Chris Whitehouse, a political consultant and expert on medical technology policy and regulation at Whitehouse Communications, an advisor to MedTech suppliers, chair of the Urology Trade Association, and governor of the Anscombe Bioethics Centre, reports on the impact of poor training, management and choice of product are having on patients with incontinence, and on NHS budgets.
Only 11% of medical staff caring for patients with incontinence have never had to issue patients with unsuitable continence products, and a staggering 62% report they have to give patients unsuitable continence products “always”, “often” or “sometimes”; according to a recent survey.
The impact of this on the NHS is huge, with 61% of survey respondents saying that patients are admitted to hospital or care facilities due to previous mismanagement of their incontinence, and 29% warning that this leads to some patients unwittingly bed-blocking. 60% of respondents think urinary tract infections could be managed better to avoid either the admittance of patients in the first place, or delay in discharge of continence patients.
The research was undertaken by OnePoll for leading continence product supplier, Essity, whose spokesperson, Richard Maddison, told MedTech Insights that: “Patients’ lives can be made miserable by poor continence care and choice of inappropriate product. Clinicians should be getting access to the best quality products to allow these things to be right for the person first time, and they should be supported in this by purchasing managers within the NHS to do this.
“The drive to the bottom on price, for the cheapest product available, even if it is not at times the most clinically appropriate, is adversely impacting patient dignity, experience and health outcomes. This piles up costs in NHS staff time spent changing patients, and laundering their clothes and bedding; and it leads to very costly and unpleasant consequences such as pressure sores, skin infections and urinary tract infections”.
To help ensure such major failings in procurement culture and practice are addressed, the MedTech Directorate of the Department of Health and Social Care has for several years been leading the process of developing Standard Guidance on assessing “value” rather than “item price” for roll-out across the NHS in England from early 2026, but, more recently, NHS Supply Chain appears to have been developing its own rival methodology, causing confusion and concern across the MedTech sector.
This comes against the background of a series of Late Stage Assessments of medical technology undertaken by the National Institute of Health and Care Excellence [NICE] with great disruption to industry, only for NICE to conclude that there is a lack of evidence available for the drawing of any meaningful conclusions. Categories assessed included stoma bags, wound-care products and urethral catheters for intermittent use.
Responding to a request for information about the cost of these projects, both those of NICE itself and those of the category manufacturers impacted, NICE has admitted that no assessments of that cost were even made. This is despite trade associations and individual manufacturers repeatedly pointing out in advance of the launch of the individual Assessments that evidence of the kind being demanded was not typically available for many categories of medical devices, particularly those involved in this project; and that the projects with their unnecessarily tight timelines, were placing huge burdens on businesses.
The whole tone and approach of the project was the antithesis of the collaborative approach to dealings with industry to which NICE claims to be committed.
The Author used AI in preparing this article, comments upon or questions about which can be addressed to chris.whitehouse@whitehousecomms.com.
