Cecily Palmer
Professional perspectives on impacts, benefits and disadvantages of changes made to community continence services during the COVID-19 pandemic: findings from the EPICCC-19 national survey
Palmer, Cecily; Richardson, Davina; Rayner, Juliette; Drake, Marcus J; Cotterill, Nikki
Authors
Davina Richardson
Juliette Rayner
Marcus J Drake
N Nikki Cotterill Nikki.Cotterill@uwe.ac.uk
Professor of Long Term Conditions (Continence Care)
Abstract
Background: The COVID-19 pandemic required changes to the organisation and delivery of NHS community continence services which assess and treat adults and children experiencing bladder and bowel difficulties. Although strong evidence exists for the physical and mental health benefits, improved quality of life, and health service efficiencies resulting from optimally organised community-based continence services, recent audits identified pre-pandemic pressures on these services. The aim of this study was to explore professional perceptions of changes made to community continence services due to the COVID-19 pandemic and consequent impacts on practice, care provision and patient experience. Methods: Online survey of 65 community continence services in England. Thematic analysis using constant comparison of open-ended questions. Frequency counts of closed-ended questions. Results: Sixty-five services across 34 Sustainability and Transformation Partnership areas responded to the survey. Use of remote/virtual consultations enabled continuation of continence care but aspects of ‘usual’ assessment (examinations, tests) could not be completed within a remote assessment, requiring professionals to decide which patients needed subsequent in-person appointments. Remote appointments could increase service capacity due to their time efficiency, were favoured by some patients for their convenience, and could increase access to care for others. However, the limited ability to complete aspects of usual assessment raised concerns that diagnoses could be missed, or inappropriate care initiated. The format also restricted opportunities to identify non-verbal cues that could inform professional interpretation; and made building a therapeutic relationship between professional and patient more challenging. Remote appointments also posed access challenges for some patient groups. A third of participating services had experienced staff redeployment, resulting in long wait times and some patients being left without care; or reported additional caseload, which had delayed care provision for patients with continence issues. Participants perceived continence care to have been deprioritised, and more generally undervalued, and called for greater recognition of the impact of continence care. Conclusions: Remote appointments offer efficiency and convenience. However, ‘in-person’ approaches are highly valued for optimum quality, patient-centred continence care, and good team relationships. Failure to restore redeployed continence staff will diminish patient health and quality of life, with associated costs to the NHS.
Journal Article Type | Article |
---|---|
Acceptance Date | May 30, 2022 |
Online Publication Date | Jun 15, 2022 |
Publication Date | 2022-06 |
Deposit Date | Jun 6, 2022 |
Publicly Available Date | Jun 16, 2022 |
Journal | BMC Health Services Research |
Electronic ISSN | 1472-6963 |
Publisher | BioMed Central |
Peer Reviewed | Peer Reviewed |
Volume | 22 |
Issue | 1 |
Article Number | 783 |
Pages | 783 |
DOI | https://doi.org/10.1186/s12913-022-08163-3 |
Keywords | Incontinence; community continence services; COVID-19; impact; remote consultations; remote appointments; digital health; redeployment; access to care; qualitative |
Public URL | https://uwe-repository.worktribe.com/output/9611716 |
Publisher URL | https://bmchealthservres.biomedcentral.com/?gclid=EAIaIQobChMI_K2I3JmZ-AIVFrLVCh1TUABbEAAYASAAEgJ99fD_BwE |
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Professional perspectives on impacts, benefits and disadvantages of changes made to Community Continence Services during the COVID-19 pandemic: findings from the EPICCC-19 national survey
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© The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http:// creat iveco mmons. org/ licen ses/ by/4. 0/. The Creative Commons Public Domain Dedication waiver (http:// creat ivecommons. org/ publi cdoma in/ zero/1. 0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
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