By Dr. Rachel Okonkwo, Health Psychologist and Patient Experience Lead Β· Category: Closing the Care Gap Β· Published 17 March 2026
When we set out to understand why so many people living with a stoma, a chronic wound or a continence condition wait before asking for help, we expected to hear about products. What we heard about, again and again, was shame.
What we mean by the care gap
At Convatec we use the phrase care gap to describe the distance between the support people living with long-term conditions say they need, and the time clinicians actually have to give. It is not a failure of compassion. It is a failure of capacity. Ninety-six per cent of nurses tell us they need more time, resources and education for their patients β and that shortfall is felt most acutely in the conversations that have nothing to do with a device and everything to do with a life.
Across structured interviews and listening sessions with roughly 400 people β patients, family carers, stoma care nurses, tissue viability specialists and community nurses β one theme surfaced in every single group. People are not only managing a condition. They are managing how that condition is perceived.
Five things people told us
- The first weeks are the loneliest. Discharge is a cliff edge. People described leaving hospital with a bag of supplies, a phone number and very little sense of what normal was going to look like.
- Odour and noise dominate the worry list. For people with a stoma, the fear of being noticed in public consistently outranked concerns about the surgery itself.
- Nobody wants to be a burden. Patients routinely under-report leaks, soreness and skin breakdown because they do not want to waste a nurse's time.
- Partners and carers are invisible. Family members described feeling responsible for care they had never been trained to give, and unsure whether it was their place to ask questions.
- Clinicians feel the gap too. Nurses told us the emotional conversation is the first thing squeezed out of a fifteen-minute appointment, and the thing they most regret losing.
Stigma is a clinical risk factor
It is tempting to file stigma under wellbeing and move on. What people described points somewhere less comfortable. When people feel embarrassed, they change their behaviour in ways that carry real clinical consequences.
- Delayed reporting. A minor peristomal skin irritation that would resolve with a seal change becomes an excoriated, painful area that takes weeks to settle.
- Self-rationing. People stretch appliance wear time or reuse products to avoid ordering more, increasing leak and infection risk.
- Withdrawal. Social isolation reduces activity, appetite and sleep β all of which work against healing and against confidence.
In other words, the emotional conversation is not the soft part of care. It is often the part that determines whether the clinical plan works at all.
What closing the gap looks like in practice
The teams who close the gap most successfully are rarely the ones with the biggest budgets. They are the ones who have redesigned small moments.
- Name it first. Clinicians who raise odour, intimacy, body image and returning to work before the patient does give permission for an honest answer.
- Set expectations in weeks, not platitudes. Telling someone that most people feel steadier by week six is more useful than telling them they will be fine.
- Bring the carer into the room. Teaching two people rather than one halves the number of anxious phone calls later.
- Signpost peer support early. Hearing from someone who has been through it changes what people believe is possible.
- Follow up asynchronously. A short check-in message at day 30 catches problems people would never book an appointment for.
Beyond the box
This is the thinking behind me+β’, our patient support programme. It exists because a pouching system, a dressing or a catheter is only ever half the answer. me+β’ offers personalised video guidance, product selection help, emotional wellbeing content and access to a peer community β the companionship that a fifteen-minute appointment cannot contain. For clinicians, Convatec Academy provides the education, webinars and selection tools that give back some of the time the system takes away.
Where we go next
Closing the care gap is not a campaign with an end date. It is a commitment to keep asking people what they actually need, and to keep building the education, the products and the support that answer it. If there is one thing 400 conversations taught us, it is that dignity is not a bonus feature of good care. It is the mechanism by which good care works.
Forever caring. You can keep being you.