Impact Review 2025/26: Bladder and Bowel Confidence (BABCON) HIT

Redesigning the local continence care pathway

To improve treatment and support for people with bladder and bowel conditions, it is essential to understand how individuals currently move through local services.

Over the past year, the BABCON project has made progress in understanding the complexities of the existing bladder and bowel care pathway. This has included initial pathway mapping and engagement with patients to identify barriers to diagnosis and treatment. Findings have been shared with the Wessex Continence Pathway team, whose established pathway offers a potential model for the Bristol, North Somerset and South Gloucestershire region.

BABCON is now working with the Integrated Care Board to access relevant datasets and is engaging with referral teams to improve the quality of information recorded on the GP system, Remedy.

The next practical step will be to trial a package of self-help interventions, including the CONfidence app, as a first point of contact for people entering the pathway.

Delivering multi-professional training and education

Many people experience bladder and bowel problems following a stroke. In November 2025, BABCON worked with the Stroke Health Integration Team (HIT) to deliver a multi-professional study day focused on continence after stroke.

BABCON co-director Professor Nikki Cotterill and Helen from the Sirona Bladder and Bowel Team led presentations and breakout sessions for 60 professionals working across acute, rehabilitation and community stroke services. Sessions focused on practical ways to support people whose continence has been affected by stroke.

Topics included post-stroke bladder rehabilitation, pelvic floor training for bladder and bowel health, and cultural differences in attitudes towards continence. The session supported shared learning and strengthened connections across services.

FGM and incontinence

A previous Sirona Health Links project supporting Somali women to seek help for bladder and bowel problems highlighted the impact of Female Genital Mutilation (FGM) on incontinence. A UWE Bristol- funded project supported by BABCON found that incontinence is largely overlooked in existing FGM research and that women’s voices are underrepresented.

This work has secured BNSSG Research Capability Funding to support community-led research delivered by local organisation Voice for Her. The findings are expected to inform the development of culturally sensitive educational resources for women at risk of, or experiencing, incontinence associated with FGM.

Influencing policy for bladder and bowel care

Professor Nikki Cotterill continues to represent the region in national policy discussions on continence. This has included attending three parliamentary roundtable events, presenting at the relaunch of the All-Party Parliamentary Group on Bladder and Bowel Continence Care, and submitting written evidence to a parliamentary inquiry into frailty and its contributing factors, including incontinence.