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Continence care ‘needs stronger emphasis’ in nurse training

“No healthcare professional is without power.” That was the key message from Sir Robert Francis KC in his address to attendees at the Association for Continence Professionals’ (ACP) conference held in Liverpool this week.

More than 250 delegates assembled for the annual conference, which this year marked the first under the organisation’s rebrand, having formerly been known as the Association for Continence Advice.

“Undergraduate training doesn’t have enough bladder and bowel aspects to it”

Polly Weston

Sir Robert has recently been appointed as interim chair of the Infected Blood Compensation Authority, the body that will administer the compensation scheme for those affected by the national scandal, in which more than 30,000 people received contaminated blood or blood products from the NHS between the 1970s and 1990s.

On the opening day of the two-day conference, the barrister, who specialises in clinical negligence and led the investigation into the Mid Staffordshire hospital scandal, urged nurses to find their voice and not to tolerate the intolerable, before offering examples of poor nursing care in which patients were left soiled and distressed.

Sir Robert outlined a need for a nationally integrated continence strategy with regular audits which would assist the nursing profession, stating it should not be down to the profession to operate without such support “from top to bottom and bottom to top”.

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In response to a nurse who advised that continence care was not part of the training curriculum, Sir Robert said: “To be blunt about it, the willingness and ability of someone to be able to undertake the continence care of someone is a fundamental test, should be a fundamental test, of why or whether it’s good for you to become nurse or not.

“Not everyone is, there’s no shame in that, and we need to recruit the right people. I would have thought it should be part of everyone’s training – let’s do something about it.”

Polly Weston at the Association for Continence Professionals conference in May 2024

Polly Weston

ACP chair Polly Weston said she was passionate about ‘next steps’ following the conference and addressing one of the emerging themes of lack of undergraduate training in urinary and faecal incontinence.

She said: “I sit on part of a national research project into faecal incontinence.

“As part of that research project, one of the things that is emerging from it is the lack of undergraduate training, not just for nurses but actually looking across the whole spectrum of healthcare professionals –medicine, physio, nursing.

“Undergraduate training doesn’t have enough bladder and bowel aspects to it to drive them through to find that inspiration and passion as they move into their career.”

Lived experience was very much part of the annual conference, with patients also among the many speakers, including dad-of-two Jonathon Hall who left much of the nursing audience in tears with his powerful and moving account of being tested and treated for prostate cancer.

Jonathon Hall at the Association for Continence Professionals conference in May 2024

Jonathon Hall

Although Mr Hall used humour throughout his thought-provoking presentation, it did not mask the depth of emotion felt during what he described as sometimes degrading and humiliating encounters with health professionals.

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Having been left incontinent as a result of his prostatectomy, Mr Hall is tackling the taboo of male incontinence and actively campaigning for ‘Bins for Boys’, a Prostate Cancer UK-led mission which seeks legislation to ensure access to sanitary bins is compulsory in all male toilets – something Sam Davison, clinical procurement specialist nurse at South Tees Hospitals NHS Foundation Trust, said was already being implemented across the trust.

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