Tracy Evans, clinical team leader for the continence service at Southern Health NHS Foundation Trust, discusses the benefits of effectively procuring incontinence products.
Did you know? Currently, there are 164,833 people in the UK who are supported by the NHS for incontinence issues. This leads to just under one million incontinence pads being used, and then binned, per day – not including gloves, wipes, and other PPE used by caregivers. So certainly an area with enough critical mass, in terms of widespread usage in the NHS and social care sectors, to merit exploration.
Those working in the sector, like myself, would like to see the NHS and local authorities across the UK moving towards an increasingly patient-centred approach to procuring incontinence products. It can be all too tempting to look at which product might be the cheapest per item, but also looking at which product would be best for patient outcomes and quality of life, and which would avoid any relapses in patient health and unintended negative side-effects, has to be the best way forward.
By avoiding a ‘one size fits all’ approach, not only does the patient benefit from a product clinically assessed as the best for their needs, but the NHS can also benefit by reducing overall spend (on incontinence pads alone, by up to half a billion pounds a year). Time can also be saved in patient care, and there can be knock-on environmental benefits too.
Rationale for change
It’s well reported that, across the UK, insufficient staffing (leading to increased workload) is the biggest stress factor for medical and social care professionals. From this follows a heavy patient load and multiple, physically demanding tasks and long hours. Because staff resources are limited, anything that can reduce unnecessary workload is crucial.
There is also the matter of hospital beds being occupied by patients who could be more speedily discharged to other services if the appropriate care package was in place. Some continence colleagues estimate that, just last week, one third of their patients could have been discharged from hospital earlier if they were able to change themselves, and reveal that changing just one patient takes an average of 15.34 minutes. Put simply – if a broad range of continence products were procured and clinicians could choose the most appropriate one for every patient, nurses and caregivers could turn beds around more quickly, and avoid their time being sapped by unnecessary changing.
The ripple effect of having the widest possible choice of incontinence pads would be immense. For example, whilst choosing more expensive pads for certain patients might be costly at the outset, this would be offset by a reduction in the average number of items used by those patients during the course of a day. This would also reduce the amount of gloves and PPE used, which would result in far less waste. Going down from six to four pads a day per patient across the country would result in almost 340,000 fewer pads thrown out every single day!
Net zero is at the forefront of the NHS and councils’ minds, rightly so – and there are other steps which will contribute to protecting our communities and the next generations. Hospitals and care homes could make savings in water and electricity in terms of how often bed sheets are washed, as choosing the right product for each patient would result in fewer leaks.
We also need to look at patients as individuals, as there is no one-size-fits-all when it comes to care. In research undertaken, only nine per cent of medical professionals who look after incontinence patients said they would feel comfortable having a loved one receiving care in a setting where issues of poor-quality incontinence products were prevalent.
Caring for patients should always be the priority and local authorities also need to look at it from their citizens’ point of view. Like any type of care, incontinence should be treated with the utmost dignity and we really need our electees to be our voice for change, especially when something as simple as this could have such a human (but also positive financial and ecological) impact.
In summary, patients needing incontinence support from the NHS typically use several pads a day, every day, so it is easy to see why some NHS trusts or local authorities could be tempted to switch to the cheapest product to save money on such high volumes. However, this would be a false economy.
Ensuring a good variety of product options (i.e. both cheaper and more expensive pads) gives the clinician the opportunity to assess each patient (both physical ability and mental capacity) and offer the most appropriate solution to their individual needs. Remember, a more costly unit price might still result in a saving due to a product’s better quality and therefore fewer items needed in a day.
It could also mean fewer leaks and associated laundry costs, and a saving in terms of the time spent by healthcare staff in changing and cleaning patients. It may even mean a reduction in skin infections or ulcers, better mobility for the patient (particularly the elderly) and a resulting decrease in the number of falls and subsequent hospital admissions.
All of which point towards greater patient independence and confidence, fewer treatments or NHS appointments needed and, most importantly, a better quality of life for the person being cared for.