News
New UK Report Calls for Rethink of Continence Care as NHS Reform Accelerates
Coinciding with the start of World Continence Week 2026, the Urology Trade Association, in partnership with The Urology Foundation and the Spinal Injuries Association, and with the support from Shine, today publishes a new UK-wide report on the experiences of people living highlights how people living with continence conditions.
The report highlights the challenges many people face in accessing care and support, and the need for continence services to keep pace with wider NHS reforms.
Drawing on responses from people living with continence conditions, including individuals with neurological and long-term mobility-related needs, the report provides insight into the day-to-day realities of continence care and its impact on dignity, independence and quality of life.
14 million people across the UK live with continence problems, equivalent to more than 21,000 people in every parliamentary constituency, yet many people continue to struggle in silence because of the stigma surrounding continence conditions.
For many, poor continence care is not simply a clinical issue. It can affect confidence, independence and the ability to participate fully in everyday life, with people often worrying about leaving home, travelling, working or maintaining social relationships.
The consequences are also felt across the wider health system. Poor continence management can contribute to avoidable pressure on the NHS and hospital admissions, with Urinary Tract Infections (UTIs), which can be linked to inadequate continence care, estimated to cost NHS hospitals in England £604 million per year.
The findings are published at a time of major NHS transformation, including the implementation of the 10 Year Health Plan, which sets out a shift towards prevention, care closer to home, and more personalised, patient-centred services.
Alongside this, ongoing reforms in procurement and commissioning – including Value-Based Procurement, the review of Part IX of the Drug Tariff, and wider NHS commercial and procurement strategy reforms – are reshaping how continence products and services are accessed and delivered across the system.
Key Findings from the Survey
The report highlights consistent patterns in patient experience, suggesting variation in how continence care is delivered, accessed and reviewed across the UK.
- Limited involvement in care decisions: Nearly half of respondents reported little or no involvement in decisions about their continence care, with many stating they were not fully supported to discuss options or preferences.
- Unmet patient priorities: Over a third of respondents said their personal priorities were not fully reflected in care planning, suggesting gaps in shared decision-making.
- Restricted product choice: Many respondents reported limited choice of continence products.
- Limited clinical review: 83% of respondents reported not having had a clinical review of their continence products in the past year, indicating that ongoing reassessment is not consistently embedded in care.
- Impact on daily life and wellbeing: Many respondents described the impact of continence conditions on travel, work and social participation, alongside emotional effects including embarrassment, anxiety and reduced confidence.
The survey findings include responses from individuals who, as part of their continence care management, may use absorbent pads alongside other continence products. Unlike many other continence products, absorbent pads may be obtained either through NHS prescription or purchased independently.
Of the 232 respondents, 49 reported using pads either alone or alongside other products. As a result, findings should be interpreted with caution, as this group may include individuals who access their products privately and whose experiences may not fully represent those of individuals using products obtained solely through NHS prescription.
Looking Ahead
The findings reinforce the importance of continuing to strengthen continence care as part of wider NHS reform priorities, particularly as the health system moves towards more preventative, community-based and personalised models of care.
A clear message emerging from the report is that positive patient experience is closely linked to regular clinical engagement, shared decision-making and access to care and products tailored to individual needs and circumstances.
Respondents were consistently more likely to report positive experiences in which they felt informed, listened to, and supported in accessing products and care approaches suited to their individual circumstances. The findings underscore the priority of ensuring patients can play an active role in decisions about their care, supported by clinicians with the time, training and specialist knowledge needed to guide personalised treatment choices.
This has important implications for the future organisation of continence services. Delivering genuinely person-centred continence care will require continued investment in workforce capacity, specialist continence expertise, and clinical education, ensuring healthcare professionals are supported with the time and resources needed to deliver the personalised, preventative care that underpins effective long-term condition management.
The report also reinforces that continence care cannot be approached through a one-size-fits-all model. Continence conditions vary significantly between individuals, meaning that access to appropriate products, informed clinical support and regular reassessment remain central to maintaining independence, dignity and quality of life.
As reforms continue across procurement, community care and medical technology, the findings emphasise the importance of ensuring that decision-making reflects not only cost considerations, but also clinical outcomes, patient experience and long-term value across the care pathway.
Ultimately, the findings point towards a clear opportunity to strengthen continence care as part of the NHS’s wider transformation agenda, supporting more personalised, preventative and community-based care while ensuring patient outcomes and lived experience remain central to future reform.
Quotes
“By drawing on the lived experiences of people with continence conditions, this report reminds us of the ultimate goal of all healthcare reforms: improving outcomes for all patients, wherever they live across the country. As a trade association, the UTA is proud of the role industry plays in supporting continence care across the NHS, working in close and ongoing partnership with healthcare professionals and service providers”
Chris Whitehouse, Chairman of the Urology Trade Association.
“Everyone experiencing bladder leakage deserves the right information and support, including access to continence services, specialist treatment and products. No one should be left to manage alone or with inappropriate products. That’s why we believe action is needed now to ensure that people get the care they need. On behalf of The Urology Foundation, I hope this report encourages those involved in policy, clinical care, education and research to use these insights as a foundation for change”, said Rebecca Porta, Chief Executive of The Urology Foundation.
“Living with a spinal cord injury means paralysis for life; it also brings a multitude of lifelong physical and health challenges. Continence care is one of the most impactful. It shapes independence, confidence, and everyday life in ways that are easy to overlook but impossible to ignore. Our collaboration on this survey is our commitment to amplify patient voices and ensure that services and policies respond to the realities of life after spinal cord injury”,
Nik Hartley, CEO of Spinal Injuries Association.
“Many people living with spina bifida depend on continence care throughout their lives, making access to appropriate support critical to their health, independence and wellbeing. This report gives an important voice to those experiences and highlights why continence care must be recognised as a core part of person-centred healthcare. We hope its findings will help drive improvements that better reflect the needs of people living with lifelong conditions”, said Kate Steele, CEO of Shine.
