Containment products are extensively used within healthcare, and cost the NHS an estimated £80 million per year (1). They have an enormous environmental impact, and could be used much less if good prevention, assessment and treatment strategies are put in place. 

Containment products can have a negative impact on an individual's dignity and independence and should only be used when all suitable assessment, treatment and management strategies have been implemented (1).

This abstract is a retrospective review of the author's work over the last four years following a change in job role. The author took over the management of the containment product budget, and service, for one NHS Trust in the United Kingdom. A plan was soon established for the running of the service, and the required changes, but once work started it became obvious that there were many issues that needed to be identified, analysed and managed.

The resulting project was hindered and altered by an incredible variety of challenges (including the pandemic). Some challenges were anticipated but most were not. It became obvious that the service itself was not unusual, but the author was unable to find another service that had undertaken such an extensive, planned redesign.

A brief  narrative was kept throughout to monitor changes, problems and solutions. The project is now close to completion and this is n ideal opportunity to share a retrospective analysis of a service redesign.

Over the financial year 2022/2023, the service has spent £550.00K of the anticipated £650.00K budget for containment products. 
Over 5,000 people have been removed from the containment product list (but not all these were active patients).
There have been seismic changes n the team structure, assessment and treatment processes and product service management.
There is now one member of staff allocated to managing the product service day to day and it has been separated out from the rest of the service completely.
The product service now follows all appropriate clinical and best practice guidelines.

Until now, the metrics have been difficult to rely upon as the various service changes have made comparing metrics inaccurate. It is still likely that the confidence level in the service metrics should be kept low but the service is now in a better position to start collecting meaningful metrics.

The last four years have required flexible and energetic leadership. The management of the containment product service has been changed dramatically with positive effects on the staff, patients, budget and environment. There is still much work to be done but this is an excellent opportunity to reflect and to share the work on as wide a scale as possible.

Containment products are an essential element of long-term bladder and bowel management for many people, but they must be used appropriately. There will be many services across the world that struggle with managing this aspect of continence service and the sharing of good practice, trials and tribulations is one way to make this part of our work easier.

Excellence in Continence Care, NHS England, 2018