Millions of people across the UK living with incontinence are facing shortages of sanitary products due to supplies being rationed by NHS trusts, according to a coalition of charities.

The shortages are leading to a “pad gap” where people are having to pay for incontinence products themselves, according to an open letter from organisations including the Royal College of Nursing, Prostate Cancer UK, and Bowel and Bladder UK.

Around 14 million people across the UK experience incontinence. Healthcare workers in the NHS expect to fit up to five pads a day for patients who experience incontinence, according to research, but freedom of information data from 110 NHS trusts show that more than half (53%) have a cap on the availability of products.

Of these trusts, 34% have a cap of three products a day, while the remaining 66% have a cap of four products a day, which is lower than the expected need.

As a consequence of the shortages, many people with incontinence and their families are forced to use their pension or personal independence payment (PIP) to purchase these products while struggling to cover other basic costs.

The government is introducing “value based procurement” across the NHS, which means trusts need to consider products that improve patients’ quality of life regardless of cost.

According to the letter, these measures represent a “once in a generation opportunity to improve health outcomes for all” that will benefit people who experience incontinence and ease the burden on NHS staff and carers.

Prof Alison Leary, the deputy president of the Royal College of Nursing, said she often heard from nurses who were concerned about the shortages of incontinence products. “The effective rationing of incontinence products means that staff and patients both suffer – patients do not get the dignified care they need and nursing colleagues feel they are not meeting patients’ fundamental needs,” Leary added.

Millie Baker, the executive director of Bladder Health UK, said the consequences of inadequate incontinence provision were not only clinical but deeply personal.

“People are living with the shame of persistent body odour, anxiety about visible leaks or smells when leaving the house or socialising, and skin damage caused by the acidity of urine in contact with delicate areas,” Baker said.

“Some avoid relationships, limit clothing choices, or withdraw from everyday life out of fear and embarrassment. Others experience disturbed sleep due to pad leakage, emotional distress, or even infection. These are not small inconveniences – they are indignities that strip away a person’s confidence, autonomy and wellbeing. Dignity in continence care is therefore not an optional extra, but a vital component of compassionate, effective adult social care.”

NHS England has been approached for comment.