The Third Version of the Best Practice Guide (2018/19) has been developed as a tool for commissioners, continence leads and those involved with the care pathway for patients with continence problems.
The Guides aims to transform continence care through sharing best practice. It provides a constructive platform for decision makers across the NHS, government and political parties to ensure the goal of a better system of continence care becomes a reality.
How the Guide was produced
The 2015 Original Guide began with a round table discussion of parliamentarians, nurses, patients, and healthcare professionals and focused on the areas that most needed change. The Committee sent a ‘Call for Evidence’ to every continence advisor and commissioner across the country asking for input. The response we received was fantastic and helped form the original Guide. The original Guide was launched in November 2015 and has been the centre piece for the Committee’s work moving forward.
In the 12 months that followed, we have worked hard to promote the Guide to CCGs, Trusts, vanguard sites, parliamentarians and to the third sector. Then, in October 2016, the Committee launched an Updated version of the Best Practice Guide which includes more examples of best practice in continence care. We have also worked to produce a Welsh specific version of the Guide which was launched in the Senedd on November 3rd. The Committee has been delighted with the uptake of recommendations produced within this Guide and continues to work to grow this positive response.
In 2018, the UACC decided it was time to update the Guide again to ensure it remains a hub of best practice and practical information. We believe the Guide should be a “live” document which should constantly be updated to reflect the best practice that is happening across the UK. The updated version includes up-to-date case studies and service information, as well as the most relevant recommendations. The Guide is still very much a tool for promoting best practice in continence care and ensuring that all patients are able to access high quality care.
Recommendations of 2018/19 Updated Guide
The following recommendations have been made to improve patient outcomes, and we are continuously working to ensure these are adopted and utilised:
A national public health campaign promoting bladder health should be initiated and there needs to be overall better signposting of information for patients.
GPs should be comfortable asking questions to patients presenting with symptoms of urinary incontinence and should instigate a patient management plan. As a part of this, they should use a standardised pathway for care to rule of ‘red flags’.
There should be a financial incentive to diagnose incontinence issues in patients and instigate a patient management plan, such as a Quality Outcomes Framework (QOF).
Bladder ultrasound scanning should be used as the first choice to help a healthcare professional make an informed decision about the clinical management of a patient presenting with urinary bladder complications. A business case for scanners can be downloaded from the Online Toolkit.
Intermittent catheterisation (IC) should be the method of choice to drain retained urine wherever feasible.
All relevant healthcare environments should invest in appropriate staff training in catheterisation, which could include e-learning.
All Trusts should promote the use of catheter passports. A template catheter passport can be downloaded from the Online Toolkit.
Every Trust should have one named person responsible for continence. This continence lead should be responsible for promoting education and training.
GPs should receive training on the different continence products available and/or refer to community continence teams where the specialist knowledge is based.
Patient management systems should be used to improve prescribing, patient care and quality of life whilst reducing cost.