Community Children's Nursing Service

Definition/Description

Pathway and Referral Process for City Health Care Partnership (CIC), Community Children’s Nursing Continence Service.

Red Flag Symptoms

Enuresis

Practitioners should be alert to signs of polydipsia and polyuria, and sign/symptoms indication possible infection (NICE Clinical guideline [CG111] Bedwetting in under 19s, 2010).

Constipation

Blood in stool, mucous in stool, ribbon stools, faltering growth, abnormal appearance or position of the anus, abdominal distension, abnormal neuromuscular signs, abnormal reflexes (NICE Clinical guideline [CG99] Constipation in children and young people: diagnosis and management, 2010).

Exclude Red Flag Symptoms

The Community Children’s Nursing Continence Service is not an emergency service and therefore has no facilities to see urgent referrals. Where the nature of the concern suggests an immediate response is required or where the condition is deteriorating or escalating rapidly the appropriate acute services should be considered.

Guidelines on Management

Community Children’s Nursing Continence Service offer assessment, advice, support and treatment for enuresis and constipation.

Specialist Continence Needs: Nursing advice and support for children and young people with specialist continence needs, for example, catheterisation.

Training Parents and Carers: Tailored training and support for parents and carers.

Transition Planning: Support for young people aged 14 years and over with long term health needs, to help them move into adult health services.

Services are delivered in clinic settings across the city, as well as in the home or other community venues as appropriate. We aim to deliver a child-centred service which is accessible and family-friendly, and we actively encourage patient/family engagement in the planning and delivery of care wherever possible.

The service works in collaboration with a range of other services including Community Children's Nursing Services, General Practitioners, Therapists, Child and Adolescent Mental Health services and colleagues in the acute setting. The service works closely with other providers, and liaises with Local Authorities, Education and Social Care in both Hull and the East Riding to ensure that the needs of children, young people and their families are appropriately met.

School-aged children from the Hull area with diurnal/nocturnal enuresis should, in the first instance, be referred to the appropriate 0-19 Public Health Nursing team who will offer advice and support and follow the referral pathway to the continence/enuresis service as necessary. Children and Young People’s 0-19 Public Health Service have responsibility for ensuring that information regarding constipation, recommended fluid intake, good toileting/bedtime routines, ways to increase fluid intake and handy hints for children with daytime or night time symptoms are provided and discussed with the child and family.

For children with other underlining conditions e.g. neurological conditions, cerebral palsy, autism, etc. the service accepts direct referrals for Continence Product assessment from age 4 years.

Health Visiting and School Nursing Service contact details can be found by visiting www.chcpcic.org.uk and following the links to Children & Young People’s Services.

The Children’s Bowel and Bladder Charity ERIC Website https://www.eric.org.uk/

Bladder and Bowel UK https://www.bbuk.org.uk/

Referral Criteria/Information

Do Not Refer

Constipation

Do not refer under 2 years of age
Do not refer without confirmed diagnosis of constipation
Do not refer if not examined by GP or Consultant to initially rule out any organic cause for constipation

Enuresis

Do not refer under 5 years of age
Do not refer if not registered with Hull GP or not living in Hull
Do not refer if not been examined by a GP or consultant to initially rule out any organic cause for the wetting

Referral Criteria

The service accepts referrals for:

Constipation for children aged 2 years and above
Enuresis for children aged 5 years and above
Continence product assessment for children aged 4 years and above

Referral is via Electronic referral to Community Childrens Nursing CHCP.CIC chcp.communitychildrensnursing@nhs.net

Constipation

The service will only accept referrals for Constipation for children aged 2 years and over who have had a recent diagnosis of constipation and have been examined by a GP/Consultant (or other suitably qualified health professional as determined by the practice) to initially rule out any organic cause for constipation.

Enuresis

School-aged children from the Hull area with diurnal/nocturnal enuresis should, in the first instance, be referred to the appropriate 0-19 Public Health Nursing team who will offer advice and support and follow the referral pathway to the continence/enuresis service as necessary.

The service will only accept referrals for Enuresis for children who are 5 years and over who have daytime or night-time wetting and have been examined by a GP/Consultant (or other suitably qualified health professional as determined by the practice) to initially rule out any organic cause for the wetting. The child must have a Hull GP.

Prior to the referral to the continence service the referrer will have completed the appropriate checklist below (Constipation/Enuresis) and ensured that all areas have been addressed. The checklist must accompany the referral.

Referrals

Referrals into the service are channelled through the Single Point of Access (SPoA) team for triage. All referrals into the service must be made on the Service’s referral form (available from the address below).

We accept referrals from health care professionals including GPs, therapy services, and community children's nurses. We do not accept referrals from parents/carers or children. Referrals should be accompanied by the appropriate checklist (Enuresis/Constipation).

Referrers will be notified if the referral is declined and a letter of explanation will be provided.

Single Point of Access
Marfleet Primary Healthcare Centre
Preston Road
Kingston upon Hull
HU9 5HH
Tel (01482) 221261
Fax (01482) 344076

Referrals into this service should be made on the designated referral form; please complete as much of the form as possible. It is important that the referrer indicates Reason for Referral, includes reports from other services involved and completes required checklists as appropriate.