Elderly people are not always being treated with dignity when it comes to continence care.
Two in-depth studies of continence care of older people in hospitals and nursing homes raised concerns about dignity, privacy, cleanliness and hand washing facilities.
The studies were carried out by the University of Kent and the RCP's Clinical Effectiveness and Evaluation Unit (CEEu), and the results have been used to inform the next round of the National Audit of Continence Care, which begins this week.
For the first study, researchers interviewed 33 people between the ages of 68 and 89 over a four-month period about continence issues and how these affected their dignity.
The second study observed continence care for 10 patients over a period of days and gave very similar results.
The results showed a huge variation in the quality with patients complaining that they often had to wait to use the toilet despite buzzing for help. At times they were left for long periods on the commode which was uncomfortable and painful. Paticipants said they were not always cleaned following toileting which led to distress and a loss of dignity.
The studies were supported by the Royal College of Physicians and the British Geriatrics Society.
Jackie Morris, British Geriatrics Society Dignity Lead, said it was unacceptable for older people not to receive dignified continence care.
"We have produced a set of standards and decision aids aimed at helping healthcare professionals to ensure patients and residents in long-term care have their toileting needs met with privacy and dignity."
Jo Webber, deputy policy director at the NHS Confederation, described the delivery of "discrete and appropriately personalised care" to deal with incontinence as a "core part of patient care in a hospital environment."
"Some services offer excellent care that gets the fundamentals of compassionate care right and we need to make sure that those services performing less well are brought up to the standards of the best."
Dr Adrian Wagg, clinical director of the National Audit of Continence Care, said there was room for improvement in the care for people with incontinence.
"The National Audit will show us the extent to which the current NICE guidelines are being implemented, enable providers to improve care, and should lead to improvement in the way the many people who suffer with bladder or bowel problems are managed," he said.