Reflections from the ACP 2025 Conference: Reimagining Continence Care through Integration, Innovation, and Inclusion

Attending the ACP 2025 Conference was an energising experience that brought together professionals across disciplines to reflect on the future of continence care in the UK. What emerged was a compelling narrative of systems change, equity, and the pressing need to talk openly about often-silenced aspects of health—from pelvic floor dysfunction to post-operative intimacy and neurodivergent needs.

The day began with a powerful address from Richard Desir, Nursing Officer, who presented The All-Wales Approach to Continence Care. Wales, he noted, is both the UK’s most aged and one of its most socioeconomically disadvantaged regions. These demographics have significant implications for healthcare delivery, particularly for bladder and bowel services. With a population of just over 3 million—now increasingly diverse with over 12% from Black and minority ethnic backgrounds—Wales is charting a progressive course. Initiatives such as the 2022 Pelvic Floor Hub and sustained investment in pelvic health coordinators across all health boards exemplify this forward-thinking approach.

Desir highlighted the importance of the Women’s Health Plan, which aims to address the fact that 75% of women do not disclose continence issues. The plan is underpinned by the work of a clinical fellow and reinforced by national integration efforts, including the 2022 UK Unplanned Admissions Consensus Report. There’s also a growing emphasis on early education, with policy leads in the education sector working to ensure accurate and inclusive continence content is embedded in the curriculum. The Welsh model, increasingly expanding into men’s health through initiatives such as Boys Need Bins and the Make Pelvic Floor survey, demonstrates the strength of cross-sector partnerships—echoed in the collaborative work of Angie Rantell (ACP Co-Chair), Emma Chapple (BAUN), and Kate Lough (POGP).

Continuing this theme of inclusion and innovation, Aneleigh Schofield questioned whether current models of care are truly fit for purpose in her session, Business as Usual – Or Is It?. She advocated for a multidisciplinary device and approach to support women with pelvic health issues during pregnancy and up to a year postnatally. Her focus on obstetric anal sphincter injuries, musculoskeletal conditions, and pelvic floor dysfunction underscored the urgent need for prevention, timely access, and personalised support. She emphasised that educational materials for both patients and professionals must be revisited and co-created, taking into account language barriers, neurodiversity, and generational differences. Education, she argued, should be a dynamic and evolving process.

This call to broaden our understanding of pelvic health continued with Samuel Swift’s candid exploration of male continence issues in Make Pelvic Health. He spoke frankly about the near-universal experience of incontinence and erectile dysfunction following prostate surgery, and the reluctance many men feel in discussing these deeply personal outcomes. Swift’s work focuses on supporting men through preparation, empathy, and open conversations, aiming to shift perceptions and normalise pelvic health for all genders.

The later sessions of the day delved into equally vital yet often overlooked areas. Ashley Brown from King’s College London offered insight into the complex intersections between intimacy, sexual health, catheter use, and neurological conditions. Her psychological lens illuminated the importance of maintaining intimacy and self-esteem for those with long-term catheter use, particularly in the context of neuro-disability.

Polly Weston and Kerry Doherty presented their work on developing a neuro pathway in Putting Patients First, detailing how personalised pathways are essential in supporting people with neurological conditions. Their approach underlined that people living with neurodiversity must be placed at the centre of care planning—not as an afterthought but as a design principle.

Roger Blake rounded off the day with a vital and often under-discussed issue: constipation and continence challenges in people with learning disabilities. His session made clear the need for better integration between specialist nurses, carers, and primary care providers to prevent avoidable hospital admissions and reduce distress among this vulnerable population.

Throughout the conference, there was a recurring theme: sustaining momentum in continence care will require more than individual passion or localised innovation—it demands national frameworks underpinned by lived experience, robust evidence, and shared learning. This was echoed in the session led by Michelle Hogan-Tricks and Rebecca Cousins, who explored industry’s role in removing jargon, promoting accessibility, and amplifying patient voices. Drawing on clinical studies such as the PRIMUS trial at North Bristol NHS Trust, they illustrated how evidence-based research—when paired with meaningful communication—can create real change. Upcoming work like the INGEON project promises to continue this trajectory, ensuring that continence care becomes not only more advanced, but more humane.

As the conference closed, it was clear that the field is moving away from silence, stigma, and siloed thinking. The future of continence care lies in intersectional, interdisciplinary, and inclusive solutions—and the ACP 2025 Conference proved that we’re well on our way.