A group of MPs have called on the government to intervene over what they describe as the “rationing” of continence products across the NHS, warning that thousands of patients are being left without adequate support, and may be costing the health service more in the long run.
The intervention comes after Freedom of Information data revealed that more than half of NHS trusts impose limits on the number of continence pads patients can receive each day.
The call, in the form of an early day motion (EDM 216), was signed by Jodie Gosling, chair of the All-Party Parliamentary Group on Bladder and Bowel Continence Care, alongside fellow APPG member Cat Eccles. Support also came from Mohammad Yasin, who sits on the All-Party Parliamentary Group on Adult Social Care, and Alison Bennett, the Liberal Democrats’ spokesperson for care and carers.
Research suggests some patients with incontinence may require up to five pads a day – yet 34% of trusts with a cap limit patients to just three, while the remaining 66% allow four. The restrictions sit below what many healthcare professionals consider necessary and comes despite guidance from the National Institute for Health and Care Excellence (NICE) as well as advice from the Association of Continence Professionals, stating that provision should be based on individual clinical need rather than blanket prescription.
While MPs warn that rationing risks undermining patients’ dignity, independence and health, they also highlight growing evidence that providing the right products, and supporting patients through community‑based continence care can actually lower costs for the NHS.
Jodie Gosling, chair of the Bladder and Bowel Continence Care APPG, said: “We recognise there has to be a move away from ‘pad culture’ through improved continence support and training, but this should not leave patients without the products they need. Rationing pads does not solve this issue, and the impact reaches every part of daily life – from work and education to mental health and independence. We need a patient-focused approach, via community care initiatives and value-based procurement. We can still bring down costs whilst treating patients with dignity.”
The motion cites evidence suggesting that restrictions on continence products may ultimately increase pressures on the NHS and social care services. An NHS trust pilot referenced in the EDM found that introducing better-fitting continence products reduced staff time spent on continence care by 47%, potentially saving £188,000 annually. The pilot also reportedly led to a 42% increase in residents independently managing their continence needs and a 100% reduction in leakages.
The EDM also noted that almost two thirds of healthcare professionals caring for patients with incontinence said they had provided patients with continence pads that were unsuitable for their needs, while one in 20 said they had to do so routinely.
Tracy Whitehouse, Service Manager and Adult Specialist Nurse at Bladder and Bowel UK, said: “The correct provision of continence pads is essential to maintain a person’s health, dignity, safety, comfort, and quality of life, as well as the efficiency and cost-effectiveness of care services. Getting provision wrong can lead to skin breakdown, social isolation, the potential for falls, UTI’s, & potentially avoidable hospital admission – at what cost? The right pad for the right person is an exact science; it is not a one size fits all.”
Jenny Park, Director of Services, Dementia Carers Count, said: “Many people caring for a family member with dementia at home find themselves navigating continence care. It can be exhausting. Carers can find themselves struggling to cope with the personal care someone needs. Having access to continence care products that fit and work well can make all the difference. The right products and the right support means that carers are more able to cope as well as giving more dignity to the person they’re caring for.”
Concerns over continence care provision have been mounting in recent months. In April, a coalition of health charities and professional bodies – including Royal College of Nursing, Prostate Cancer UK and Bladder and Bowel UK – warned that restrictions on pad provision had created what they described as a “pad gap”, leaving some patients and families forced to spend their pensions or personal independence payments to cover shortages in NHS support.
The motion calls on the Secretary of State for Health to ensure NHS executives, procurement managers and NHS Supply Chain comply with NICE guidance and provide patients with enough appropriate products to meet their clinical needs, emphasising that this approach supports both better patient care and greater cost‑effectiveness for the NHS.
