FOI 2025/1323

For CYP in Bolton, continence services are embedded within other service pathways.

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In Manchester, the commissioned service level is that referrals are processed within 2 working days. The maximum waiting time for a continence clinic appointment is commissioned at 10 weeks.

Specialist continence nurses undertake most assessments. District Nurses, Community Matrons, Case Managers and Learning Disability Nurses also complete basic continence assessments, supported by the continence service.

All patients receive a comprehensive assessment, history, and tailored treatment plan as first-line management. Conservative interventions include bladder training, pelvic floor exercises, biofeedback, lifestyle and dietary advice, and access to specialist pelvic floor physiotherapy. Containment products are only considered for intractable cases.

Patients are advised that during this time they must buy their own products.

At the time of providing this FOI data, at the “call back” stage there is currently 0 days wait, however this can and does vary depending on demand.

(Children) initial assessment 6 weeks approx..

In Stockport the average wait time for paediatric continence service referral is 10.3 weeks. We do not hold date on maximum waiting time although we can report that were 5 referrals waiting over 18 weeks as at the end of June 2025.

● advice on pelvic floor exercises

● advice on anal sphincter exercises

● lifestyle changes including fluid volume and type, diet and correct toileting position

● bladder training

● medication review

● medication recommendations – General Practitioner to prescribe

● Intermittent Self-Catheterisation (ISC) or indwelling urinary catheter

● Absorbent products, urinals and other toileting aids are not considered treatment for incontinence but may be used as a coping strategy pending definitive treatment, as an adjunct to ongoing therapy or for long term management after other treatment options have been explored.

9.5 Nursing Home Residents –

Level 1 with Level 2 Support 1 st Level Nurses within the Nursing home assess patients registered as in need of ‘Nursing’ within the private sector. On completion of the assessment, patients will be referred to the Continence Advisory Service whereby a visit to advise will be undertaken by the Continence Promotion Sister.

• To include baseline charts, urinalysis, bladder and or bowel diaries, treatment plans, medication reviews.

• Buffer supplies may be requested for new residents in the assessment period via ‘Funded Nursing Care Administrator’.

• The ‘Continence home delivery administrator’ must be informed of residents in receipt of products from the community, who are admitted into a ‘nursing home bed’ as funding is via the FNC source.

9.6 Residential Home Patients –

Level 1/2

• On admission patients presenting with bladder and or bowel dysfunction will be referred to the Continence Advisory Service, unless they are in receipt of regular/complex nursing interventions by the District Nursing Service. In this case the DN will undertake the continence assessment as part of their holistic care. Patients in receipt of products will be required to self-purchase until full completion of the continence assessment (DoH 2000).

• To include baseline charts, urinalysis, bladder and or bowel diaries, treatment plans, medication reviews.

• Complex cases should be referred to the Continence Advisory Service and maybe discussed via telephone, by submission of the completed assessment and treatment plans or with a joint visit.

Where a referral is received for a child transitioning into adult services, or for any other patient transfer between services, the care of the patient remains with the referrer until the receiver accepts full responsibility for the care programme.  This acceptance process will include agreement of treatment plan, ongoing goals, and awareness of any special provisions in place.

Bladder and Bowel Specialist nurses within HMR would access any specialist training via the Continuing Professional Development pathway supported within the NCA.

General practice staff receive training to allow them to deliver GP contract there is no additional requirement for continence training specifically

There is a dedicated lead who provides continence training to the care homes, people living in their own home and across Schools (Bladder and bowel team) at the NCA.

They undertake all the continence training, moisture lesion training and good practices (also including stoma).

The Bladder and bowel team will undertake assessments of individuals and work with the care home to provide training and appropriate levels of support as required alongside prescribing products

• provide advanced clinical support to all levels of staff

• provide training and education to staff within the locality, including the private, voluntary and social care sector

but there are no requirements for the service to report to the commission who they have trained and to what level of competency.

No programmes have been commissioned in NHS GM (Tameside

Any further information will be obtained by Northern Care Alliance and Manchester Local Care Organisation

• KPI 1: All patients seen by a continence nurse specialist will have a specialist assessment and action plan.

• KPI 2: 70% of patients’ will report that their symptoms have improved, or that they are successfully able to manage them to a level acceptable.

The paediatric continence service uses the Friends and Family survey to collect patient satisfaction.

• All patients seen by a continence nurse specialist will have a specialist assessment and action plan April 25 – 100%

May 25 – 100%

• 70% of patients will respond that their symptoms have improved, or that they are successfully able to manage them to a level acceptable

April 25 – 95%

May 25 – 96.8%

Stockport Locality do not routinely receive the survey results from the paediatric continence service.

As Stockport Locality do not routinely receive outcome / patient satisfaction data from the paediatric continence service, changes to service planning or pathway redesign would only take place where strong and recurring themes were flagged.