The Continence Advisory Service Bladder and Bowel Health – Community Services (HTNHSFT) Humbernhsft www.humber.nhs.uk Caring, Learning and Growing

Continence Advisory Service Background….. Who are we? Where do we work from? What do we do? Referral process…… Caring, Learning and Growing

Caring, Learning and Growing Background   Urinary incontinence has more sufferers than asthma, epilepsy and diabetes combined Over 6 million sufferers in the UK 1 in 3 women will suffer from urinary incontinence at some time in their life Incontinence costs around 1% - 2% of total NHS budget Caring, Learning and Growing

Caring, Learning and Growing Background Prevalence and severity of urinary incontinence increases with age Urge urinary incontinence increases the risk of falls by 26% and the risk of fractures by 34% in women over the age of 65 years Avoiding a hip fracture may save costs of £5,680 per patient Half of those with a hip fracture never return to their full level of independence with 20% requiring long term care Caring, Learning and Growing

Caring, Learning and Growing Who are we? Karen Nelson (Band 7 – 0.9WTE) and Sara-Jane Barlow (Band 6 – 0.8WTE) Specialist Nurses in Bladder and Bowel Dysfunction Cover children and adults across S&R CCG and children across Whitby area of HR&WCCG Input into Community Ward at Malton Caring, Learning and Growing

Caring, Learning and Growing Where do we work from? North Hub – Community Services, based at Tennyson Avenue Scarborough clinics at Lawrence House, Prospect Road Surgery, Castle Health Centre and Eastfield Surgery (any patient can attend any clinic) Malton Hospital Whitby Hospital Home Visits / School visits Caring, Learning and Growing

Caring, Learning and Growing What do we do? Specialist Assessment for bladder and bowel dysfunction Evidence Based Care (NICE Guidance) Caring, Learning and Growing

Caring, Learning and Growing What do we do? HOLISTIC ASSESSMENT Lifestyle Contributory factors Symptom Profile Bladder / bowel diaries Bladder Scan Treatment and Management Plan TREATMENT PROGRAMMES Lifestyle changes Psychological support Bladder training Pelvic Floor Exercises Self catheterisation Trans anal irrigation Product advice Medication advice Caring, Learning and Growing

Caring, Learning and Growing What do we do? Advisory Service – to anyone! Health Promotion Education Supervision Support Policy / Procedure Monitor the Home Delivery Service (1300+ people in S&R) Caring, Learning and Growing

Caring, Learning and Growing Referral process…. Free continence products? Continence products on prescription? Continence Assessment Consider reusable products We do not supply any bedding products / waterproof products / disposable continence sheets Strict National Criteria (Guidance for the provision of containment products for adult incontinence. A consensus document. 2017) We supply nothing that holds less than 400mls Pull ups! Strict criteria – may have to be bought Home delivery service Caring, Learning and Growing

Caring, Learning and Growing Referral process…. District Nursing Team are first point of contact for continence assessment / review of products e.g. discharge from hospital, change of condition, catheter related issues If focus is on management refer to District Nursing Team for Continence Assessment If focus is on treatment refer to Continence Advisory Service for Specialist Assessment Caring, Learning and Growing

Caring, Learning and Growing Referral process…. Children (generally age 4 and above) – if already seen by Universal Services then refer to Continence Advisory Service for Specialist Assessment We do not supply enuresis alarms Examples of referrals may include constipation and soiling; day time wetting; complex interventions such as intermittent catheterisation or trans anal irrigation Caring, Learning and Growing

Caring, Learning and Growing