Continence care is going down the pan as costs are cut and prices rise

A recent article by June Rogers MBE of Promocon on Nursing Times.net has summarized many of the issues faced by Continence services as continence nurses are being forced to restrict types and quantities of products, regardless of need.

“We know the NHS will have to save £15-20bn over the next five years.

Health secretary Andrew Lansley has said that this “implied something like 3-3.5%, probably about 3%, efficiency savings each year in the NHS… we may need to do more, because we have increases in demand”.

On the ground, we have all been told we need to make significant savings within our individual departments of approximately 10% of our budgets. This means that those of us working in continence services are under considerable pressure to save, on average, more than £100,000 per year. This is almost impossible when we are already struggling on limited budgets, while the cost of disposable incontinence products and the ageing population who need continence care are both increasing.

The cost of continence products produced in the Eurozone has been dramatically affected by the exchange rate. Between 2007 and 2009, costs rose over 30%.

While the exchange rate has moved slightly this year, industry has still seen a cost increase of around 28% since 2007. Products produced outside the Eurozone are affected by fluctuating local currencies. In addition, raw material prices are increasing and, as those used in continence products are priced internationally in US dollars, there will be a double hit as the euro is weak against the dollar.

The figures do not add up. We want to provide the same level of service, balance the books and save 10% at a time when products are costing nearly 30% more.
Continence services can only realistically seek to cut costs via efficiency savings, rather than on product price. However, many of us are frustrated that our ideas to improve efficiency are often lost within the bureaucracy of the NHS and because continence is not anyone’s “target”, which means it sparks little interest.

Particularly frustrating is the snail’s pace at which services are being transferred from acute to primary care, where they could be better served.

Yet it is disposable product provision that leaves many continence nurses in the line of fire. Calls to the PromoCon helpline, a charity that offers product advice, are increasing. Patients and families are complaining about the limited type and number of products for which they are eligible. The phrase “Don’t shoot the messenger!” often comes to mind as nurses are told by management to restrict the type and number of products they prescribe to save money. This means that many services are not able to provide products to meet patients’ needs.”