Clearer labelling on catheters needed to prevent patient harm

Clearer labelling on urinary catheters is now required from suppliers following incidents where patients were fitted with the wrong type.

During detailed work to develop NHS Supply Chain’s new supply framework for Urology, Bowel and Faecal Management products, which includes urinary catheters, it emerged that there had been incidents of incorrect usage leading to patient harm.

Fay Allen from NHS Supply Chain’s Clinical and Product Assurance (CaPA) team said: “It was found that there were incidents of female catheters being used on male patients urethrally, leading to potential or actual patient harm.  

“As part of the work developing the new framework agreement for these products, we sought a clearer understanding of why these issues were occurring so that we could look at options to prevent this in the future.”   

Discussions with healthcare professionals, including nurses and healthcare assistants, suggested that clinicians knew which products to use and there were no product faults, but that human error was a possible cause.   

Simon Hall, of NHS Supply Chain: Rehabilitation, Disabled Services, Women’s Health and Associated Consumables, said a change to the requirements to catheter packaging had resulted from this engagement process. This change was to support healthcare professionals and help reduce potential patient harm. The new products descriptions required had also considered and been mindful of people’s gender identities.  

The requirements for urinary catheter products supplied through NHS Supply Chain now include that all catheters must display two printed labels on the outer packaging, to be described as: 

  • standard or male, indicating suitable for all adult groups  
  • female or short, indicating suitable for female urethra or short passage i.e. supra-pubic, where it is inserted into the bladder through a cut in the abdomen, a few inches below the navel  
  • paediatric; indicating that the product is a variant suitable for children.

NHS Supply Chain will support any future work to review the impact of this specification change as required. As part of the NHS family it is prioritising safety as a core part of its approach to supplying clinical products by aiming to raise standards and effective partnership working at national and local levels.

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