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

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

3. 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

4. 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

5. 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

6. 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

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

8. 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

9. 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

10. 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

11. 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

12. 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

13. Caring, Learning and Growing