Faced with an ageing population, one of the most significant scientific and social challenges today is how to improve and manage health across the life course. A taboo but common complaint of ageing is incontinence. We argue that incontinence is the single greatest barrier to the UK government’s Ageing Society Grand Challenge ‘to ensure people can enjoy at least 5 extra healthy, independent years of life by 2035, while narrowing the gap between the experiences of the richest and poorest’ (Centre for Ageing Better, 2020, p. 1).
Indeed, a national audit of UK healthcare concluded that “people of all ages, and vulnerable groups in particular… suffer unnecessarily and often in silence, with a ‘life sentence’ of bladder and/or bowel incontinence” (Wagg et al., 2010, p. 6). The economic burden of incontinence is comparable to other common complaints of ageing, such as arthritis, which is equivalent to 1% of GDP (CDC, 2020; Hu et al., 2002). The population of Bradford is ethnically diverse with 36.1% identifying as Black, Asian or minority ethnic (Bradford Metropolitan District Council, 2020). While there are no statistics incontinence statistics available specific to Bradford, research nevertheless shows higher prevalence for ethnic minorities, which indicate higher associated service costs that may lead to discrimination in admission to care services (Bliss et al., 2013). NHS health and social care professionals within Bradford welcome further research in this area, as indicated by recent discussions.
At the heart of our proposal, is that we can:
- promote discussion and innovation around incontinence across the ‘ageing market’, and
- aim to improve continence resilience across a local economy, which are aligned to Challenge Frameworks aims to sustain physical activity, manage the common complaints or ageing, live well with cognitive impairment, support social connections and create healthy and active places.
This study will adopt a qualitative approach and will consist of 4 phases:
- Qualitative interviews will be undertaken with a sample of patient, public and service providers to identify barriers and facilitators to service provision and the existence of workarounds to support personal, community and system resilience.
- Patient focus groups will be completed piloting the use of visual prompts derived from a variety of archaeological and anthropological contexts to broker sensitive discussions.
- Patient/public/provider stakeholder panels will be convened to co-design products and services to build personal, community and system resilience.
- Feasibility analysis of proposed interventions including implementation/impact/costing evaluation.
Access to stakeholders will be sought through university collaborations, the FoH service user group, the Wolfson CAHR, Y&H PSTRC and the DHEZ. The findings of this study will identify gaps in NHS service provision and innovation in personal, community and system practices which support patients with incontinence. This output can influence formal local service design and development and present data to support funding business cases and commissioning of services within primary and social care. Closer to home, it will advise local council on patient’s needs in everyday use of business and social premises to inform local government decisions on access to public conveniences and other support mechanisms.