This most basic of needs – Dr Martin McShane

Dr Martin McShane’s Blog:I was at a roundtable on how health and care services need to change to meet the needs of people with multiple conditions.

We heard from a patient who described the problems he was facing managing his diabetes, the after effects of his cancer care and his respiratory and arthritic problems.

And then he said: “But none of those really bother me as much as working out how to make sure I can get to the loo on time”.

Problems with the bladder affect more than 14 million people in the UK, and 6.5 million have bowel problems. It is estimated 900,000 children and young people are affected. Robert Francis referred to continence as: “This most basic of needs”.

Continence is something which embarrasses people, they suffer in silence and those who don’t complain or shout the loudest often get ignored. It is not just a physical problem. It is psychologically distressing. Yet, in an analysis of calls to their helpline, the Bladder and Bowel Foundation, estimated half the people had never spoken to a healthcare professional about their problems.

We need to make sure that professionals and individuals with continence issues know how to source help, access resources and what standards can be achieved. We need to raise the standards of continence care and outcomes for people.

It is an issue where health and social care can work together to support and enable independence, support less reliance on pads and products by using alternative treatments, reduce admissions to hospitals and care homes and avoid complications. Great continence care can deliver better quality and reduce costs – the Holy Grail!

This is why guidance for those who commission and provide continence services has been produced.

Clinical experts in bladder and bowel, patient advocates and representatives from national charities and third sector bodies have worked as one, under the leadership of Sarah Elliot, Chief Nurse, NHS England South, to agree the guidance. It is designed to raise awareness with professionals and sets out how to support a workforce that appreciates what can be done and also empower individuals to know what is appropriate for them in their lives.

We need to empower people to self-manage and live independently with personal dignity.

The outcomes framework seeks to ‘enhance the quality of life for people with long term conditions’. There is perhaps no better area to make this happen than with ‘this most basic of needs’.