as pelvic floor exercises for stress urinary incontinence, or bladder training and fluid intake advice for overactive bladder.
LSC ICB has a dedicated programme of work supporting the transformation of core community services in line with the Government’s 10-Year Health Plan, and bladder and bowel services are considered as part of the community transformation programme ensuring all residents of Lancashire and South Cumbria have access to evidence-based bladder and bowel care when and where they need it.
The community services are aligned to acute National Health Service trusts. Where there needs to be surgical management or specialist input, this is generally presented through a routine referral to urology, gynaecology or gastroenterology services. All localities across LSC ICB provide these services. LSC ICB is continually reviewing and working towards transformation of clinical pathways and services to manage demand as closer to home as possible via specialist multi-disciplinary teams within the community.
Across LSC ICB, there is also a urogynaecology programme that is developing the front-end of the gynaecology pathway for access to specialist women’s health physiotherapists rather than referrals direct to secondary care gynaecology services. This aims to reduce pressure in gynaecology services and to provide specialist assessments and treatments with reduced waiting times for patients.
Asked by: Andrew Rosindell (Reform UK - Romford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps he has taken to improve incontinence care provided by the NHS.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
Millions of men, women, young people, and children of all ages are living with bowel and bladder problems. All continence problems can be debilitating and life changing. They affect a wide range of care groups and can be a particular concern for the ageing population.
The National Institute for Health and Care Excellence (NICE) has published five guidelines on the management of urinary and faecal incontinence to date. These guidelines cover the management of urinary incontinence in people with neurological disease, the prevention and management of pelvic floor dysfunction, and pelvic organ prolapse in women. NICE has also published a further 14 products in relation to urinary incontinence and 12 in relation to faecal incontinence.
The Department has also commissioned NICE to produce late-stage assessment guidance on one-piece closed bags for colostomies and intermittent urethral catheters for chronic incomplete bladder emptying in adults. These late-stage assessments gather the views of clinical experts and patients to help NICE assess and compare the value of products in widespread use across the National Health Service.
The NHS must also have regard to the Excellence in Continence Care guidance, published in 2018. This provides advice for commissioners, providers, and healthcare staff on understanding and addressing continence needs within their local population. This guidance is supported by British Society of Urogynaecology. Further information on the Excellence in Continence Care guidance is available at the following link:
https://www.england.nhs.uk/publication/excellence-in-continence-care/
NHS England has also produced Safer Bowel Care for Patients at Risk of Autonomic Dysreflexia, a serious medical emergency that can occur in people with spinal cord injuries, which offers resources to support safer bowel care practice and highlights the importance of implementing the Excellence in Continence Care framework.
In addition to national guidance, the Nursing and Midwifery Council (NMC) has professional standards relating to bladder and bowel nursing care. The NMC Code places strong emphasis on the principle of “Prioritising People”, which sets out the expectation that registrants should always respond to individual patient needs.
NHS England is also developing a best practice catheter care pathway across all settings to be completed by the end of this year.
Our focus on the shift from hospital to community will help to drive more joint working in neighborhoods between primary care, pharmacies, community health care, and social care, to help people to manage incontinence at home, by giving them access to the right self-care, the right professional support, so they aren’t passed from service to service, and reducing their need for emergency admissions to hospital.
Asked by: Martin Wrigley (Liberal Democrat - Newton Abbot)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps he is taking to support people with bladder and bowel control conditions in Devon.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
All providers in Devon are asked to follow the formulary within the services they provide. The formulary provides information on continence care, with further information available at the following two links:
https://southwest.devonformularyguidance.nhs.uk/formulary/chapters/18-continence
https://northeast.devonformularyguidance.nhs.uk/formulary/chapters/18-continence
As part of focused work in gynaecology, NHS Devon is in a project development phase to design and implement improved pathways for women with stress urinary incontinence and overactive bladder conditions.
Livewell Southwest provides a continence service, offering assessments to adults, those aged 17.5 years old and above, living in Plymouth, West Devon, and South Hams. Livewell provides a holistic continence assessment, including routine observations, bladder scans, and skin integrity checks, as well as reviewing past medical history, medication, mobility, carer support, and diet and fluid. They offer ongoing support and products for any bowel and/or bladder issues that are identified and may refer patients to specialist nurses for further support or district nurses for ongoing care.
Conservative advice is always given as first line management options during assessments, such as pelvic floor exercises for stress urinary incontinence, or bladder training and fluid intake advice for an overactive bladder. Livewell also liaises with general practices to request medication and to request ongoing referrals to secondary care specialists if needed. Livewell works closely with the other community teams. All patients are offered an annual reassessment.
For children and young people, there is a team of specialist children’s nurses and specialist nursery nurses who provide assessment, treatment, support, and advice for children and young people with bladder and/or bowel difficulties. They provide continence promotion, and healthy bladder and bowel advice for children with additional needs. They see and assess children who are eligible for continence products because of a learning or physical disability.
Devon has commissioned a paediatric integrated community nurse led bladder and bowel service for children and young people up to the age of 19 years old, to improve quality of life, to support effective self-management where appropriate, and to prevent chronic conditions developing and needing treatment or surgery in secondary care where possible.
Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of reporting by the i Paper on 14 December 2024 that 53 per cent of NHS trusts providing continence care cap the number of continence products which they provide to patients on a daily basis, rather than on the basis of need; and what steps they intend to take in response.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Patients deserve the very best health and care, and by developing a 10-Year Health Plan, we will deliver the three shifts needed to get the health service and the nation’s health thriving once again. We are committed to ensuring that the National Health Service is managed in a way that prioritises patient care and which delivers the best possible outcomes.
NHS England published Excellence in Continence Care, a copy of which is attached, on 23 July 2018, bringing together evidence-based resources and research for guidance for commissioners, providers, and health and social care staff. This guidance covers both urinary and bowel, also known as faecal, incontinence. The guidance states that “…pathways of care should be commissioned that ensure early assessment, effective management of incontinence, along with other bladder and bowel problems such as constipation and urinary tract infections and their impact on social, physical and mental well-being”. NHS England will consider the next steps for Excellence in Continence Care.
The National Institute of Health and Care Excellence has produced guidance on the management of faecal incontinence in adults, which healthcare professionals and commissioners are expected to take fully into account when delivering services for people with bowel incontinence. The guidance aims to improve the physical and mental health and quality of life of people with faecal incontinence.
Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what practical steps are being taken to help raise awareness of (1) patient dignity, and (2) patient choice, in continence care.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Patients deserve the very best health and care, and by developing a 10-Year Health Plan, we will deliver the three shifts needed to get the health service and the nation’s health thriving once again. We are committed to ensuring that the National Health Service is managed in a way that prioritises patient care and which delivers the best possible outcomes.
NHS England published Excellence in Continence Care, a copy of which is attached, on 23 July 2018, bringing together evidence-based resources and research for guidance for commissioners, providers, and health and social care staff. This guidance covers both urinary and bowel, also known as faecal, incontinence. The guidance states that “…pathways of care should be commissioned that ensure early assessment, effective management of incontinence, along with other bladder and bowel problems such as constipation and urinary tract infections and their impact on social, physical and mental well-being”. NHS England will consider the next steps for Excellence in Continence Care.
The National Institute of Health and Care Excellence has produced guidance on the management of faecal incontinence in adults, which healthcare professionals and commissioners are expected to take fully into account when delivering services for people with bowel incontinence. The guidance aims to improve the physical and mental health and quality of life of people with faecal incontinence.
Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the merits of prioritising patient dignity and choice in continence care as part of the 10 Year Health Plan.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Patients deserve the very best health and care, and by developing a 10-Year Health Plan, we will deliver the three shifts needed to get the health service and the nation’s health thriving once again. We are committed to ensuring that the National Health Service is managed in a way that prioritises patient care and which delivers the best possible outcomes.
NHS England published Excellence in Continence Care, a copy of which is attached, on 23 July 2018, bringing together evidence-based resources and research for guidance for commissioners, providers, and health and social care staff. This guidance covers both urinary and bowel, also known as faecal, incontinence. The guidance states that “…pathways of care should be commissioned that ensure early assessment, effective management of incontinence, along with other bladder and bowel problems such as constipation and urinary tract infections and their impact on social, physical and mental well-being”. NHS England will consider the next steps for Excellence in Continence Care.
The National Institute of Health and Care Excellence has produced guidance on the management of faecal incontinence in adults, which healthcare professionals and commissioners are expected to take fully into account when delivering services for people with bowel incontinence. The guidance aims to improve the physical and mental health and quality of life of people with faecal incontinence.
Asked by: Rachel Blake (Labour (Co-op) - Cities of London and Westminster)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps her Department is taking to improve paediatric continence services for disabled children.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government is committed to raising the healthiest generation of children ever. This involves ensuring that children receive the appropriate care and support whenever they need it.
NHS England published Excellence in Continence Care on 23 July 2018, bringing together evidence-based resources and research for guidance for commissioners, providers, and health and social care staff. This guidance covers both urinary and bowel, also known as faecal, incontinence, and is available at the following link:
https://www.england.nhs.uk/publication/excellence-in-continence-care/
In 2023, NHS England published the guidance, National clinical constipation pathway for primary care for children, for clinicians for the prevention and management of constipation in children and young people. This work involved developing the national constipation pathway alongside ERIC, The Children’s Bowel and Bladder Charity, with the final guidance available at the following link:
To make children’s services better, we are changing the National Health Service through our 10-Year Health Plan to make it fit for the future. The plan will be published in June.
Asked by: Blair McDougall (Labour - East Renfrewshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment he has made of the adequacy of (a) information and (b) support available to men living with incontinence.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
No such assessment has been made. NHS England published Excellence in Continence Care on 23 July 2018, bringing together evidence-based resources and research for guidance for commissioners, providers, and health and social care staff. This guidance covers both urinary and bowel, also known as faecal, incontinence. The guidance states that “pathways of care should be commissioned that ensure early assessment, effective management of incontinence, along with other bladder and bowel problems such as constipation and urinary tract infections and their impact on social, physical and mental well-being.” NHS England will consider the next steps for Excellence in Continence Care, which is available at the following link:
https://www.england.nhs.uk/publication/excellence-in-continence-care/
The National Institute of Health and Care Excellence has produced guidance on the management of faecal incontinence in adults, which healthcare professionals and commissioners are expected to take fully into account when delivering services for people with bowel incontinence. The guidance aims to improve the physical and mental health and quality of life of people with faecal incontinence.
Asked by: Blair McDougall (Labour - East Renfrewshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment he has made of the impact of urinary incontinence on men’s (a) physical and (b) mental health.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
No such assessment has been made. NHS England published Excellence in Continence Care on 23 July 2018, bringing together evidence-based resources and research for guidance for commissioners, providers, and health and social care staff. This guidance covers both urinary and bowel, also known as faecal, incontinence. The guidance states that “pathways of care should be commissioned that ensure early assessment, effective management of incontinence, along with other bladder and bowel problems such as constipation and urinary tract infections and their impact on social, physical and mental well-being.” NHS England will consider the next steps for Excellence in Continence Care, which is available at the following link:
https://www.england.nhs.uk/publication/excellence-in-continence-care/
The National Institute of Health and Care Excellence has produced guidance on the management of faecal incontinence in adults, which healthcare professionals and commissioners are expected to take fully into account when delivering services for people with bowel incontinence. The guidance aims to improve the physical and mental health and quality of life of people with faecal incontinence.