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Recognising excellence in continence care – Sarah Elliott

Ahead of Continence Awareness Week to be staged in June, the Chief Nurse for NHS England in the South explains the need for commissioners to listen to patients:

I recently attended the National Continence Care Awards organised by the Expert Group on Lower Urinary Tract Symptoms, a group of primary and secondary healthcare professionals and patient representatives.

It is not often that a light is shone on bladder and bowel problems but this is something the nursing team is working towards changing in NHS England.

A wide range of people can be affected by continence problems – children, pregnant women and women who have had children, those with neuropathological problems or musculoskeletal problems and men who have had a prostatectomy, to name just a few – and there can be considerable psychological impact.

At the latter end of last year, NHS England published Excellence in Continence Care: guidance for commissioners, providers and people living with continence issues on what good looks like. We brought together existing excellent research and guidelines for best practice in continence care and translated into a clear commissioning plan.

Walking into the room at the Awards, I had the opportunity to hear more about the work that is taking place across England to make care and experience of using services better for patients.

What struck me was the buzz of conversation between clinicians, patients and MPs, all of whom had a common interest of making a difference to continence services. There was lots of laughter and people reminded me you need to keep a sense of humour if you are living with continence problems.

I was also struck by the sense of collaboration; everyone playing their part in the interest of excellent continence care and clinicians and patients sharing expertise and personal experience as equal partners.

The National Continence Care Award categories are closely aligned to the areas we address in Excellence in Continence Care including recognition for commissioning high quality care.

Commissioners are well-placed to focus on transforming the care of people and for me, the biggest priority is making sure that those who commission continence services both understand the burden of continence needs within their local population and work in collaboration with providers.

One example of commissioners and providers working together to improve care for patients is the joint initiative between Somerset CCG and Somerset Partnership NHS Foundation Trust, which won the category for commissioning.

They have introduced ambulatory care clinics which provide local care in what is a rural area and where travel time is a significant factor for both patients and community nurses. The clinics include ongoing support for catheterised patients, through regular appointments for routine catheter changes and emergency catheter care within clinic hours.

The service is continuing to develop and grow but has already shown significant benefits for patients and their care.

In order to understand the needs of people living with bladder and bowel problems, commissioners need to listen to what patients have to say. I was heartened to see Jacqueline Emkes receive the patient champion award in recognition of the active role she takes in supporting other patients and working with health care professionals to improve continence care.

Jacq was one of our patient representatives involved in developing the Excellence in Continence Care guidance. Her story and experience at the receiving end of continence care really helped us to understand what the NHS can do to ensure we provide the best care and support people to manage their bladder and bowel problems.

Indeed, one of the most rewarding aspects of developing the guidance was listening and responding to people using continence services and giving them the opportunity to rebalance power, so people can have a greater role in the assessment and management of their continence condition and in service design.

I urge commissioners to talk to people like Jacq when they are designing their continence pathways; to work with partners to ensure local plans consider people’s needs and offer the right treatment and support; and to take inspiration from the winners of these awards.

Now is the opportunity to put into effect the best care and to guide people to the help they need to manage their bladder and bowel problems.

Sarah Elliott was appointed as the Regional Chief Nurse for NHS England (South) in April 2014 and also leads a number of national commissioning work streams including continence.

Following qualification, Sarah practiced as a nurse in a range of hospital settings including intensive care. She later developed an interest in health promotion and public health and trained as a Health Visitor and Practice Teacher in Brighton.

She has held several Director of Nursing posts in a number of organisations within the South in community/mental health Trusts and commissioning organisations.

In addition to leading the agenda for commissioning for quality and safety in NHS services across the south, Sarah has initiated multiple patient and public involvement activities.

Alongside Sarah’s professional working life, Sarah has undertaken voluntary work with Youth Offending teams and the Alzheimer’s Society. She is also an accredited coach and special advisor to the CQC.

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