Continence Issues in Children Glos Care Pathway Overview

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Community Paediatric & Neurodisability Service - Referral Guidelines - GHNHSFT

Please follow the resource link below to the guidance and referral criteria for the assessment of children within the GHNHSFT Community Paediatric and Neurodisability service. This guidance is for General Practitioners, Public Health Nurses and Therapists

Health Visitors - GHC

Health visitors support families with young children aged 0-5 years by listening to any worries or questions a family may have.

Health visitors provide advice and support including:

  • Raising awareness of healthy bladders and bowels to reduce the risk of problems, such as constipation, developing
  • Initial dietary and lifestyle advice
  • Advice on  reward charts
  • Introduction to toilet training

Find your local health visitor by following this link to the GHC website.  Parents can contact the health visitor directly.

To find out more information go to the Resource link below for Care Services website for Health Visitors.

School Nurses

The team of school nurses provide a public health nursing service for school aged children and young people. 

  • Raising awareness of healthy bladders and bowels to reduce the risk of problems, such as constipation, developing
  • Initial dietary and lifestyle advice
  • Advice on reward charts
  • Introduction to  toilet training

School nurses who have had additional training also run Continence Clinics and are competent in providing advice and information on nocturnal enuresis, constipation and toilet training problems for children who have ongoing issues following the Universal support.

They deliver:

  • Formal assessment following agreed pathways including reviewing fluid intake/output charts
  • Toilet training programmes
  • Enuresis:
    • Explanation of the three systems approach
    • Ensuring adequate daily fluid intake
    • Dietary advice
    • Recommendation on types of drinks to avoid
    • Providing alarms for night time wetting
    • Offering the choice of seeking medication from the family GP eg desmopressin.
  • Constipation:
    • Dietary and lifestyle advice
    • Offer the choice of seeking medication from the family GP e.g.stimulant laxatives or macrogols

Please complete and return this referral form.

Special School Nurses are based at Springbank Community Resource Centre
Telephone: 01242 285 960

The central support team can be contacted on 0300 421 8225

Locality   Telephone Number Email
Cheltenham Springbank Community Resource Centre 01242 581009
Cotswolds Cirencester Hospital 0300 421 8906
Forest of Dean Dilke Memorial Hospital 0300 421 8661/8662
Gloucester Finlay Hub 0300 421 1795
Stroud Stroud Maternity Hospital 0300 421 8959
Tewkesbury Tewkesbury Community Care Office 0300 421 6161

ChatHealth is a text messaging service offering the county’s 11-19 year olds confidential advice about their health and wellbeing. It is offered by the GCSNHST School Nursing Team.

The service offers support to young people with questions relating to a wide range of health and wellbeing issues including relationships, bullying, healthy lifestyle, anxiety, drugs, smoking, stress, body worries, alcohol, self-harm and sexual health. As well as giving advice, the School Nursing Team can signpost to appropriate services and other support.

Messages sent to the dedicated number (07507 333351) are delivered to a secure website, and responded to by a GCSNHST School Nurse. The service is available Monday to Friday from 9am to 4.30pm, excluding bank holidays. Texts are usually replied to within 24 hours. Out of hours, anyone who texts the service receives a bounce back message explaining where to get help if their question is urgent, and when they can expect a response. 

Although the service is confidential and young people do not need to disclose their name, if there is a concern for an individual’s safety, there are safeguarding procedures in place. Young people will still be able to see a School Nurse face-to- face in a school or college drop-in or other setting.

To contact the service, text: 07507 333351

Paediatric Bladder and Bowel Care Service (formerly CYP Continence Service) - GHNHSFT

The Gloucestershire Paediatric Bladder and Bowel Service (formerly Children and Young People's Continence Team) are are made up of 3 Specialist Nurses who run clinics around the county in both general hospitals, community hospitals and health centres. 

The service aims to improve the clinical outcomes and quality of life for children and young people and their families through evidence-based treatment that promotes continence, preventing unnecessary long-term reliance on nappies and pads and the possible need for surgery

The Paediatric Bladder and Bowel Care Service offers a wide range of interventions ranging from tips and techniques to motivate children and develop their skills, to drug treatments and bedwetting alarms as part of a more complex and comprehensive treatment plan.  The team provide on-going support and products tailored to the needs of children and young people.  Appointments are scheduled for a review of progress at least every 6 months.

Referral criteria:

GPs should not refer directly to the Paediatric Bladder and Bowel Care Service in the first instance unless the child has complex bladder or bowel problems.


  • Day and night wetting that is not resolved by conservative guidelines and/or assessment and treatment by school nurse team. Pathway referral paperwork needs to be completed prior to referral by School Nurse. 


  • Day/night wetting without completed pathway from School Nurse
  • Toilet training and provision of products without toilet skills assessment
  • Requests for bed/body worn alarms for bedwetting without completed pathway by School Nurse
  • Gastroenterology
  • Stoma Care
  • Urology conditions
  • Surgery general/urology
  • Behaviour problems
  • Social problems
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