Now more than ever, those with an interest or specialism in continence care need to be able to access professional development, as well as share knowledge and experiences with colleagues. Covid-19 has rapidly altered service provision and specialist professionals working across different geographical areas have not yet had sufficient opportunity to come together in person and process what these changes mean for their practice and patients. This upheaval has, of course, affected everyone whose work touches on bladder and bowel issues.  

Ongoing specialist education has taken a hit. This is one of the reasons that Bladder and Bowel UK’s symposium in Bolton in March 2022 represented such an exciting and valuable opportunity. At a time when healthcare professionals are under more pressure than ever, the symposium programme was designed to meet diverse educational needs within this specialist field of practice.  

Given the current state of affairs, it is no wonder that professionals working in the field of bladder and bowel care are enthusiastic about returning to in-person events. We await results from the EPICCC-19 study from the University of the West of England, University of Bristol and the National Institute for Health Research Applied Research Collaboration West, which is assessing the impact that the pandemic has had on community continence care services for adults and children. It is anticipated to show that widespread service redeployment, resulting in lengthy waiting times, alongside reduced access to specialist education, have taken a major toll on the scale and reach of continence services — as well as on the morale of the professionals delivering them.  

This continues a trend of bladder and bowel services falling into that unenviable category of ‘Cinderella services’, with services continuing to lack investment, recognition and succession planning, with many undergraduate education programmes still barely touching on this subject. This is despite the significant day-to-day negative impact of continence issues on patients’ lives, and those of their carers. The enduring taboo of incontinence has a knock-on effect on recruitment into this specialist area. For those with bladder and bowel difficulties, the stigma and embarrassment affects their ability to approach their healthcare professional, as well as subsequent engagement and compliance with treatment regimens (Hägglund and Wadensten, 2007). The pandemic has likely exacerbated the barriers to access, with continence services one of the first areas to be targeted for redeployment. What is more, over the past two years, access to the physical examination element of essential patient assessments by continence specialists, has been restricted. While there are undoubtedly some opportunities presented by remote assessments, the complexities are extensive.  

Similarly, the accelerated shift to remote education has its benefits, but the continence field finds itself poorer after the scarcity of face-to-face education. Given that bladder and bowel care remains underfunded and insufficiently recognised (Eustice, 2013), the relationships between professionals in the field are integral to its progression, development, functioning and sustainability into the future. These relationships need forums to facilitate personal, professional and service development, so that patients continue to receive quality care based on the best and most up-to-date evidence.  

Bladder and Bowel UK’s symposium was the organisation’s first in-person event in two years, providing delegates with some of that much-missed opportunity to update skills and knowledge as well as to meet friends and colleagues from other services across the country.  

The event allowed continence professionals to reflect on the past two extraordinary years, and to maintain professional development and promote excellence in the specialism, ensuring that bladder and bowel services continue to evolve and thrive in the future. 

The next Bladder and Bowel UK continence symposium is in September 2022. Topics at the symposiums have concurrent adult and paediatric streams so, are suitable for professionals working with children as well as those who work with adults. Evidence of attendance and certification will be provided in order to support CPD and NMC revalidation for nurses. 


Eustice S (2013) Reversing deterioration in continence services. Nurs Times 109(27): 18–9  

Hägglund D, Wadensten B (2007) Fear of humiliation inhibits women’s careseeking behaviour for long-term urinary incontinence. Scand J Caring Sci 21(3): 305–12 

This piece was first published in the Journal of Community Nursing. To cite this article use: Carassik Ratty S (2022) Supporting bladder and bowel services to evolve and thrive. J Community Nurs 36(1): 14