When nature calls! Managing incontinence

From EPSA - European Public Sector Award


The Health Service Executive (HSE) provides health and social services to everyone living in Ireland. It employs over 100,000 people with an annual budget of over €13 billion. There are four HSE administrative areas; the Roscommon Continence Care project is based in County Roscommon which is one of six counties in the HSE West administrative area. Roscommon is an inland county with a population of 58,768, of which 15% is over the age of 65 years. In Ireland, transformational changes are being experienced throughout the health service in order to ensure resources are directed towards providing a better quality of service for everyone. While many aspects of the transformation were planned, the downturn in the economy and its impact on services could not be predicted. If services are to be maintained, judicious decisions on how scarce resources are allocated will have to be made, including reviewing and changing the methods by which services are provided. To this end the HSE are examining innovative ways of streamlining work practices and processes to ensure easy equitable access to high quality care and service. This project is one such initiative providing a framework to improve the delivery of continence care by setting up a primary care-led continence advisory service for the local population.

Bladder and bowel problems may affect anyone of any age and health status and may have a significant impact upon quality of life. A high quality and comprehensive continence service is, therefore, an essential part of healthcare. It is estimated in HSE West that over 10,000 adults and children suffer from bladder problems, based on the number of people who access disposable products through HSE Services. The true figure is probably substantially greater. When left undiagnosed or unmanaged, incontinence can have devastating consequences, and can place a huge burden on healthcare providers and other resources.

The continence care model developed across County Roscommon has significantly improved care for children and adults with bladder and bowel problems by redesigning the way services are provided and delivered in all Primary, Community and Continuing Care (PCCC) settings as well as private nursing homes across the County. This involved the development of continence guidelines/protocols and delivery of a number of education programmes open to staff from all services. Central to the project is the synergy database, an information management system which manages the data derived from clinical assessments. This system leads to the provision of regular home delivery of appropriate products to clients across County Roscommon, either direct to their own homes, residential care units or private nursing homes. This project is a partnership between all clients and healthcare staff across public, private and voluntary sectors. It has been proven to deliver cost-effectiveness and with a focus on prevention and rehabilitation it sets out a model of good practice for continence care, which has the potential for national roll out and has already been replicated in six counties so far.

Award info
Award category: smart public service delivery
Award type: diploma
Award year: 2011
Project type
Sector: Public health and social welfare/affairs
Type of activity:
Keywords: Sustainable, innovation, change, integration, engagement, efficiency, cost effective, redesigning service delivery, quality, equitable, accountability, information management, ease of access, cost containment, best practice, synergy, client centered
Short English description: This project is one such initiative providing a framework to improve the delivery of continence care by setting up a primary care-led continence advisory service for the local population.
Further information
Organisation: Health Service Executive, West
Other applicants:
Level of government: local level
Size of organisation: >100
Number of people involved: >15
Country: Ireland
EU membership: EU member
Language code: en
Start date:
End date:

When nature calls! Managing incontinence (53.3240777, -8.1674767)
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