The Updated Guide 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 initial uptake of recommendations produced within the Guide and looks to continue and grow this positive response.

Recommendations of 2016 Updated Guide

The following recommendations have been made to improve patient outcomes, and we are continuously working to ensure these are adopted and utilised:

1)    GPs should be comfortable asking questions to patients presenting with symptoms of incontinence.  
2)    The Quality Outcomes Framework (QOF) should include a financial incentive to diagnose incontinence issues in patients and instigate a patient management plan. 
3)    A national awareness campaign on incontinence should be initiated and there needs to be overall better signposting of information for patients.  
4)    Bladder ultrasound scanning can be used to help a healthcare professional make an informed decision about the clinical management of patients presenting with urinary bladder complications.
5)    Intermittent catheterisation (IC) should be the method of choice to drain retained urine wherever feasible. 
6)    Hospital Trusts should invest in appropriate staff training in catheterisation.
7)    Every Trust should have one named person responsible for continence.  This continence lead should be responsible for education and training.  
8)    All Trusts should promote the use of catheter passports. A template passport should be developed and used by all Trusts. 
9)    GPs should receive training on the different continence products available and/or refer to community continence teams where the specialist knowledge is based. 
10)    Patient management systems should be used to improve prescribing, patient care and quality of life whilst reducing cost.  
11)    NHS England should prioritise the development of commissioning guidance on bladder (and bowel) incontinence to improve the quality of local commissioning with a focus on avoiding unnecessary hospitalisation and recommending a named continence commissioner/prescribing lead in each CCG.