Read the Children’s Continence Commissioning Guide 2019.

The Paediatric Continence Forum has launched  its new Guide (September 2019) on how to commission and run integrated, nurse-led, community-based paediatric continence services. These are clinically effective, improve the lives of children and their families and generate significant cost savings for the NHS.

Bladder and bowel (continence) problems affect more than 900,000 children and young people in the UK, with a significantly negative impact on their health, wellbeing, education and emotional and psychological development. However services in this area of child health remain fragmented and inadequate, with too many children attending A&E/ admitted for acute constipation and urinary tract infections, or are referred inappropriately to already overstretched paediatric outpatient departments. This unhappy situation could be sorted out much earlier and more effectively in the community.

A central premise of the Guide is that all children from birth to 19 with continence difficulties should have access to an integrated Community Children’s Continence Service (CCCS).

This research-based Guide gives a clear description of what a “good” service looks like and how it should be run. It includes; an appropriately resourced multidisciplinary team led by a children’s continence nurse specialist and clear and effective care pathways to other key services. Also included are good referral pathways to and from universal school nurse and health visitor services at Level/Tier 1- services which provide an important role in the early identification of problems with toilet training and the onset of continence difficulties.

Read the Children’s Continence Commissioning Guide 2019.

Dr Penny Dobson MBE Chair of the Paediatric Continence Forum, said:

“The PCF is concerned about the increasing pressure on paediatric continence services across the UK. Our 2017 FOI survey found that only 41% of CCGs and Health Boards commission all four continence services ( bedwetting, daytime wetting, constipation/soiling and toilet training).Services in many areas are therefore  fragmented and inadequate.

This clear and informative Guide is an opportunity for commissioners to create positive and effective clinical services for this all too often neglected group of children, as well as make savings for the NHS. By doing so commissioners will also fulfil the terms of the NHS Long Term Plan, by; reducing A&E attendances; creating an integrated and collaborative structure for service delivery and, most importantly, responding to the needs and wishes of all children, including those with learning and physical disabilities”  

Read the Children’s Continence Commissioning Guide 2019.

Read and give Feedback

Here is the literature review of the Commissioning Guide.

We welcome your feedback on the Guide and if you would like to share your own experiences of service development, do contact us by email

Case Studies

A Decade in the Making: Development of a comprehensive, nurse led, community based, Children and Young People’s Continence service across West Sussex.

Developing Continence Support at Level 1 and a complementary Children’s Continence Pathway

Service Development in Waltham Forest