Sandwell and West Birmingham Hospitals NHS Trust – Faecal Incontinence and Constipation Healthcare

Sandwell and West Birmingham Hospitals NHS Trust – Faecal Incontinence and Constipation Healthcare


>>Elisabeth Clarson: Before the FINCH service
was developed, patients with faecal incontinence and constipation problems were seen by lots
of different people really and bounced around the system. Then they’d be told there wasn’t
really a lot they could do or be given lots of laxatives in constipation cases or pads
if they’ve got incontinence and were basically sent on their way. There were very little
services for them and they were basically left to suffer in silence at home.>>Sandra Botwood: Before I came into this service I was passed from pillar to post from one doctor to another doctor and I was at my wits end.>>David Twose: I was diagnosed with bowel cancer in 2013 then I had an operation that took away part of my bowel. After that, it was great but
I had this problem of going to the toilet. From 5 o’clock at night until 10 o’clock
I just couldn’t keep off the toilet.>>Elisabeth Clarson: When the service started it was consultant led and from 2012 it started becoming nurse
led and we introduced the integrated care pathway for faecal incontinence which is where
we started to integrate. We are specialist nurses in our own right
so we are able to see the patient and take a full history, order the investigations,
interpret the investigations and initiate treatments and actually discharge them so
they can see one of us straight the way through the whole process, so they get continuity
of care right the way through.>>Kelly Stackhouse: In 2012 we launched a pilot for an integrated care pathway so the patients that were being
referred came directly through to ourselves we then triaged out to either community, consultant
or ourselves to be seen, treated and we can integrate throughout each of those pathways
at any stage should we need to by utilising our MDT meetings.>>Gill Davey: Sandwell and Dudley have started working in partnership to embrace the Dudley
continence service and help our patients a bit closer to home, so these patients don’t
have to come to Sandwell and I can actually treat them at home and we’re actually working
this across boundaries and across Trust.>>Kelly Stackhouse: We’re actually hitting 78% success rates with our patient outcomes so patients are
actually seen and discharged and treated within approximately 3 visits, which is our average.
Cost savings that have occurred, we have reduced our laxative usage. A lot of patients who
have bowel problems will have urinary symptoms also but we have made a significant impact
on pad cost savings so we’ve reduced that by 53%.>>David Twose: The team have helped no end. If I’ve had
a problem they’re always there at the end of a phone. The impact – it’s given me
my life back.>>Sandra Botwood: The team have been amazing to me. I’ve got a lot more confidence. I can go out now. It’s
had an amazing impact on my life.>>Elisabeth Clarson: The patients days came around from one of our cancer patients actually and I was seeing
him in clinic and he was sitting there telling me how isolated he was so we started the anti-reception
syndrome survivorship days. The Poos News was born middle of last year really – all
the patients met up and put their bits together. It’s been really helpful in giving them
a peer group and we also find that some of them may have symptoms and another patient
will tell them actually I’ve got that and I do this… It actually helps them manage
their symptoms between them you know and it saves them coming to hospital for a visit
because they sort it between themselves which is really, really good.
So the Leading Change, Adding Value commitments, we feel that probably number 5 is most important
to us, which is working with patients and the carers and families – that’s what is
most important.

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