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GPs should be incentivised to identify continence needs, says NHS England

GPs should be incentivised to better identify and manage bladder and bowel incontinence in at-risk patients, new guidance issued by NHS England says.

The guidance, Excellence in continence care, sets out a range of ways to improve services for patients living with bladder and bowel problems.

It suggests that as GPs were relieved of QOF duties they would be well placed to take on case-finding and offering support for continence problems through the enhanced service on case management of elderly and vulnerable groups.

However, the GPC said the suggestion showed NHS England was ‘out of touch’ with overburdened GPs and that the main barrier to good care was the long waiting times when referring patients to continence services.

The recommendations come out of the Francis Report into failings at the Mid-Staffordshire NHS Foundation Trust, which highlighted concerns about ‘this most basic of needs’.

NHS England said people with continence needs often believe there is no help available, while continence problems are frequently overlooked ‘by providers in all settings’.

It said it wants to improve services to give patients a better quality of life and more independence, with less reliance on pads and products by using alternative treatments – as well as cutting admissions to hospitals and care homes and reducing complications, such as urinary tract infections, faecal impaction and skin breakdown.

The guidance says that GPs could be encouraged to case-find and support more patients with continence through their case management of elderly and vulnerable patients.

It states: ‘Changes to the GP contract require case management of patients, personalised care planning and care coordination and these will support greater awareness of needs.

‘Movement away from the QOF will give GPs opportunities to focus on real quality improvements including: case finding of patients with bladder and bowel problems; self-support; the identification of the requirement for domiciliary care and nursing home support.’

Dr Richard Vautrey, deputy chair of the GPC said many practices were already ‘developing closer links with community teams as part of their focus on the 2% most vulnerable patients’ but that ‘the reality in many areas is that the continence services can’t cope with the number of referrals they receive and waiting times can often be unacceptably long’.

Dr Vautrey added: ‘The suggestion that the modest QOF reductions so far implemented have given GPs any more time to do this shows how out of touch NHS England seem to be about the level of workload pressures GPs and their practice teams are under.’

 

Readers' comments (10)

  • NHS England should be completely and utterly igonred unti they sort out the herds of elephants in the room.

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  • I did not go into General Practice to be a nurse or social worker. In fact I would be awful at this - I struggle when a patient asks for a simple dressing. This is utter nonsense and a waste of GP time.

    I suggest NHSE and Government via Local Authorities provides funding and commissions these services from appropriate providers, if they are so important, and not from General Practice. In fact the providers are there already in the form of Adult Social care and community nursing. Oh. Hang on a minute. They are facing cuts so passing on their work to General Practice seems to be the answer.

    However the more that gets dumped on us the less time we have to deal with what we are trained and skilled at doing and the more of our'core' work will have to be dumped elsewhere. Unfortunately the only other dumping ground apart from General Practice is A&E!

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  • NHSE should allow incontinent people, or their carers/relatives, to self-refer to continence services. NHSE should also take care of its workforce before its too late. Oooops, it already is. Like urinary incontinence, once you start you cannot stop.

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  • We cant even prescribe incontinence pad in our area,and the community team that does are allowed to prescribe 4 pads daily for individual patients!

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  • This really is rearranging the deckchairs on the Titanic. What are these people thinking? SO JUST TO MAKE IT PLAIN- GENERAL PRACTICE IS IN CRISIS BECASUE OF A SHRINKING SHARE OF THE NHS BUDGET, INCREASED COMPLEXITY IN AN AGING POPULATION AND A RECRUITMENT CRISIS. DO NOT MAKE ANY MORE RECOMMENDATIONS UNTIL YOU HAVE ADDRESSED THESE ISSUES.

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  • I'm sure the spec for the "Continence DES" will be published soon, start 2016/17.

    Oh, no, hang on. Funded through the global sum.

    I love NHS England.

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  • It suggests that [as] GPs were relieved of QOF duties....

    Anyone got a mop?

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  • Are they just taking the *iss or are they full of @hi* you decide.

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  • Until you put the blazing roof fire out, please stop adding petrol and kindling to the basement, disconnecting the smoke alarms and knotting firemans hoses.

    Red sky at night, More unfunded Shyte.

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  • GPs should not be "incentivised". End of.

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