Children and young people's continence team

Our services

We support children and young people from 5 to 18 years. The service offers specialist assessment and management of continence issues including:

• Advice relating to diet, fluid intake, sleep patterns and routines relating specifically to help with continence
• Provision of a range of interventions and treatments including night time wetting alarms and medication
• Bladder scanning
• Support and education into a child's school
• Referral to Paediatricians where needed
• Continence product assessment
  

New patients

Referrals are accepted from GP's, Health Visitors, School Nurses and Paediatricians.

When we receive a referral a nurse will triage this. We must see that your child has already received level 1 intervention which will include basic advice to promote healthy bladders and bowels to reduce the risk of issues becoming chronic such as constipation and Fluid intake / dietary advice, providing initial advice on nocturnal enuresis, constipation and toilet training problems.

For bladder problems, you and your child must have been supported by a health care professional for 6 weeks.

If your child is constipated, they must have been taking macrogel (i.e movicol) treatment for at least 3 months.

When a referral is accepted we will send you a bladder diary to complete for 3 days. This must been returned to us before an appointment is made.

All new referrals will have an initial face to face appointment.

If your child has previously been seen by the service within the last 6 months, we will accept a self referral. If it has been longer than 6 months, a referral from a health care professional will be needed.

Provision of continence products for children and young people

We will offer an appointment to the product clinic for children and young people:

• once they are over 5 years of age and
• the family and carers have undertaken a toilet skill development programme, with support from a Health Care Professional for a minimum of 6 months, unless a toilet skill development programme is inappropriate because there are clear underlying anatomical or neurological reasons for lack of bladder/bowel control

An appointment in the product clinic does not mean that a child has been automatically deemed eligible for the provision of continence products and a comprehensive assessment will be completed at this appointment.

Children and young people who have achieved day-time continence will not be receive provision products for night time only, even if they have a disability or additional needs.

What is the process following the continence assessment for a child/young person who is unable to achieve toilet training?

If your child has been assessed for a product we will record a weight, hip and waist measurement in order to ensure correct size product samples are sent.

Sample products will then be sent to try with the child or young person. They can take up to 7 working days to arrive at your home address.

If the samples are not suitable, please let us know so we explore further products which may be more suitable for your child.

Once your child continence containment product has been established an account and delivery will be activated on the Home Delivery Service. This may take up to 7 working days for delivery following activation

How to obtain further supplies

Your prescription of products is for 12 weeks, and you will need to phone the home delivery team on 01952 580400 to request further products.

We advise you call the team two weeks prior to your prescription running out. Once you have placed this order you will then be informed of your delivery date and the next date you will need to call the team again to obtain further supplies.

What if my child requires more products than what is being offered?

The number of products issued per 24 hours is calculated by the health care professions following an individualised clinical assessment of need. Typically, provision would not be more than 4 products per day. If the correct product has been prescribed and the product is used according to manufacturer’s instructions a maximum of four per day should meet your child's needs. This is because the products are highly absorbent and do not need changing until they reach capacity or are soiled. If your child is requiring additional products outside of this amount then this would need to be purchased on an individual basis unless there is a clinical need

If your child is having more frequent bowel movements than usual, they should be assessed for any bowel disorders including constipation by an appropriate medical practitioner.

If your child is passing higher volumes of urine than usual, they should be assessed by an appropriate medical practitioner.

Annual product reassessments

All children and young people who receive continence containment products through the NHS need to undertake six monthly to annual product reassessments. This is to ensure bladder and bowel health, product suitability, product size and fit and that continence containment products are still required.

If two consecutive reassessment appointments are not attended, then your child's product delivery will be suspended until a reassessment has been carried out.

Existing patients

Following the initial face to face appointment, most follow up contact will be over the telephone phone. When we call you it will be from a withheld number. If we do not manage to call you at a convenient time to be able to speak to you, we will often send you an email asking for an update.

Discharge from the service

We discharge children and young people from the service where continence has been achieved or where you feel confident in managing your child's needs. If we do not see any improvement with the treatment plans we put into place, we refer to:

• Alder Hey Children's Hospital for bladder problems.
• Shrewsbury and Telford Hosital for bowel problems.

When we make these referrals, we will discharge your child from the service.

Services we do not offer

We do not see children and young people who are constipated registered with a Shropshire GP. You will need to seek support from your GP, school nurse or be referred to the Paediatricians at Shrewsbury and Telford Hospital Trust.

What to bring with you

Please bring the bladder diary if you have been asked to bring this to your appointment otherwise please send this back to the team before your appointment. The diary provides important information that helps the service to decide the most appropriate treatment plan.

If your child has been booked for a bladder scan, we need them to have a full bladder so please ensure they drink plenty before the appointment.

If you have been given an enuresis alarm but no longer use this please bring this to the appointment.

Where are we?

We deliver clinics in the following locations:

• Coral House, Shrewsbury
• Stichley Health Centre, Telford
• Donnington Health Cente, Telford

Who are we?

We are a nurse-led service based within the Integrated Community Children's Nursing Services.

We have registered nurses and an assistant practitioner who are experienced in working with children, young people and their families with continence care needs,

The constipation clinic is also supported by a Paediatric Psychologist.

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