The Paediatric Continence Forum has recently launched its updated Guide on how to commission and run integrated, nurse-led, community-based paediatric bladder and bowel (continence) services. These are clinically effective, improve the lives of children and their families and generate significant cost savings for the NHS.
Bladder and bowel (continence) problems affect more than 1.5 million children and young people in the UK, with a significant negative impact on their health, wellbeing, education, emotional and psychological development. However, services in this area of child health remain fragmented and inadequate, with too many children attending A&E, being admitted for acute constipation and urinary tract infections or being referred inappropriately to already overstretched paediatric outpatient departments. This unhappy situation could be addressed much earlier, more effectively and more cost-effectively in the community.
A central premise of the Guide is that all children from birth to 19 with bladder and / or bowel issues should have access to an integrated Children’s Community Continence Service (CCCS).
This research-based Guide gives a clear description of what a ‘good’ service looks like and how it should be run. It includes: an appropriately resourced multidisciplinary team led by a children’s bladder and bowel nurse specialist, and clear and effective care pathways to other key services. Also included is the role of universal school nurse and health visitor services that have an important role in the early identification of difficulties with toilet training and the onset of bladder and bowel health issues.
This updated version gives a clear breakdown of the impact of bladder and bowel health issues for the child and their family, it reflects the changes to commissioning in England with the formation of Integrated Care systems and the expectation in the NHS Long Term Plan that the quality of care for children with long term conditions will be improved. Transition to adult services is considered and prevalence data have been updated.
Davina Richardson, Author of the CCCG and Co-Chair of the Paediatric Continence Forum, said:
“The PCF is concerned about the increasing numbers of children with bladder and bowel conditions and the resultant pressures on paediatric services across the UK. Our 2021 FOI survey found that only just over half (50.93%) of NHS organisations provided or commissioned services for all areas of childhood bladder and bowel difficulty. Only 37.89% of NHS organisations provided or commissioned these as an integrated service, covering all bladder and bowel issues as the PCF recommends. Services in many areas are therefore fragmented and inadequate, resulting in increased costs to the NHS and stress for the children and families.
This clear and informative Guide is an opportunity for integrated care boards to commission and deliver positive and effective clinical services for this all too often neglected group of children, as well as make savings for the NHS. By doing so commissioners will also fulfil the terms of the NHS Long Term Plan, by reducing A&E attendances, creating an integrated and collaborative structure for service delivery and, most importantly, responding to the needs and wishes of all children, including those with learning and physical disabilities.”
paediatriccontinenceforum@whitehousecomms.com
http://paediatriccontinenceforum.org/
@PaedContForum
