The Minister for Secondary Care (Karin Smyth)
It is a pleasure to see you in the Chair, Mr Deputy Speaker; you have done an excellent job of making sure that all Back Benchers get to contribute to this afternoon’s important debate. I will have to cut some of my comments, but hopefully I will get to address everybody’s points. We are having this debate during World Continence Week, and I congratulate my hon. Friend the Member for Dudley (Sonia Kumar) on securing it. There could not be a more appropriate time to raise awareness of this issue.
Millions of men, women, young people and children are living with bowel and bladder problems. Incontinence is an issue that robs people of their dignity, as we heard from my hon. Friends the Members for Chelsea and Fulham (Ben Coleman) and for Harlow (Chris Vince), and too many suffer in silence. As my hon. Friend the Member for Dudley rightly says, this subject is taboo, and I congratulate her on securing her first debate in the Chamber. It is great to have her expertise in this area.
All continence problems can be debilitating and life-changing. They affect a wide range of care groups, and can be a particular concern for older people. In recent years, public discussion and awareness has opened up. The advertising of products has become slightly more commonplace, helping people to normalise these issues, with which so many people live from day to day. However, we are still a very long way from being a society that supports people with incontinence to live without stigma.
As these issues affect people of all ages, we need to recognise that different approaches are required. We heard an excellent contribution from the hon. Member for Dumfries and Galloway (John Cooper), who raised that point, as did the hon. Member for Farnham and Bordon (Gregory Stafford). The hon. Member for Strangford (Jim Shannon) talked about children, and my hon. Friend the Member for Nuneaton (Jodie Gosling) talked passionately about people with learning disabilities.
There is no one-size-fits-all approach to managing incontinence, but dignity and compassion must be at the heart of the care provided. That is why we are introducing reforms to put the patient at the heart of the care pathway and the decision-making process around it. The 10-year health plan, and its focus on the three shifts needed to deliver a modern NHS—moving from hospital to community, from analogue to digital, and from sickness to prevention—will benefit people at risk of developing incontinence and those already living with it. For example, preventing type 2 diabetes or helping people into remission will help to reduce the number of people who develop continence problems as they go through life.
We have heard many contributions about women’s health. NHS England has established a perinatal pelvic health service, which focuses on the prevention, identification and timely treatment of a range of issues antenatally and for at least 12 months after birth. The initiative aims to support women who experienced trauma during childbirth, including conditions such as urinary incontinence and pelvic organ prolapse, as noted by my hon. Friend the Member for Gravesham (Dr Sullivan).
In addition to perinatal pelvic health services, continence services are provided more widely via women’s health hubs, and the core specification outlines that incontinence care is a key consideration for local organisations when establishing hubs. I commend my hon. Friend the Member for Wolverhampton West (Warinder Juss) for bringing his expertise and experience to this debate, and for supporting so many women. I know that in the last Parliament many Members of this House supported women through the horrors of mesh implants, and we are moving that issue forward.
By moving from sickness to prevention, the Government want to shorten the amount of time people spend in ill health and to prevent illnesses before they happen. Although prevention is extremely important, we must also ensure that those living with incontinence receive the best possible care, wherever they live. A key part of that involves the NHS providing high-quality guidance on how to care for people living with incontinence. The National Institute for Health and Care Excellence has published five guidelines on the management of urinary and faecal incontinence, which 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 advice on a further 14 products for urinary incontinence, and on 12 products for faecal incontinence.
My Department has commissioned NICE to produce late-stage assessment guidance on one-piece closed bags for colostomies, and on intermittent urethral catheters for chronic incomplete bladder emptying in adults. These late-stage assessments will gather the views of clinical experts and patients to help NICE assess and compare the value of products in widespread use across the NHS. In addition to NICE’s guidance, the NHS must have regard to the “Excellence in Continence Care” guidance, published in 2018.
NHS England has also produced guidance on safer bowel care for patients at risk of autonomic dysreflexia, a serious medical condition that can affect people with spinal cord injuries. The guidance offers resources to support safer bowel care practice, and highlights the importance of implementing the excellent incontinence framework. In addition, the Nursing and Midwifery Council has professional standards relating to bladder and bowel nursing care. Its code places a strong emphasis on the principle of prioritising people, setting 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, which is to be completed by the end of this year.
The provision of suitable care, with the products necessary to deliver that care, is essential for minimising the physical harm related to complications and treatments for continence problems, which can lead to admission to hospital for extended lengths of stay. The NHS will commission pathways of care that ensure early assessment and effective management of incontinence, along with other bladder and bowel problems. These pathways will take account of the impact of urinary tract infections on social, physical and mental wellbeing to reduce expensive pad usage, high-cost complications, and unnecessary hospital and care home admissions.
As we have heard, our focus on the shift from hospital to community will drive more joint working in neighbourhoods between primary care, pharmacies, community healthcare and social care to help people manage incontinence at home. This will help them to access the right self-care and the right professional support so they are not passed from service provider to service provider. It will also reduce their need for emergency hospital admissions, as we heard from my hon. Friend the Member for Nuneaton.
My hon. Friend the Member for Penrith and Solway (Markus Campbell-Savours) made some excellent points about access to facilities, and I know he will keep pressing my hon. Friends in the Ministry of Housing, Communities and Local Government about that issue. His points were echoed by my hon. Friend the Member for Colchester (Pam Cox).
As I stated at the outset, shifting care into community settings is one of our three shifts, and we will shortly be publishing the 10-year plan. Once again, I thank my hon. Friend the Member for Dudley for bringing forward this debate to raise awareness of this important but often overlooked issue.