This service is designed to meet the needs of Children and Young People to achieve complete continence, or to manage the condition discreetly and effectively if full control is not clinically possible. This will be achieved through:

— Clinical assessment of continence need of each child,

— Clinical oversight of suitable continence products,

— Facilitation of obtaining products from current supplier and distribution to patients.

The overarching aims of the Derbyshire Community Paediatric Continence service will be to:

— treat children and young people from birth -19 years with the full spectrum of bladder and bowel dysfunction, run by a community based multi-disciplinary team and led by a Paediatric Continence Nurse Specialist,

— have an effective referral and care pathways to medical assessment and intervention at primary, secondary/ tertiary care levels, education, Child and Adolescent Mental Health Services (CAMHS) and to social services,

— respond effectively to the physical, psychological and social needs of Children and Young People with bladder and bowel dysfunction and toileting difficulties in a way that prevents inappropriate referral to secondary care. Where specialist intervention is required, to transfer care back to the community as soon as appropriate,

— have a seamless pathway where Children and Young People would be escalated to Paediatricians in the community or secondary care for the level 3 service and de-escalated to the Public Health commissioned Level 1 service.

The overall Service level outcomes will be:

— All children and young people are seen within, 8 weeks maximum wait time for first appointment,

— Reduction in the rates of A&E attendances and unplanned admissions for constipation and urinary tract infections and reduction in consultant led outpatient appointments,

— The service will increase confidence and ability of appropriate school/settings staff and parents/carers to be able to become an integral part of the care of children with continence needs,

— Following involvement with the service, children and young people will be enabled to improve their access to the national curriculum,

— The service will demonstrate the effectiveness of the work it carries out, including comprehensive and routine use of Patient Reported Outcome Measures (PROMs) and validated, reliable and reproducible quality-of-life (QoL) measures.