Incontinence is Hurting the Dignity and Health of Millions

At the end of August, 10 charities published the findings of a shared workshop they had on the topic of incontinence which had taken place in December 2016.  The resulting report which is called “My bladder and bowel own my life.” A collaborative workshop addressing the need for continence research” recommends tackling the stigma of incontinence and funding research into this often ignored issue. This new report describes the impact of continence issues on patients with long-term conditions and older people as discussed by the workshop participants and makes 8 clear recommendations for researchers, research funders,  policy makers, commissioners and others in a position to make research into urinary and faecal continence problems more of a priority.

Research into urinary and faecal continence problems have been identified by patients, carers, family members and health and social care professionals as one of the key areas where further research is needed.  This is because there are are a lot of areas in this field where further research could be done to improve the quality of life for people with a variety of conditions and circumstances, such as long-term neurological conditions and terminal illness. The 10 charities suggest that more research is needed into:

  • the patient experience
  • health economics
  • clinical research into self-management techniques, co-morbidities, continence assessment and products, the impact of education, combined urinary and bowel continence research, side-effects and the interaction of medication prescribed for other long-term health conditions and their effect on incontinence symptoms.
  • fundamental research to better understand bladder and bowel function
  • the effect of non-surgical interventions.

Quite a knowledge gap, that needs to be tackled particularly since the NHS estimates that between 3 and 6 million people in the UK have some degree of urinary incontinence. Studies also suggest that in the UK “major faecal incontinence” affects 1.4% of the general population over 40 years old and that constipation affects between 3% and 15% of the population. It’s also widely believed that continence problems are under-reported so these figures could be quite a bit off as the numbers seeking treatment might be as low as 20% of those affected, which would mean around 15 million around a 1/5th of the UK population at any one time may be troubled by poor continence symptoms.

If you are affected by incontinence it is probably a good idea to be aware of NICE’s Topic Page on Urinary Incontinence and their Urinary incontinence in women interactive flowchart and to take some time to look at The Urology Foundation’s Urology Health Pages

 

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More New Guidance from NICE and the Importance of Healthcare Quality.

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Last month it was NG 97: Dementia, this month an equally important one NICE Guideline 100: Rheumatoid arthritis in adults: management

As with Dementia, the flowchart has also been updated making it easy to follow.

At the same time, they have also updated the Rheumatoid Arthritis Quality Standard (now Q33) which has 7 recommendations that it would be worth becoming aware of. Rheumatoid Arthritis affects over 400,000 people in the UK making it one of the most prevalent long-term conditions health professionals see. If you need to know more about rheumatoid arthritis its worth looking at the NHS Direct entry which you can see by Clicking Here

In the wake of the celebrations to mark #NHS70 and in the light of recent negative publicity about the health of the NHS, it’s probably a good time to mention this.  A new report from the Organisation for Economic Co-operation and Development (OECD), the World Health Organization (WHO) and the World Bank has claimed low-quality healthcare services are holding back progress on improving health in countries at all income levels. (i.e. the NHS is not alone in the problems its facing).

te report highlights that 1 in 10 patients is adversely affected during treatment in high-income countries. Adherence to clinical practice guidelines in eight low- and middle-income countries was below 50 per cent in several instances. Also, 10% of hospitalised patients in low- and middle-income can expect to acquire an infection during their stay, as compared to 7% in high-income countries. The report outlines the steps health services, health workers, governments, citizens and patients needed to take to improve healthcare quality. It would be a shame to let this important report slip under the radar because of #TrumpVisitUK and the Brexit mess. See:

OECD/WHO/World Bank Group (2018). Delivering Quality Health Services: A Global Imperative. World Health Organization. Geneva, Switzerland.

DOI:10.1787/9789264300309-en.

Hello from Manchester’s @BSGManchester2018 #BSG2018

 

conference_FlyerSo this week I am at the British Society of Gerontology (BSG) Conference 2018. I don’t think that I have ever been to a larger Conference and there is so much in the Conference Programme that it is almost big enough to require a wheelbarrow!

Anyway, later today I am speaking with Becky Moran the Care Home Educational Facilitator (CHEF) from NHS Lanarkshire talking about the BSG study day we held back in August 2017. See This Link for our report to Ageing Issues

At the conference the following has been announced that other people might be interested in.

Firstly, the Centre for Better Ageing at https://www.ageing-better.org.uk/ is releasing a new report today called Home Adaptations: A Typical Journey, which explores personal and professional perspectives on home adaptations. Go to the website and download it.

Secondly, Ageing and Society have released some full-text versions of some of its most interesting articles online. There are a range of topics so if you want to take a look at what is available see www.cambridge.org/ASO-BSG18

Finally, the Centre for Policy on Ageing has pooled together some of its Information Resources. An interesting one to look at is called “Policies on Ageing” which is an online resource providing easy access to government policy documents and key national reports and briefings that are raising the profile of issues around the support of older people and an ageing population. See:

www.cpa.org.uk/cpa/policies_on_ageing

Hope you find something interesting.

 

Happy Birthday to #ourNHS70

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The NHS celebrates its 70th Birthday on Thursday 5th of July 2018. I am not going to bang on about how wonderful it is. Lots of people will do that. If you need reminding see: The History of the NHS in Charts and #ourNHS70

Lots of things to watch out for this week as a result.

The NHS: To Provide all People is a good starting point. This is a film poem that charts the emotional and philosophical map of what defines the NHS and the personal experiences at the heart of the service and recognises its achievements and the challenges it faces. Based on real interviews conducted with NHS staff.

The BBC centrepiece of the season was NHS 70 Live, a 90-minute event broadcast live from a hospital on BBC Two. Hosted by Nick Robinson and Anita Rani. The programme asked some of the big questions about the NHS today and its future. Drawing on landmark independent research from four leading think tanks, the programme gave audiences a chance to contribute to the wider conversation around the NHS.

More details of what can be found on the BBC related to the NHS at 70 can be found here

The highlights on ITV include the NHS Heroes Awards and A&E Live. Their programme line-up can be found at ITV marks NHS70

Well that’s enough on Telly and catch-up to keep you busy for quite a while!  Don’t forget there ar also many local events. On Thurday I’ll be in Manchester at the #BGS2018 Conference “Ageing in an Unequal World” conference. Say hello to me if you are there as well.

All Healthcare Professionals Should Learn from the Gosport Inquiry Says British Geriatrics Society

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I chose not to Blog about this last week. However, that’s not an indication that I don’t think its important. Quite the reverse really, however, the events are so tragic its hard to know what to say other than I hope justice prevails.

For more about the story see: https://www.independent.co.uk/news/health/gosport-war-memorial-hospital-deaths-scandal-jane-barton-shipman-a8406456.html

below is the response of the British Geriatrics Society.

The British Geriatrics Society is calling all healthcare professionals to review the Gosport Independent Panel Report, and to learn from these shocking events which led to the deaths of over 450 patients who were given opiate painkillers “without medical justification” from 1989 to 2000 at Gosport War Memorial Hospital in Hampshire. The Inquiry found there was […]

via The British Geriatrics Society calls for all healthcare professionals to learn from the Gosport Inquiry to help prevent future tragedies — British Geriatrics Society

More sad stories to follow I suspect and I have no doubt I’ll be blogging some more about this in future!

Not Enough Publicity. This is All About Improving Older People’s Care!

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Two important documents that have been published this week. One from NHS Improvement and another from Public Health England.

Despite their importance though you’d be hard-pressed to know they were available.

So there is now a guide to reducing long hospital stays and further guidance on falls and falls prevention and you probably haven’t even noticed.

So first of all reducing long hospital stays. In NHS England, nearly 350,000 patients currently spend over three weeks in acute hospitals each year. Many are older people with a reduced functional ability (frailty) or who have a cognitive impairment. The benefits to the UK NHS and other healthcare systems of reducing hospital bed occupancy are clear. However, as everyone knows trying to achieve this is very difficult, particularly during the winter pressure for beds. So what can be done?

This week NHS Improvement released their “Guide to Reducing Long Hospital Stays”. Click the link and you’ll get to the page you can download it from.

Their guide is primarily aimed at acute and community trusts, but also makes reference to how system partners can play a supporting role.

Also this week (yesterday June 14th.) Public Health England’s Guide on Falls was updated.  Called Falls: applying All Our Health the guide includes core principles for healthcare professionals to follow and a large number of resources and examples of good practice from some key national agencies. Click on the link and go and explore, and see if you can adopt some of the measures suggested or check if you are doing these already.

So if these are such an important phenomenon to tackle why did these document releases not get more publicity?

A Bad Week All Round

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Some weeks are bad weeks but this week could rank as one of the worst for bad news about the NHS and its relationship with older people in a long time.

Firstly we had the revelation that 450,000 women aged between 68-71 had not been invited to routine breast cancer screening due to a computer error, that has been traced back to 2009!. Public Health England has said that it was not aware of a national problem with the screening programme until January 2018, which seems a bit worrying when they were aware at the same time that screening uptake amongst older women was falling. Watch out for the public inquiry and subsequent report particularly since NHS “everywhere else” didn’t have the same problem. Most people are probably unaware that a full review of the NHS breast screening programme was undertaken in 2012. So if you are affected by this systems failure in any way it’s worth looking at THIS REPORT and making your own mind up about the impact that it may have had on you or your loved one. My concern is that if this had been any other group would it have been noticed sooner and acted upon earlier?

As if that wasn’t bad enough a report released today (May 4th. 2018) is probably worse and even more significant. The annual report for 2017 of the Learning Disabilities Mortality Review (LeDeR) was released today and did make the national news. Their findings are very worrying and point to problems with institutional discrimination across services dealing with people with learning disabilities to the extent that life expectancy at birth if you have a learning disability is 19.7 years lower than for people without learning disabilities. Equally disturbing is that more than a third of deaths of people with learning disabilities were potentially amenable to health care interventions. Again much more will be said about this in the coming days and months so it’s worth taking a look at the primary source, which you can see and download from THIS SITE.

I haven’t even mentioned the dementia care ward at Glan Clwyd Hospital, in Denbighshire which closed in 2013 and it’s culture of “institutional abuse”. Too sad to go there but if you want to know more see this BBC Wales  TIMELINE