Margaret Ritchie, Baroness Ritchie of Downpatrick, explains how continence care could release thousands of beds, spare staff hours, and restore patient dignity.
The NHS is sinking. Hospitals are buckling, patients are left languishing in overflowing corridors, and staff are stretched past breaking point. Bed occupancy routinely soars above 95%, discharges are delayed for weeks, and patient dignity is too often the first casualty.
On average, more than 12,000 hospital beds are lost each day to bed blocking – when patients remain in hospital longer than necessary because discharge support is unavailable or preventable health issues prolong their stay. The cost to the taxpayer is eye-watering: around £4.7 million every day. Over the past three and a half years, this has meant more than 15 million lost bed days – the equivalent of shutting down 26 full-sized hospitals.
The culprits are well known: shortages in social care, a lack of home care provision, and layers of bureaucracy. But one overlooked factor has received little attention: poor-quality continence care.
Delaying discharges
In June, a survey of 500 healthcare professionals revealed that substandard incontinence products are delaying discharges and driving avoidable admissions. Experts have long argued that better continence care – through the use of higher quality products – would help many older patients leave hospital sooner and return home more quickly – and equipped with the right products better to meet their needs.
However, for years, policy has prioritised cost over quality – favouring the cheapest available products. Yet anyone familiar with care provision knows the reality: these products often fail to deliver optimal – or even acceptable – results for patients and their carers.
In fact, cheap incontinence pads often leak, causing infections and skin damage that needlessly prolong hospital stays. Nurses and care teams spend hours changing products, laundering linens, and keeping a watchful eye over avoidable complications. Medical staff find themselves repeating these tasks several times a day, fuelling burnout and cutting into time for other patients. The penny saved on procurement quickly becomes a pound wasted in hospital care. In other words, cheaper products are, by definition, a false economy.
The solution is straightforward: procure products on overall value – including quality – rather than short-sighted obsessions over unit price. One NHS pilot has already proved effectiveness: fewer leaks, urinary tract infections, products used, and enormous savings in staff time and capacity. It is an approach that is demonstrably better for patients, carers, and the NHS as a whole.
The approach, known as value-based procurement, also significantly improves the patient experience. High-quality, well-fitting continence products help patients regain a sense of control and dignity during their hospital stay. Being able to manage personal care without constant assistance restores confidence, reduces anxiety, and contributes to a faster, smoother recovery. Patients regain their independence, and nurses regain their time to focus on what truly matters: providing the best care possible to all.
Opportunity to act
The government is well aware of this, and to its credit, has committed to enact value-based procurement that prioritises patient experience and outcomes over cost – a move that could help ease high bed occupancy rates. But the change is not due until autumn next year, and its rollout has already been delayed. In the meantime, hospitals remain under severe strain, and patients linger on wards far longer than necessary.
This reform cannot be left to local goodwill. It must be driven from the top: by the Department of Health, NHS Supply Chain, and national procurement leaders. If we are serious about freeing up beds and cutting waiting lists, this is a clear opportunity to act.
The NHS does not necessarily need more money; it needs to spend more wisely. Continence care may not make headlines, but it could release thousands of beds, spare staff hours, and restore patient dignity. All it requires is the political will to act sooner rather than later.
Baroness Ritchie is a Labour Peer and serves as an officer of the All-Party Parliamentary Groups on Dementia and on Access to Medicines and Medical Devices.
