Dr Martin McShane, NHS England’s Director for Patients with Long Term Conditions, explains why we must ask patients the right questions and not let them suffer in silence:

Domain 2 of the NHS outcomes framework is about ‘enhancing the quality of life for people with long term conditions’ and, as I listened to this year’s Reith lecture by Atul Gawande about how he learnt to ask the right questions, I thought about the questions we don’t ask, the topics we don’t address and the problems that people are reluctant to discuss unless given the space and acceptance to do so.

So we need to talk about incontinence.

In the UK, there are over 14 million people who have bladder control problems and 6.5 million with bowel control problems. That is a lot of people who could have a better quality of life if it was acknowledged and addressed.

However, men, women and children of all ages and vulnerable groups in particular continue to suffer with this condition unnecessarily and often in silence. It is a significant factor in admissions to hospital and residential care. It robs people of dignity and mobility. Which is why, working with colleagues from the Nursing Directorate, I want to support work to raise the profile of continence care.

Nursing colleagues have launched a programme of work, Excellence in Continence Care, to support commissioners to recognise the value better continence care brings; value to the system as well as, most importantly, the individual.

Improving continence services has many benefits including:

• A reduction in admissions to permanent care settings: nursing homes, secondary care, homes for disabled children and adults;
• Fewer costly emergency admissions to secondary care with urinary tract infections, pressure ulcers and catheter related infections;
• Reducing prolonged use of costly incontinence products through low cost interventions such as physiotherapy and medication;
• Better continence care contributes to independent living and improved quality of life.

Imagine if we could enhance the quality of life for 14 million people – wouldn’t that be something worth talking about?