Improving Catheter Care: My Catheter Passport and beyond

By Dr Adrian Hopper, Consultant Geriatrician, Guy's and St Thomas' NHS Foundation Trust

Last month, we launched My Catheter Passport across Guy’s and St Thomas’, King’s College Hospital and our teams working within the community which has been a triumph for everyone involved. We developed the Passport in response to concerns about the lack of clear information about patients’ catheters being shared across care settings, including why a patient even needs a catheter. We believe that these issues contribute to  the rates of catheter associated urinary tract infections (CAUTI) developed within the community, as well as why patients attend hospital with issues such as blocked catheters, which could have been prevented with clear care plans.

It always amazes me when I hear of another patient who is unaware of why they were given a catheter in the first place or who has contracted a catheter associated urinary tract infection (CAUTI). People are at a higher risk of UTIs when they have a catheter inserted, and unfortunately CAUTIs have been associated with increased mortality, length of stay in hospital and healthcare costs. It can be frustrating when I know that with the right care and information, CAUTIs can be prevented.

As a consultant geriatrician at Guy’s and St Thomas’ and chairperson of the Southwark and Lambeth Integrated Care Infections Working Group (a group made up of people with catheter care experience and health and social care professionals), I’m driving forward the fight against CAUTIs and the impact they have on people. I also want to make sure that GP practices, community services and hospitals communicate more effectively with each other, so patients receive the best care.

The My Catheter Passport was a fantastic opportunity for us to co-design something with patients and health and social care professionals. It is a patient-owned document packed full of useful information and contact details for people with catheters, to empower them to live as independently as possible. The Passport will now be given to all adult patients when they are discharged from hospital and to those currently receiving care in the community; and patients should have it with them whenever they are seeing a health and social care professional about their catheter. This is because there is a section of the Passport that health and social must complete to record any changes or issues with the patient’s catheter. We hope that this will improve communication between care settings. I am extremely pleased with how the Passport turned out, especially as it is a true example of co-production with local people and professionals.

The Passport is one of a number of interventions that we want to spread across the five South East London hospitals, as part of the ‘No Catheter, No CAUTI’ campaign. The campaign is led by the Health Innovation Network’s Patient Safety Collaborative. Follow the campaign on Twitter – #HINstopcauti.

The collaborative has recently been set up to share best practice across partners to improve catheter care with the aim of significantly reducing CAUTIs. This will be achieved by testing a series of interventions that support avoiding unnecessary catheterisation, the prompt removal of catheters, learning from rapid review of CAUTIs, as well as community based interventions such as the Passport.

We have achieved a lot in the last year, all of which we should be proud of. However, in the process of developing the Passport, we discovered further challenges to delivering a gold standard in catheter care for patients. Most notably, the catheter care pathway is fragmented, so patients are coming to A&E with issues that could be managed in the community; and there is a disjointed prescription process, which can lead to duplication of prescriptions and an increase in cost.

As you can see, we are not without our challenges in catheter care and it’s clear we still have a lot of work to do across Southwark and Lambeth. It was agreed that these challenges need to be explored further and solutions drawn up to address them. The conversations to do this have already started and the Infections Working Group will come together to map out a new service model that would work for people with catheters.

I’m lucky in that I get to work with people that are equally passionate about catheter care and addressing the challenges we face. I had the pleasure of witnessing this enthusiasm at the #CatheterSummit at the beginning of the year. I am excited about the future and what we can do together so patients with catheters in Southwark and Lambeth receive the best possible care that is right for them.