• This comparative study found that significantly more people with severe incontinence had contacted a health professional than had those with slight to moderate incontinence (P=0.00008). There was a significant linear trend towards people with severe incontinence seeing a health professional (P=0.00007). • The majority of people who were incontinent had not been asked to complete a bladder chart, which is an essential requirement for assessment and diagnosis of the type of incontinence and the subsequent health interventions that are offered. • Significantly more people in the health authority with an established continence advisory service had completed a bladder chart, had received physiotherapy and currently undertook pelvic floor muscle exercises than did those in the health authority without a continence service. • The majority of sufferers did not use any aids or appliances. Of those who did use incontinence aids, a majority bought their own. There was a significant linear trend for increased pad usage with increasing severity of incontinence (P=0.0003). • Significantly more people in the health authority with the continence service were satisfied with their healthcare and services, while more of those in the health authority without a service were unsatisfied (P=0.005). Significantly more people in the health authority without a service felt that healthcare and services could be improved (P=0.00001). • Significantly more people with severe incontinence were dissatisfied with services than were those with slight to moderate incontinence (P=0.01).