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How Bolton NHS Foundation Trust improved care, reduced waste and achieved cost savings with AttendsWhen Bolton NHS Foundation Trust reviewed its continence product provision following the end of an existing supplier contract, the team saw an opportunity to do more than simply replace products. Instead, they set out to improve clinical outcomes, increase cost efficiency, enhanced patient support, and strengthen service delivery. By partnering with Attends, the Trust successfully implemented a new, patient-focused continence pathway – delivering measurable improvements across both care quality and operational efficiency.The ChallengeThe Trust faced several key challenges with its previous provision: Limited access to product sampling, making accurate assessments difficult Lack of flexibility in product range Inefficiencies in product usage and allocation A need to align continence provision with broader sustainability goals At the same time, any transition needed to be carefully managed to avoid disruption to: Patient care Clinical workflows Care home operations Jo Bond, Team Lead – Bladder & Bowel Service, Bolton NHS Foundation TrustWhy Attends?Following a full supplier review, Attends was selected based on a combination of product quality, service support and approach. Key decision drives included: A comprehensive product range supporting a wide range of continence needs Proven product performance and clinical reliability A collaborative, partnership-led approach Dedicated account management and training support Alignment with the Trust’s goals around efficiency and sustainability Rather than a simple supplier relationship, the Trust chose Attends as a strategic partner.The ApproachThe transition to Attends was delivered through a structured, partnership-led implementation. Strategic Planning Mapping of existing products to Attends equivalents Development of tailored formularies for different patient groups Creation of clear product reference guides Patient-Centred Transition Direct engagement with patient cohorts to understand individual needs Careful management of product changes to maintain comfort and dignity Focus on “right product, right person, right outcome” Training & Engagement Attends played a central role in delivering a comprehensive training programme. Face-to-face product demonstrations Hands-on sessions for care home staff Support for district nurses and acute teams Ongoing access to educational resources This approach ensured: High engagement across clinical teams Increased confidence in product selection Strong adoption from day one Care Home Collaboration A standout element of the project was direct engagement with 34 care homes, where Attends: Coordinated training sessions Delivered practical demonstrations Supported staff in optimising product usage This led to more appropriate product selection, including a shift towards lower absorbency products where clinically suitable.The ResultsThe partnership delivered significant benefits across clinical, operational and financial areas. Cost & Efficiency Achieved £35,000 annual cost saving across continence provision Improved product utilisation and reduced over-prescribing Better visibility of usage through system monitoring and reassessment prompts Waste Reduction & Sustainability Reduced unnecessary product usage Improved fit and suitability, minimising waste Supported Trust-wide sustainability objectives Clinical Outcomes No increase in skin-related issues following transition Maintained high standards of patient care and comfort Improved confidence in product selection among clinicians Service Improvement Streamlined processes across wards, community teams and care homes Increased engagement and collaboration across stakeholders Stronger alignment between procurement and clinical teams Partnership in Practice“Since transitioning to Attends, we’ve developed a strong and collaborative partnership that has delivered real value across our services. The dedicated account management and ongoing support – particularly around training in hospital, community, and care home settings – has been instrumental in ensuring a smooth and sustainable implementation.” “Not only are we very pleased with the quality and reliability of the products, but the transition has also enabled us to significantly reduce waste and improve overall efficiency. As a trust, we have achieved cost savings of £35,000, which is a meaningful outcome in the current healthcare landscape.” “The support we received throughout the transition process was excellent, and the continued partnership approach has helped us embed best practice and drive improvements in continence care provision. We look forward to continuing this positive working relationship.”Jo Bond, Team Lead – Bladder & Bowel Service, Bolton NHS Foundation TrustAttends worked closely with: Bladder & Bowel Specialists District Nursing Teams Care Home Staff Procurement Leads This collaborative approach ensured the transition was not only smooth – but sustainable long-term.Looking AheadBuilding on this success, the Trust is continuing its continence services through: Introduction of Continence Champions across care settings Ongoing training and refresher programmes Annual Continence Promotion Day aligned with World Continence Week Attends remains a key partner in supporting these initiatives.Looking to transform your continence provision?Attends works in partnership with NHS Trusts to deliver tailored, clinically-led solutions that balance cost efficiency with patient dignity and care quality. Get in touch to learn how we can support your service.

This case study reviews the role of Continence Champions in promoting best practices in continence care within a care home setting. The recommendations from Attends’ 2023 observational study were implemented at an 85-bed care home that provides person-centred care to residents with varying conditions, including dementia, frailty, physical disabilities and palliative care.How did we achieve this?Following the recommendations from the observational study, Attends introduced the role of Continence Champions in the care home. Continence Champions are trained Nurses or Senior Healthcare Assistants responsible for overseeing the assessment and management of incontinence using Attends products. They ensure that the right products are chosen for each resident and offer guidance on proper product use. The Continence Champions were tasked with: Educating staff on the Attends product range and appropriate product usage. Ensuring the Product Selector Tool is kept up to date and prescribed products are used. Providing support to staff and ensuring correct product use. Research shows that Continence Champions are effective in driving positive changes (Miech et al, 2018). An initial meeting was held with the Care Home Owner, Nurse Manager and In-House Trainer to identify suitable Continence Champions. A tailored training plan was implemented, covering product assessments, product selection, fitting techniques and the importance of using the wetness indicator. The training also emphasised that products can be reapplied if they contain only small amounts of urine. This approach is designed to improve care while reducing the overall cost of incontinence products without compromising on quality.Challenges & Overcoming ResistanceAs with any new initiative, the introduction of Continence Champions was initially well-received. However, there was some resistance from a small minority of staff who were hesitant to switch residents from high absorbency XL all-in-one products to products that better suited their needs based on their urine output and using the correct size of Slip based on their hip and waist measurement. Additionally, there was reluctance to transition from Attends Pull-Ons products to a 2-piece system, which is recommended in the Guidance for the Provision of Absorbent Pads for Adult Incontinence.To address this resistance, Attends provided ongoing support and additional training to staff, helping them to understand the benefits of using the right product for each individual resident.ResultsWith the support of Attends and the Continence Champions, all residents were reassessed, and products were selected based on their individual needs for containment, comfort, discretion and dignity. This has led to a 33% reduction in the overall cost of continence products, with monthly expenditure dropping from £4,000 to £2,667. Additionally, waste disposal costs have been reduced by 50%, from £2,000 to £1,000 per month, thanks to proper product selection, which has minimised unnecessary waste. Continence Champions continue to receive regular updates and training from Attends, ensuring best practices are maintained. Residents are reassessed every six months, unless there is a change in their continence needs.Attends products have been an absolute asset to our home care services here in Maryland. The ease of use and the level of protection provided by these products give both caregivers and patients peace of mind. We’ve seen a reduction in skin irritation and fewer instances of leaks, which has been crucial in maintaining the quality of life for our elderly patients.Raymond, Continence Champion at Maryland HealthcareLong-Term BenefitsThe implementation of Continence Champions brings lasting improvements in care and operational efficiencies. Ongoing staff training on best practices ensures high standards of care while adapting to residents' changing needs. By focusing on appropriate product selection, the care home achieves cost savings, reduces waste and minimises environmental impact. The Continence Champion model helps continuous improvement, empowering staff to make informed decisions and proactively address challenges. Over time, this results in better resident satisfaction, improved care outcomes and a more streamlined approach to continence management. The model is also scalable, offering potential for wider adoption across other care homes or healthcare settings.Going ForwardAttends will continue to provide training and support, recognising that ongoing education is important for maintaining best practice (Castle, 2009). The Continence Champions have proven to be invaluable in managing the provision of containment products and it is essential that replacements are identified promptly when Champions leave the team. This ensures continuity of care and the consistent application of best practices.ConclusionThis case study highlights the benefits of implementing Attends’ recommendations through the role of Continence Champions. By providing specialised training and ongoing support, Attends has helped to streamline incontinence care, ensuring the selection of the right product for each resident’s needs. The resulting cost savings, improved product use and enhanced resident comfort demonstrate the value of this approach in care homes. With the continued support of Attends and the commitment of care home staff, this model is poised to lead to lasting improvements in both care quality and operational efficiency. For more information on how Continence Champions can support your care home or facility, contact us today.I appreciate the fact that Attends offers a wide selection, allowing us to choose the right product for each patient's unique needs. We’ve been using these products for some time now, and they’ve made a noticeable difference in both the quality of care and the satisfaction of our patients.Kellie, Continence Champion at Maryland HealthcareReferences Castle NG. Perceived Advantages & Disadvantages of Using Agency Staff Tool. Br J Community Nursing. 2013;18(12):580–587. Association for Continence Advice Consensus Guidelines Group. Guidance for the Provision of Absorbent Pads for Adult Incontinence: A Consensus Document. Version 19. 2021. Miech EJ, Rattray NA, Flanagan ME, Damschroder L, Schmid AA. Inside Help: An Integrative Review of Champions in Healthcare-Related Implementation. Sage Open Medicine. 2018.