ICS0047

Written evidence submitted by Urology Trade Association

About the Urology Trade Association

The Urology Trade Association (UTA) was established in 2007 to represent manufacturers and suppliers of urology products. Our members produce a range of urology products, including catheters, sheaths and stoma care products, which aid the treatment of conditions that can affect the kidney, bladder, prostate and bowel. The association seeks to:

       promote and sustain patient choice in access to continence products;

       increase patient and public awareness about continence issues; and

       ensure that patients are not placed at adverse risk by ill-advised policy decisions.

Improving outcomes in population health and healthcare

The UTA generally supports closer collaboration between the NHS, local authorities and care providers, to improve local services and the overall health and healthcare of the populations integrated care systems (ICSs) serve. As the new 42 Integrated Care Systems continue to take shape, the UTA believes that patients need to be at the heart of the design and delivery of local healthcare. This is especially important in the urology space where there is comparatively weak advocacy in continence care compared to other medical device areas for people with long term conditions such as stoma care.

The stated objective of improving the health of local populations allows for a degree of variation between ICSs in commissioning. From 1 July 2022, Integrated Care Boards (ICBs) assumed delegated responsibility for local primary medical services (which were previously under the remit of Clinical Commissioning Groups), with all ICBs expected to take on responsibility for the commissioning of pharmaceutical services (including Dispensing Appliance Contractors (DACS)) by 1 April 2023. ICSs should be open to engaging with DACs as they help ensure that the safety and health of patients living with urinary incontinence is well managed, thus improving the health of the populations they serve and reducing the burden on the NHS.

Section 14Z36 of the Health and Care Act requires each ICB to promote the involvement of patients in decisions which relate to their care or treatment. To improve outcomes of those with urological conditions, there needs to be greater awareness and education of continence care more generally, especially of those involved in procurement. The NHS estimates that around 14 million men, women, young people and children of all ages are living with bladder problems in the UK. Many of these rely on urology appliances to manage their conditions and maintain their quality of life.

The Health and Care Act 2022 also provides more flexibility in hospital discharge and repeals the legal requirement for adult social care needs assessments to take place while an individual is in hospital. Although this flexibility allows for local areas to adopt discharge processes that best meet local needs, greater consideration must be given for urology patients, such as those with a urinary tract infection (UTI), to ensure that they are not discharged from hospital until they are clinically ready, as this could lead to re-infection.

Tackle inequalities in outcomes, experience and access

The UTA is committed to tackling inequalities in patient outcomes, experience, and access to high quality urology products. To help facilitate this, all local commissioners must ensure that they are properly supported in understanding patient rights. As outlined in the NHS Constitution, patients have the right to receive care and treatment that is appropriate to them, meets their needs and reflects their preferences. In relation to urology patients, this should mean that they receive a high quality of care and access to the full range of products listed on Part IX of the England and Wales Drug Tariff. The Tariff is the authorised list of urology and stoma products approved by the Health Secretary for prescription and clinical use on the NHS for all patients across England and Wales.

Products placed on the Drug Tariff are guaranteed to meet specific criteria, notably that they are safe, of good quality and are cost-effective. Maintaining access to the Drug Tariff will ensure the patients have access to products that have had a medical professional involved in the prescribing process. The introduction by some NHS Trusts of local formularies (a more limited list of available products), risks patients and their clinicians not being made readily aware of the full range of products available on the Drug Tariff. Not only does this curb patient access to care, but it also creates variation across regions and health inequalities, leading to a postcode lottery and poorer patient outcomes if the product used is not suited to an individual patient.

Enhance productivity and value for money

ICSs can enhance productivity and value for money by continuing to work with DACs, who ensure that the safety and health of patients living with urinary incontinence is well managed by helping to liaise with nurses, arrange prescriptions, deliver products and answer any questions a patient might have. DACs bring valuable additional capacity to the health service which simply could not cope without them.

October 2022