West Sussex Children's Continence Service

1. West Sussex Children's Continence Service Nina Bunce, Senior Continence Nurse Specialist – Children Tina Fenner, Continence Nurse Specialist - Children

2. How many children are affected: Constipation with faecal incontinence • 1 in 30 children between the ages of 4 - 5 years • 1 in 50 children between the ages of 5 – 6 years • 1 in 75 children between the ages of 6 – 10 years • 1 in 100 children between the ages of 10 – 12 years Daytime wetting • Number of children with wetting accidents during the day are more when younger and become • 1 in 8 children at 11years • 1 in 33 children at 16 years

3. Night wetting • Affects over half a million children in the UK between the ages of 5 -16 years • 1 in 7 children at 7 years • 1 in 11 children at 9 years • 1 in 50-100 from the age of 15 years and older. Children with special needs • From 4 years children can be assessed for products – New assessment form will help to determine pathway of care = toileting programme or product supply. Hand over by HV to SN and annual reassessment to be continued by SN teams. (If child has pull ups reassessment every 6 months.)

4. What does the Children’s Continence Service do? • Nurse led service West Area: • Clinics held at Child Development Centre, Chichester. Lead Community Paediatrician, Dr.Melissa Bracewell – possibly to be identified for lead of service for whole of West Sussex South East Area: • Clinics held at Lyons Farm, Business Park, Worthing and Littlehampton North Area: • Vacant post for 18 hours Clinics to be held at Horsham and Haywards Heath

5. Each area has approx 150 new referrals per year - increasing • Follow up appts average between 300 – 350 per year. • Children of complex needs are being identified to clinics 3% children with faecal incontinence attend Paediatric Outpatients – referrals now to clinics = no extra funding ( Chichester and Worthing) • We offer treatment and behavioural management interventions Home visits/TAC/meetings in school/ etc. Production of literature, guidelines, assessment tools/training Uniformity of children’s assessment form/referral to service form and re-assessment for products. At current training being given out for use by all areas • Working with Education re policy for management in schools.

6. Where we are now………… • Training to Health Visitors, School Nurses, Community Children’s Nurses • Guidelines on practice for day/night wetting and faecal incontinence for community practitioners • Guidelines for school nurse led enuresis clinics • Leaflets for day/night wetting/faecal incontinence/medication/toilet training • Developed new continence assessment forms for products and reassessment of products for agencies to use = for all over county = lack of disparity for forms