Agenda item

Scrutiny Review - Urinary Incontinence

-           Director of Public Health to report.


Councillor Doyle, Cabinet Member for Adult Social Care and Health, introduced the report and the response by Public Health following the completion of a scrutiny review of urinary incontinence services in May – June 2014.


This review identified a series of recommendations which cut across the Council’s Directorates. 


There were three main aims of the review which were:-


·                To ascertain the prevalence of urinary incontinence in the borough and the impact it has on people’s independence and quality of life.

·                To establish an overview of current continence services and costs, and plans for future service development.

·                To identify any areas for improvement in promoting preventive measures and encouraging people to have healthy lifestyles.


The review focused primarily on prevention rather than the costs of current service provision, but recognised that preventative work contributed towards achieving savings for services, for example by reducing admissions to hospital or residential care. Centralisation of continence prescribing had improved outcomes for service users and future service development with greater emphasis on prevention should also produce both further savings and better outcomes.  Awareness raising of the importance of good bladder and bowel health and being physically active, plus doing pelvic floor exercises as a preventive measure, could lead to fewer people having their quality of life diminished through urinary incontinence and result in lower future demand for services.


The review conducted was a spotlight review and formulated six recommendations as follows:-


1          RMBCStreetpride and partner agencies such as SYPTE should ensure all public toilets in the borough are clean and well equipped to meet the needs of people who have urinary incontinence, including suitable bins for the disposal of equipment and disposable products.


          Response - SYPTE have confirmed that the toilet facilities provided by SYPTE at its Interchanges meet the requirements recommended in Urinary Incontinence Scrutiny review.  All SYPTEs toilet facilities are appropriately maintained, regularly cleaned and re provisioned with consumable products throughout the day including weekends to ensure a pleasant customer experience.


          Response RMBC Facilities Management have confirmed that toilet facilities in Rotherham have suitable waste disposal systems are cleaned regularly to meet the needs of people with urinary incontinence.


2          RMBC Sport and Leisure team should establish greater links with the Community Continence Service in order to support people to participate in appropriate sport and physical activity.


          Response – Active Rotherham agree to work more closely with the Community Continence Service and take further guidance on how to improve the pathways to physical activity from the service.  Suggestions include literature for patients and information on suitable exercises for pelvic floor to be added the new Get Active Rotherham website which is currently under development.


3          RMBC Sport and Leisure team should liaise with other sport and leisure activity providers to consider building more pelvic floor exercises into the Active Always programme and wider leisure classes


          Response – Active Rotherham will include pelvic floor exercises into their existing “active always” provision.  Public Health will also raise the importance of pelvic floor exercises at the next Rotherham Active Partnership meeting and long term conditions subgroup which covers most activity providers across the Borough.  If there are any training requirements identified, these will be considered and delivered to the Rotherham Active Partnership members to ensure the exercises are embedded in all services.


4       There should be greater publicity by partner agencies, coordinated through the Health and Wellbeing Board, to reduce stigma associated with incontinence and to raise public and provider awareness of:

a) the importance of maintaining good bladder and bowel health and habits at all life stages (through media such as screens in leisure centres and GP surgeries, further website development, VAR ebulletin and a campaign during World Continence Week from 22-28 June 2015)


          b) healthy lifestyle choices having a positive impact on general health but also helping to prevent incontinence, such as diet, fluid intake and being active

c) the positive benefits of pelvic floor exercises as a preventive measure for urinary incontinence, including the use of phone apps for support


          d) the need to include the impact of incontinence due to medication, such as diuretics, within a patient’s care


          Responses – SYPTE offered the opportunity to use Rotherham Interchange to promote health issues in either road show or poster display format. 


          Public Health offer the opportunity for key messages to be included on our Public Health TV screens as well as encouraging Pharmacies to consider prioritising incontinence as one of their Public Health Campaigns for 2015.


          Information will also be included on the Get Active Rotherham website to raise awareness and confidence of patients with urinary incontinence.


          It is recognised that the wide distribution of this review should also result in an increase in awareness of the needs of those experiencing urinary incontinence.


5       RMBC Neighbourhoods and Adult Services should work with care homes to encourage more staff to participate in the training offered by theCommunity Continence Service and to increase staff understanding of the impact of mobility, diet and fluid intake on continence.


          Response – Neighbourhood and Adult services have previously offered incontinence training to care home staff but this was not taken up and as a consequence the training was cancelled.  It is unclear if there was a need for training or if this is already being met by the Community Continence service support to Care Homes.  Further information is being sought and NAS Learning and Development Team are happy to provide further training if necessary.


6       That the Health Select Commission receives a report from Rotherham Clinical Commissioning Group in 2015 on the outcomes of the project considering future service development of the Community Continence Service.


          Response – The CCG have been forwarded the Health Select Commission report and will be invited directly to attend the Commission and report back their findings.


Resolved:-  (1)  That the response to the Urinary Incontinence Scrutiny Review recommendations be approved.


(2)  That the proposed next steps be approved.


(3)  That everyone involved in this review be thanked for their input.


(4)  That the response to the Scrutiny Review be submitted to the next available meeting of the Overview and Scrutiny Management Board.

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