Continence promotion services in Barnet

Healthwatch Barnet carried out an engagement project in 2018 to understand patients’ experiences of the adult continence promotion service provided by Central London Community Healthcare (CLCH) at Finchley Memorial Hospital. The service supports adults with bladder and bowel problems through specialist nursing advice, treatment, self-management support and continence products.

Healthwatch surveyed 18 patients and carers attending the clinic between April and May 2018. Most participants had been referred by their GP, although one patient had successfully self-referred after finding information about the service independently. Patients included people with a range of complex conditions such as Parkinson’s disease, stroke-related disabilities, mobility problems and learning disabilities. 

Overall, patients reported very positive experiences once they reached the service. They consistently said that the specialist continence nurses were friendly, approachable, listened carefully to their concerns and provided clear information about treatment options. All respondents stated that they understood their treatment after attending the clinic and felt listened to by staff. 

However, many patients felt they had not received enough information before attending their first appointment. Several people said their GP had not adequately explained what the service offered, what would happen at the appointment or how long treatment might last. Some patients arrived at their first appointment with little understanding of what to expect. 

Patients generally found appointment booking straightforward and appreciated receiving text or telephone reminders. Most also had a direct contact number for the continence team and felt able to seek advice or request follow-up appointments when needed. Follow-up arrangements were viewed positively, with patients reporting that they could obtain additional support whenever necessary. 

Access to the service was more challenging for some patients. Several respondents reported difficulties travelling to Finchley Memorial Hospital, particularly those relying on public transport. Long walks from bus stops, mobility problems and concerns about future transport arrangements were common themes. A small number of patients also reported negative experiences when contacting hospital reception staff to rearrange appointments. 

Healthwatch identified issues with signage within the hospital, which sometimes resulted in patients waiting in the wrong area. In addition, two patients required language support but were not using formal interpreting services, despite being aware that interpreters could be provided.

Most patients who had been prescribed continence products reported no difficulties obtaining them. Satisfaction with the overall service was high, with many describing it as “excellent” and praising both the quality of care and the professionalism of the nursing staff.

Healthwatch concluded that the service was highly valued by those who used it but appeared underused, with low levels of self-referral and clinics quieter than expected. The report recommended improving information provided before first appointments, increasing awareness and promotion of the service, making referral information easier to find online, improving signage at Finchley Memorial Hospital, and ensuring interpreting services are consistently offered and promoted to patients who need them. 

In response, CLCH agreed to produce information leaflets and promotional posters, review patient interactions with reception staff, continue offering interpreters where required, and address signage issues where possible. Barnet Clinical Commissioning Group also committed to working with providers and partners to increase awareness of the continence service across the borough.