Asked by: Rosie Cooper (Labour - West Lancashire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether adult and paediatric incontinence is classified as a long-term medical condition by the NHS.
Answered by Caroline Dinenage
The National Health Service supports patients with health problems that affect them over both the short and long term. Adult and pediatric continence challenges are already being considered as part of the National Bowel and Bladder Health Project to support the delivery of the ambitions of the Excellence in Continence Care Programme within the NHS. This is led by NHS England and NHS Improvement and is aimed at improving the experience of care for patients and their carers.
This programme will work towards a model of care which takes into account the expertise and resources of the people with long-term conditions and their communities, which the National Bowel and Bladder project aims to support via the clinical pathway workstreams. This will help to provide a holistic approach to patient care and lives, and help individuals achieve the best outcomes possible.
Asked by: Rosie Cooper (Labour - West Lancashire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether it is his Department's policy that continence challenges should be (a) considered and (b) treated by NHS England to be a long-term condition.
Answered by Caroline Dinenage
Continence challenges are already being considered as part of the National Bowel and Bladder Health Project to support the delivery of the ambitions of the Excellence in Continence Care Programme within the National Health Service. This is led by NHS England and NHS Improvement and is aimed at improving the experience of care for patients and their carers.
This programme will work towards a model of care which takes into account the expertise and resources of the people with long-term conditions and their communities, which the National Bowel and Bladder project aims to support via the clinical pathway workstreams. This will help to provide a holistic approach to patient care and lives, and help individuals achieve the best outcomes possible.
Asked by: Chris Green (Conservative - Bolton West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what the (a) terms of reference and (b) timeframe is for the National Bowel and Bladder Product trial undertaken by NHS England; and if he will make a statement.
Answered by Caroline Dinenage
The National Bowel and Bladder Health (NBBH) Project was developed following a series of workshops held between members of the Excellence in Continence (EICC) Board and the All Parliamentary Group on continence in 2018, with the aim of aligning objectives across existing initiatives to support the delivery of the Excellence in Continence Care Programme. The NBBH Project terms of reference, with oversight from the EICC Board, are being reviewed and updated by workstream membership with an expectation that they will be finalised by the next EICC board meeting in December when timeframes for delivery will also be confirmed.
Asked by: Rosie Cooper (Labour - West Lancashire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what progress has been made on the NHS England Excellence in Continence Care Board's work with the supply chain on the National Bladder and Bowel Health Project.
Answered by Caroline Dinenage
Chairs for each of the National Bladder and Bowel Health Project workstreams have been identified and invited to the Excellence in Continence Care Programme Board in September.
Terms of reference for the project have also been completed.
Expressions of interest for the Stakeholder forums have been sent out via the Excellence in Continence Care Programme Board contacts, Trade Association contacts and via “NHSSupplyChain” on Twitter.
Asked by: Rosie Cooper (Labour - West Lancashire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many Primary Care Networks are being established; where those networks will be located; how many patients those networks will be responsible for; and what assessment he has made of the effect of those networks on the commissioning of bladder, bowel and continence care services.
Answered by Jo Churchill - Minister of State (Department for Work and Pensions)
Primary Care Networks (PCNs) are being developed to cover England. NHS England have reported that, as of 1 July 2019, 1,259 PCNs had been formed with 99.7% of all general practitioner (GP) practices being covered by a network. PCNs are networks of GP practices typically covering population footprints of 30-50,000 people.
In England, it is the responsibility of National Health Service commissioners to make decisions on individual urinary continence care on the basis of the available evidence, taking into account guidance from the National Institute for Health and Care Excellence (NICE) and NHS England where available. In July 2018 NHS England published revised guidance for commissioners to support the development of high-quality continence services. NICE guidance is always evidence based, adhering to the latest clinical thinking and research to determine the best treatment for patients.
Asked by: Jim Shannon (Democratic Unionist Party - Strangford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many people have a diagnosis of incontinence.
Answered by Steve Brine
NHS England published revised guidance on Continence Care in July 2018 which is available at the following link:
https://www.england.nhs.uk/wp-content/uploads/2018/07/excellence-in-continence-care.pdf
This guidance states that in the United Kingdom an estimated 14 million men, women, young people and children of all ages are living with bladder problems, 900,000 children and young people suffer from bladder and bowel dysfunction, and 6.5 million adults suffer with some form of bowel problem.
Asked by: Jim Shannon (Democratic Unionist Party - Strangford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what support (a) is and (b) he plans to make available on the NHS to prevent bladder leakage.
Answered by Steve Brine
NHS England understands the need for improved services and care to be consistently available for those suffering from bladder and bowel problems.
NHS England published guidance on 16 November 2015 to help improve the care and experience of children and adults with continence issues. Continence problems can be debilitating, often embarrassing and can be life-changing.
The guidance deliberately focuses on ensuring people with incontinence can access a timely and effective assessment rather than directing clinical commissioning groups (CCGs) to provide a particular level or type of continence aid because wherever possible we want to help people achieve continence which in many instances with the right advice, information and treatment is feasible.
NHS England is currently refreshing the Excellence in Continence Care Guidance and anticipate publishing this in the next couple of months. This updated version will contain a wealth of case studies to showcase best practice and sign post to the latest evidence based practice to support system change and by utilising the CCG assurance process they will continue to monitor improvement.
Asked by: Thangam Debbonaire (Labour - Bristol West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the availability of Level 1 paediatric continence services for (a) school nurses, (b) health visitors and (c) GPs to provide preventative early treatment for (i) bladder and (ii) bowel problems in children.
Answered by Steve Brine
Clinical commissioning groups (CCGs) are responsible for commissioning continence services and work with local partners to ensure the appropriate level of services are provided dependent upon local need.
CCGs may choose to commission the health visiting and school nursing service to deliver continence services. Public Health England (PHE) has developed commissioning guidance to support local public health delivery; the guidance also clarifies the commissioning responsibilities for continence services. Further information is available here:
Continence services are not included in the public health grant and PHE has not undertaken a national assessment of continence services.
Asked by: Neil Gray (Scottish National Party - Airdrie and Shotts)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what steps his Department is taking to reduce the number of inappropriate referrals to hospital settings for bladder and bowel problems in children and young people aged 19 and under.
Answered by Jane Ellison
Whenever possible, children and young people with bladder and bowel problems should be able to access community based assessment and treatment services.
In November 2015, NHS England published the Commissioning Framework for Continence Services Excellence in Continence Care which covers children and adults and outlines a pathway including assessment, diagnosis and treatment to recovery where possible. The framework sets out a number of principles for a good design of service including integration across primary, secondary and tertiary services, health, education and social care.
The framework references the Paediatric Continence Commissioning Guide (Paediatric Continence Forum, September 2014) which provides a specification for paediatric continence services and in particular community based services.
Asked by: Glyn Davies (Conservative - Montgomeryshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what estimate his Department has made of the number of people with (a) urinary incontinence and (b) faecal incontinence in England.
Answered by Jane Ellison
NHS England has advised that according to a survey conducted in 2008, there are over 14 million adults who have bladder control problems and 6.5 million with bowel control problems in the United Kingdom.
The Department does not collect information on the number of people living with urinary and faecal incontinence specific to Northern Ireland, Scotland and Wales. This is a matter for devolved administrations.
The Healthcare Quality and Improvement Partnership (2010) established that in order to achieve the best clinical outcomes, continence services have to be integrated across primary and secondary care and care home settings.
They also concluded that ‘there is an urgent need for improved and equitable practice for all people with bladder and bowel problems’ through the development of commissioning frameworks, evidence-based training for health professionals and patient empowerment to increase their expectations of cure.
Improving continence care provision through integrated services brings many benefits including:
- a better quality of life and more independence through finding solutions appropriate to individual needs;
- less reliance on pads and products by using alternative treatments;
- a reduction in admissions to hospitals and care homes;
- fewer complications, such as urinary tract infections, faecal impaction and skin breakdown; and
- a reduction in costs.
NHS England’s Excellence in Continence Care guidance provides a framework that enables commissioners to work in collaboration with providers and others to make a step change to address shortfalls so that safe, dignified, efficient and effective continence care is consistently provided.
This guidance is aimed at commissioners, providers, health and social care staff and as information for the public and has been produced in partnership with patient and public advocates, clinicians and partners from the third sector. The roles of everyone involved in the care of people with continence needs are made clear in the guidance and publication via a launch is planned for ‘Self Care Week’ beginning 16 November. The launch will both raise awareness and promote understanding.
In addition the National Institute for Health and Care Excellence has produced a range of guidance for clinicians to support them in the diagnosis, treatment care and support and people with continence problems e.g. Urinary incontinence in women (September 2013), Faecal incontinence in adults (June 2007), Urinary incontinence in neurological disease: assessment and management (August 2012) and Lower urinary tract symptoms in men: management (May 2010).