fastingA major new report has called on policy makers and payers to place greater focus on continence as a health and social care issue rather than simply a lifestyle or quality of life problem.

The findings of the ‘Optimum Continence Service Specification’ initiated by global hygiene company SCA, suggest that there could be significant benefits for patients and the health and social care system if greater emphasis is placed on continence and a more integrated approach is taken to assessment and treatment.

Urinary and faecal incontinence currently affects at least 400 million people worldwide and incidence is likely to rise sharply in the coming years.

Listen to report co-author Dr Adrian Wagg speak at this year's GM Conference by booking your place at www.gmjournal.co.uk/managing-an-ageing-patient-from-midlife-to-beyond/

In launching the report, Mansoor Parvaiz, Vice President of Incontinence Care at SCA. said: "Incontinence is a health and social care issue with significant impact on sufferers, their caregivers and local health economies, yet continence care is not currently receiving the focus or the funding that it deserves by health systems worldwide. 

"The thinking behind this study was to address the gap that exists regarding clear guidance for payers and providers across the globe about how best to configure services to deliver cost effective, evidence based and high quality patient centred care. We hope this initiative will stimulate the debate and provide a helpful blueprint for policy makers, payers and clinicians across the globe as they strive to tackle this growing health and social care issue."

Shifting responsibility to specialists
The report makes a number of recommendations to improve the identification, assessment and treatment of incontinence, all of which can be adapted to suit local variations in practice, resources and culture around the globe.

These include:
• The establishment of robust referral pathways to detect, assess and treat incontinence to provide timely and effective care.
• Shifting the responsibility for initial assessment and treatment away from general primary care physicians to healthcare professionals with specialist continence training, such as continence nurse specialists, or other clinicians as available, in primary care.
• Establishing accredited training programmes for nurses wanting to become continence nurse specialists and other health or social care professionals such as social workers who want to improve their competence in delivering continence care.
• Using case co-ordinators to ensure more collaborative working to reduce delays for patients with multiple morbidities, connect specialists with other parts of the care pathway and strike a better balance between specialisations and holistic case management approaches.
• Promoting the use of self-management tools and techniques, providing information on the use of containment products and placing greater emphasis on shared decision making between healthcare provider and patient/care givers.
• Establishing comprehensive and standardised assessment processes to meet the needs of patients and caregivers with regards to the prescription of containment products.
• Making the use of technology, such as telehealth, integral to the delivery of continence care to enable self-care, connect patients and care givers and enable providers to monitor progress and troubleshoot problems.
• Adopting a more integrated approach to continence care where specialists are fully integrated with other parts of the care pathway

In order to improve standards in continence care, the report concludes that outcome and performance measures should be linked to financial incentives to motivate healthcare providers to provide the best possible care for patients. This would include sharing outcomes and performance data in the public domain and reporting results to patients, staff, payers and health systems administrators.

Anne-Sophie Parent, Secretary General at AGE Platform Europe, which represents over 40 million older people in Europe added: "We welcome the initiative by SCA and the other parties involved in the Optimum Continence Care Specification, to place the spotlight on this important healthcare issue and encourage policy makers to make this a greater priority.

"Incontinence is a serious medical condition which carries an enormous stigma, yet many people suffer in silence due to shame. The recommendations in this report indicate that there is much more that can be done to raise the standards of care and dignity for patients.  We hope that all those involved will draw on this report as valuable inspiration."