Bladder Resources

When most people, professionals or media discuss the NHS, it is more often NHS England that they think about. However, due to devolution, each country has its own form of NHS system. While the goal of any NHS system is to provide an excellent service for health
provision to their population, how it is delivered can vary greatly. This article examines how the initial NHS was set up, how devolution in Wales has changed how services in Wales are commissioned, and how this has impacted on continence/bladder/bowel care in Wales.

Indwelling urinary catheters remain one of the most used clinically invasive devices in the UK, with approximately 90,000 people living in community settings in England currently using long-term urinary catheters. There has been a plethora of clinical evidence published demonstrating the risks of prolonged use of indwelling urinary catheters and the increased risk of significant infection, sepsis, and, in some cases, fatality. While the use of an indwelling urinary catheter is in some cases wholly justified and unavoidable, it is the responsibility of healthcare professionals to ensure that risks are mitigated/reduced wherever possible. Use of a catheter valve system may improve the chance of normal bladder function resuming following the removal of the catheter. It is a relatively simple intervention that can be managed by many patients and offers more discretion and dignity. Use of catheter valves should always reflect latest national guidance on best practice and be incorporated into local policy. This article explores some of the clinical evidence supporting the use of catheter valves and advice on best practice.

This article looks at a telephone triage assessment clinic that was set up to improve the bowel, bladder and pelvic floor service in the authors’ locality. A pelvic floor triage questionnaire was developed to identify patients’ faecal, urinary and prolapse symptoms then, between April and December 2013, patients were referred to the colorectal pelvic floor clinic via telephone triage assessment. Investigations could also be requested directly from the telephone triage assessment clinic. The need for any investigations and patient responses to the telephone triage assessment clinic questionnaires were reviewed in the pelvic floor multidisciplinary meeting. Previously, the wait for a new pelvic floor appointment was four months and this has been reduced to two weeks (or five weeks for a new consultant appointment). The telephone triage assessment clinic has led to a reduction in waiting times, an improvement in patient experience and more efficient referral. It is also more cost effective as
it can replace a new consultant appointment.