Talking honestly about continence: Improving dignity and care

Too many people in North Yorkshire told us they felt embarrassed, dismissed, or unsupported when trying to get help for continence issues. We listened, raised these concerns with health and care leaders, and highlighted the urgent need for more respectful, timely, and joined-up care. Since then, our work has sparked action and improvements in hospitals, general practices, and community continence services across the county.

Continence isn’t easy to talk about—but it should be. In 2023, Healthwatch North Yorkshire heard from people across the region about their experiences with bladder and bowel health. Their message was clear: they want better information, more dignified support, and care that treats continence as a priority, not a taboo. Since then, our findings have led to county-wide conversations, commitments, and some early signs of progress.

What’s changed so far

Our report, It’s Time to Talk About Continence, launched in June 2023, and helped bring a hidden issue into the public eye.

• The report was presented to North Yorkshire health leaders in August 2023. In early 2024, they shared their formal response and agreed to review how continence care is provided for both children and adults.
• The Director for Health and Care in North Yorkshire confirmed the recommendations will inform a planned review of services that support people with bladder and bowel problems.
• A local voluntary group, Tadcaster Volunteer Cars and Services Association, raised the continence project at a healthy ageing meeting. It was positively received and started further local discussions.
• North Yorkshire Council confirmed they will consider including continence-related challenges in future public health and prevention plans.

Following up

Since publishing our findings, we’ve followed up with hospitals and general practices to see what action has been taken.

• We asked York and Scarborough hospitals and Harrogate and District hospitals for updates. Both confirmed they are using a wide range of continence products and are working with their teams to improve continence care and training.
• York and Scarborough have introduced a screening tool within 72 hours of hospital admission to better understand people’s continence needs.
• Harrogate Hospital uses a "toilet plan" to promote continence and avoid unnecessary use of pads.
• Both hospitals confirmed new stoma patients are given pre- and post-operative support, including clear written information and direct follow-up.
• Both hospital websites now include accessible information on continence services. Harrogate also provides details on self-referral, contact numbers, and named staff.

We also asked general practices to:

• Start conversations about continence, even if a person hasn’t raised it themselves.
• Make sure people more likely to get bladder infections are identified early, so they can be treated quickly.

Ongoing efforts and community support

• York and Scarborough and Harrogate Hospitals offer training for staff on catheter care, stoma and ostomy support, and appropriate product use. This training is available for both ward and community teams.
• The teams have also worked with groups such as the MS Society and cancer support organisations to talk about continence in the wider community.
• Harrogate has plans to restart their local support group for people with stomas and currently refers patients to support groups in York and Leeds.

Working with local care and community providers

• Care home and home care staff across North Yorkshire are being trained to recognise the signs of urinary tract infections, use continence products correctly, and support people with catheters and stomas.
• Health and care teams are promoting better conversations around bowel health by using tools like the Bristol Stool Chart. Public health campaigns are also encouraging people to look out for any changes in their bowel habits and speak to their doctor.

Our commitment

Healthwatch North Yorkshire will continue to speak up for people affected by continence issues and check whether promised changes are making a real difference. Everyone deserves care that is respectful, timely, and meets their needs—no matter how difficult the topic may be to talk about.