Paediatric Continence Forum
Political and Parliamentary Monitoring
Week Commencing 13th August 2018

With just eight months to go before the UK officially leaves the EU, leaders of the British Medical Association had warned that leaving without an agreement could be hugely damaging for the NHS. The organisation, representing doctors and healthcare leaders and professionals, has warned that one million patients receiving treatment for rare diseases could be put at risk if the UK no longer has access to the European Rare Disease Network. Access to materials vital for cancer could also be undermined.

The loss of reciprocal healthcare deals with EU countries could drive up costs by as much as £1 billion, as thousand of pensioners living abroad return to the UK for treatment. The Chair of the BMA, Dr Chaand Nagpaul, said that “the consequences of “no deal” could have potentially catastrophic consequences for patients, the health workforce, services and the nation’s health”. The organisation is now calling for a second referendum on any deal (or lack thereof) which the government agrees.

The news that the BMA is calling for a second referendum comes in the same week that more preparations are being made for customs arrangements should the UK leave the EU with ‘no deal’ in place. Plans are being put in place to utilise the Channel Tunnel, diverting some freight from road to rail. Gavin Simmonds, Director of Brexit at the UK Chamber of Shipping, said recently that British ports and shipping companies will need at least three years to set up a new customs system in the event of a ‘No Deal’ Brexit.

Any disruption to imports and exports would undoubtedly impact the health service, delaying the availability of important drugs. At the same time, many of the raw materials used in continence devices, such as catheters, are imported and thus there could be delays in the manufacturing of products.

Whitehouse will continue to monitor Brexit developments, including reaction from the health industries and pharmaceutical sector.

• Improving continence care in young people
• Virtual reality success
• Call for more doctors

Nursing Times backs campaign to improve continence care in young people
The Nursing Times has released a report outlining the impact the lack of continence provision is having on young people, especially men, and how services can be improved moving forward. The article highlights that a significant stigma exists around bladder and bowel issues, with many young people not accessing the help that is available. A quarter of young people surveyed believed bladder and bowel issues only affected older people, whilst two-thirds of those aged 18-24 said they would be embarrassed to see a doctor.

Specifically, the article highlights the plight of young men, who can become particularly vulnerable to stigma, meaning that continence problems can go unaddressed. Although men are less likely to report continence problems than women, they are susceptible at all stages of life to bladder and bowel issues. The article cites one community study which took place in Leicestershire, where 8.9% of men complained of urinary incontinence, a figure which steadily increased with age.

It will interest PCF members that the stigma associated with male continence issues was discussed at the last APPG on continence meeting. It was agreed more should be done to ensure that toilets had bins for pads and other disposable continence devices, with Baroness Greengross, Co-Chair of the Group, indicating that this was a human rights and discrimination matter.

This news will interest PCF members, as it has been remarked before that discussion on continence issues in young people can be hampered by young people and their parents feeling unable to speak up and reach out for help and assistance.

Whitehouse will monitor any plans to increase waste disposal provision in public toilets. The APPG is writing to the Equality and Human Rights Commission on this matter, and may ask for PCF backing. If so, we will liaise with the PCF about supporting any such letter.

Virtual reality key to putting patients in control of their own health
“Social prescription”, smart beds, new virtual reality and digital programmes of support are amongst a wave of digital innovations that will transform the NHS over coming years, according to a new report. ‘The Future of the NHS’, authored in part by the pharmaceutical chain Pharmacy2U, describes how artificial intelligence will radically transform the way health services are delivered.

Patients will soon be connected social networks of people living in similar situations, so they can learn to manager their own conditions from others who have gone through the same illness. For patients with severe disabilities, virtual reality could be linked to brain-controlled robotic systems. The report also predicts that dispensing prescriptions could become easier, with digital software allowing for doctors to more easily sign-off repeat prescriptions.

CEO of Pharmacy2U, Mark Livingstone, said “Technology has transformed industries from retail to travel, and is now starting to make a significant impact on healthcare”, adding that in the future “every individual will be given the technology to empower themselves to control and adapt their own healthcare requirements”

Technology has the potential to positively impact the continence sector. The ability to automatically produce repeat prescriptions, and have them delivered quickly, will undoubtedly benefit those using pads, catheters or continence devices. However, artificial intelligence should compliment the role of professional clinical staff. Indeed, whilst promoting independent living has clear benefits for those with continence issues, there should be support networks in place to support individuals.

Whitehouse will continue to monitor technological advances, and will report on any new consultations linked to technological testing or development.

NHS in urgent need of doctors at GP shortage continues
Professor Helen Stokes-Lampard, Chair of the Royal College of GPs, has said that thousand of foreign medics must be fast-tracked in order to plug GP vacancies amid a “haemorrhaging” of existing staff. She has urged the government to lift barriers slowing down recruitment from overseas. Two years ago the Government aimed to have additional 5,000 GPs trained by 2020, but since then the workforce has shrunk by 1,000.

Professor Clark said that the Royal College had been incredibly supportive of NHS England’s plans to recruit new fully-qualified GPs from abroad, but warned that “things are moving slowly with reports suggesting the target [of employing 2,000 staff from outside the UK] is in jeopardy”. Professor Clark has called on NHS England to act as a sponsor for applicants from abroad, thus reducing the wait that many entrants endure as immigration documents are examined.

Urging the new Health Secretary, Matt Hancock, to invest an additional £2.5 billion in general practice by 2020/21, Stokes-Lampard said too many patients were being forced to wait up to a month for an appointment, leaving many suffering or causing more serious health complaints. Data released at the end of last week showed that one in four patients are waiting over a week to see a GP.

The news that the NHS is in urgent need of additional investment will be concerning, if unsurprising to PCF members. Many are already fully aware that, given the reduction in the number of school nurses, increasing numbers of young people and parents are turning to their doctors to discuss continence issues. Ensuring that there are the facilities in place to have young children seen quickly and by a continence-trained healthcare professional, is vital to treating any issues.

The PCF will include reference to current staffing levels in any communication with NHS England.