Due to increased demand on the service, we currently have waiting lists for new referrals. If your child’s condition gets worse, you should contact the Children’s Continence Service for advice.

Signs of constipation or urine problems getting worse might be:

  • Constipation/soiling – not passed stools in 7 days, has stomach bloating, abdominal pain, diarrhoea and/or vomiting
  • Passing urine more than 7 times in 24-hour period, unable to hold urine, urine has an unpleasant smell, pain when passing urine, not passed urine for 24 hours, temperature, vomiting
  • Child/young person is always thirsty, and has a family history of diabetes
  • New or increased concerns for parent/carer in regard to your child/young person continence needs

NHS 111 is available by telephone if you need emergency advice over a weekend or evening. You can also ask your local pharmacy or GP practice for advice.

We are a small nurse-led community service working within Derby city and Derbyshire. We support children and young people 4-18 years (19 if your child attends a special school) with continence needs.  

We work closely with the following agencies where appropriate:

  • Children’s centres, nurseries, playgroups, schools and other education services
  • Other medical professionals such as doctors, psychologists, physiotherapists, occupational therapists, speech and language therapists and public health nurses
  • Adult services to ease your child’s transition from children’s series
  • Social Care Services
  • Private and voluntary agencies

Our service adheres to Trust policies and service specifications, which include Child Protection.

We see children who are experiencing problems with their bowels and bladder, to assess their problems and to give them some advice on ways to help. We see a range of children/young people, some for whom this is their only healthcare need and others who have a range of complex needs.

When you come to see us in clinic we will begin by asking questions about the problem. Please try not to get embarrassed, as we are always talking about wee and poo.

You may find that we ask you to complete further work at home. We try to make it simple and age appropriate but it is important that you try to complete this.

If you have any questions you want to ask, it might be helpful to write them down before your appointment. We will do our best to answer these at your appointment.

All things discussed in clinic are confidential and will not be shared with anyone else unless you give permission – the only exception to this is if we are worried  that your child/young person is in danger. However in most cases we will discuss this with you.

Alfreton Primary Care Centre

Church Street, Alfreton DE55 7AH

Telephone: 01246 515100 (option 4)

Email: DCHST.childrenscontinenceteam@nhs.net

Product order line: 0800 030 4466 (please note you will require your child’s ID number and date of birth)

 

Most children/young people will be seen initially in one of our clinics. The clinics are held at the following locations:

Alfreton Primary Care Centre

Church Street, Alfreton DE55 7AH

Telephone: 01773 546841

Ripley Hospital

Sandham Lane, Ripley DE5 3HE

Telephone: 01773 743456

Heanor Memorial Health Centre

Ilkeston Road, Heanor DE75 7EA

Telephone: 01773 599410

Ilkeston Community Hospital

Heanor Road, Ilkeston, DE7 8LN 

Telephone: 0115 930 5522

Long Eaton Health Centre

Midlands Street, Long Eaton, NG10 1RY

Telephone: 0115 855400

Swadlincote Health Centre

Civic Way, Swadlincote, DE11 0AE

Telephone: 01283 818000

Repton Heath Centre 

Askew Grove, Repton, DE65 6SH

Telephone: 01283 707170

St Oswalds Hospital

22 Clifton Road, Ashbourne, DE6 1DR

Telephone: 01335 230000

Hannage Brook Medical Centre

Hannage Way, Wirksworth, Matlock, DE4 4JG

Telephone: 01629 822434

The initial appointment will last approximately one hour. At the end of the appointment a plan of care will be agreed with the child/young person, parent/guardian and nurse.

If we feel that other people need to be involved to help you we may agree to see you at school or at home.

We have provided advice below on lifestyle changes to promote continence. We can also provide equipment such as enuresis alarms or washable or disposable continence products for disabled children/young people who are not able to be continent.

We will work with you and your GP/Paediatrician around appropriate medication.

Referrals

Children’s continence referrals are accepted from health professionals. All referrals will be sent to our central point of access site in Chesterfield.

Bladder scan appointments

To prepare for, and reduce any fears, before attending one of our bladder scan appointments, please watch the bladder scan video below. This video talks you through what happens at a bladder scan appointment.

 

Firstly, let us reassure you that continence issues in children are extremely common. Whether they are struggling during the day, during the night or both, we have lots of help and advice to support you and your little one. View our continence guides and leaflets.

We have provided lots of fun activities to do with your child around continence issues including resources that may help them on their toileting adventure in the 'I am a child' and 'useful information and links' sections.

ERIC

ERIC is a national charity for children and young people with continence needs. The website contains information such as self-help guides, case studies and fun activities for your little ones. These help promote toilet training and advice for children and their families on how to work towards healthy bowels and bladders.

If you have tried the self-help advice above and have had no success please contact your health visitor, public health nurse or GP for more support and advice.

Please note that from July 2020 we are using a new product delivery system. The number can be found on our main page and your child's ID and date of birth are needed to use the automated line. Products may take from three to 10 days to be delivered.

Many of the referrals into the service are due to basic healthy bowel and bladder advice not being followed - for example due to poor fluid intake.

We encourage all professionals to ask families to follow the advice in the continence leaflets and signpost them to the information on this page (particularly 'I am a parent' and 'I am a child') before referring into our service.

You can also check you are making an appropriate referral by downloading and completing our Continence Level 1 Checklist.

Please ask your families to complete a bladder and bowel diary to send with the referral.

If all the advice in stage one has been followed and there are still continence issues, you can download and complete the referral form and email it to crhft.DerbyshirechildrenscontinenceL2@nhs.net

For SystmOne users, please complete the referral form electronically through the system.

It's really important to remember that lots of children have wet accidents whether in the day or in bed at night. There are many things that can be done to help these accidents go away.

There are lots of fun activities to try to help you with your toileting adventure.

Poo and wee are fun to talk about. If you or a grown-up at home have a tablet or smart phone, you can download the Pooland App which has a video about 'sending Poo home'.

Going to the toilet gives us lots of jobs to do and sometimes we can get in a bit of a muddle. We have found that picture routines help us to remember all the steps we have to do when visiting the toilet.  

Here are a some guidance and advice pictures to download. 

Who would have thought that wiping your bottom could be so tricky? For some this is more difficult than for others. 

For some children no matter how hard they try, reaching their bottom is incredibly difficult. There is a quick test we try to see if this is something that is achievable and you can try it right now.

If you can raise your arm and place it over your head to touch your opposite ear then we feel pretty confident your arm can reach to wipe your bottom.

Here are more picture sequence cards to help you learn all the steps in bottom wiping.

After all your hard work we think you deserve a sticker, use our reward star chart and see how many stars you can collect.

Useful information

This section provides links to useful documents and websites that provide support to children and young people with many different types of continence issues.  

It is vital that any advice or information is tried consistently in all of the child’s or young person’s day-to-day activities.  

Continence issues take time to resolve and sometimes the improvements are so small they are barely noticeable. Even if the child is later referred to our service, all the early advice given is key to gaining successful continence, so it is vital that the advice continues to be followed even if it appears to be having little or no effect.

Toilet training

Bed wetting

  • Nocturnal Enurisis ​​​​​​(Bedtime Wetting) - helpful tips on reducing your child's nightime bed wetting.
  • Bed wetting - from ERIC
  • Bed wetting - a short video offering support to parents and carers around nighttime wetting

Daytime incontinence

Constipation

  • Constipation/Soiling - a parent's/carer's guide to constipation and soiling
  • Constipation - from ERIC
  • Constipation - a video for parents and carers around constipation
  • Treatment - a video to discuss how macrogol laxitive (commonly named Laxido or Movicol) are used to treat constipation.

An overview of constipation

Constipation in children is very common – 1 in 3 children will suffer from it – but it is often not recognised and even when it is, it is poorly managed. Watch this short video for a clear explanation of constipation:

 

Recognising the symptoms of constipation

This short video talks about how we can recognise when a child is constipated using the Poo Checker:

 

Treating constipation

This video explains the important points around treating childhood constipation, including:

1. Constipation will not go away on its own; children do NOT grow out of it. Treatment is essential.

2. Parents might think that treatment includes changing the child’s diet, increasing fluids, getting plenty of exercise or sitting on the toilet more often. However, these are all ways to promote a healthy bowel - not treatments for constipation.

3. Constipation in children should be treated with laxatives first, in line with national guidance.

Watch this video to find out more:

 

How to use macrogol laxatives

This video advises how to use macrogol laxatives. First – how do macrogol laxatives work? Secondly, how much laxative should be given? And lastly, how do we encourage children to take the laxatives?

 

Keeping bowels healthy and getting poo in the loo

This video talks about how to keep bowels healthy and getting the poo in the loo (potty training). Check it out for tips, tricks and lots of resources:

Bowel and Bladder UK - covers all the subjects above. Follow the links within the site to the relevant continence issue.

ERIC is a great organisation that supports children and families with continence issues. It has a helpline and blogs written from families sharing their experiences of their child's continence problems.

 

Quality Standards

Every nurse is registerd with the Nursing and Midwifery Council (NMC). Nurses work within and abide by the codes of practice of NMC.

The senior nurses also have a specialist qualification in children’s continience.