Primary care trusts are neglecting to assess need and implement national guidance when it comes to continence services, according to a national audit.

A freedom of information audit of PCTs in England found the overwhelming majority – 95 per cent – could not give an estimate of the number of people with continence problems in their area.

The report by health policy consultancy MHP Mandate was based on responses from 109 PCTs.

It also found 45 per cent were unable to give details of the performance of local NHS services and 38 per cent could not provide a breakdown of spending on continence services. Meanwhile, only five per cent of PCTs included continence in their joint strategic needs assessment.

About two thirds said they had not taken action to implement guidance on continence issued by the National Institute for Health and Clinical Excellence.

The report also found “worrying inequalities” in spending. Of those PCTs that did hold data on planned expenditure, the majority – 68 per cent - predicted the same or lower spending on continence services for the next financial year compared to 2010-11.

commissioning for incontinence, lower urinary tract and bowel symptoms – an audit makes a series of recommendations including steps to improve data collection, tighten up monitoring of services and set quality standards.

It says the NHS Commissioning Board should develop a set of commissioning for quality and innovation indicators on continence, lower urinary and bowel symptoms.

“It’s a sad fact that continence provision has never been a priority for NHS improvement or investment,” said Paul Abrahams, director of the Bristol Urological Institute and chair of the expert group.

“This audit – the first of its kind – provides valuable data underlining the need for urgent action to deliver a step-change in the care provided to people with continence problems.”