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CSP Scotland calls for investment in physiotherapy for 300,000 adults with bladder incontinence

6 March 2015 - 3:25pm

CSP Scotland has written to health secretary Shona Robison calling for greater investment in physiotherapy services to end poor care for people with incontinence.

MSP Shona Robison

Scottish health secretary Shona Robison

The letter dated 3 March asks for a meeting with the Scottish minister and urges the Scottish government and NHS health boards to:

  • invest in training and career pathways to increase the number of specialist physiotherapists in pelvic, obstetrics and gynaecology services
  • invest in the development of self-referral to enable patients to access specialist physiotherapists
  • review capacity and access pathways to pelvic health and women’s health physiotherapy services in health board areas
  • update the patient pathway so that patients – including those with prolapse and stress urinary incontinence (SUI) – are routinely referred for physiotherapy management before referral for surgery

Kenryck Lloyd Jones, the CSP’s public affairs and policy manager, said: ‘The bottom line is we need to ensure access to adequate and sufficient continence services for women and men. We don’t think there’s capacity in Scotland to offer what is required and services are patchy.’

He said that research shows some 300,000 adults in Scotland suffer from urinary incontinence, or nine per cent of the population. Studies have also shown that 50 per cent of women affected by SUI are moderately or greatly bothered by it.

In 2014 the Scottish government suspended transvaginal mesh surgery for women with urinary incontinence and organ prolapse. The move followed concerns about complications resulting from this type of surgery which had affected a number of patients.

But CSP Scotland found that the suspension of surgery had greatly increased the pressure on physiotherapy services which were already struggling to meet demand. Its figures show that Scotland has a shortage of physiotherapists with the post-graduate qualification to specialise in pelvic floor dysfunction.

Doreen McClurg chairs the CSP’s pelvic, obstetrics and gynaecological physiotherapy network. She told Frontline: ‘This speciality is not taught at undergraduate level and the government could support postgraduate training, as well as providing funding for additional posts.’

Another concern for CSP Scotland is that the Scottish intercollegiate guideline for the treatment of urinary incontinence, which fully recognises the value of physiotherapy, is about to be withdrawn. The guideline was written 10 years ago.

Mr Lloyd Jones said it was vital for the physiotherapy profession to propose a new guideline.

A pelvic, obstetrics and gynaecological physiotherapy network seminar at the National Assembly for Wales on 24 February heard about guidelines and best practice in Wales, as well as the issues faced by people with pelvic health dysfunction.

These included mental health problems associated with urinary incontinence Physiotherapist Ruth Emanuel told the event that physiotherapy for this condition met many of the requirements of the Welsh government’s prudent healthcare agenda.

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