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Case Studies

Tackling childhood incontinence in rural Wales

18th Apr 2019

Jennifer Walsh, a Community Children’s Nurse and Bevan Exemplar, is creating an integrated community service in Powys to support children and young people with continence issues.

One in every 12 children will have wetting and soiling problems, but only one in three families will seek help. Dealing with a continence problem can take its toll on family life and have a detrimental effect on a young person’s health, wellbeing and self-esteem.

Meeting community needs

Jennifer Walsh is a Community Children’s Nurse based in Powys Teaching Health Board who wants to tackle this issue with children and young people to ensure it does not have an adverse effect on their adult lives. Supported by leading Welsh think tank the Bevan Commission as a Bevan Exemplar, Jennifer aims to establish an integrated community-based paediatric continence service in Powys.

A single care pathway is being developed for the management of all aspects of bladder and bowel dysfunction in those aged between 0 – 19 years, responsible for meeting the needs of children and young people that live across a rural area that is quarter the land mass of Wales.

This initiative has the potential to reduce emergency admissions by 80% and could lead to a significant reduction in consultant-led appointments (constipation/ bedwetting are among the most common reasons for referral).

Health and care professionals in Powys also work closely with ERIC, The Children’s Bowel and Bladder Charity, to support young people with continence issues. ERIC is dedicated to supporting young people from 0 – 19 years and those who care for them to overcome or effectively manage their continence challenge and to establish good bladder and bowel health for life.

There’s an app for that

Jennifer has also been developing a digital solution to support children with continence issues with Welsh health technology company Aparito. This solution brings together a patient-facing app, which shares trusted information on how to manage these issues and enables children and young people to track their toilet activity, with a clinical facing platform.

Young people will be able to use the app as a digital diary for their continence problems and this information will be sent straight to clinicians – enabling young people to manage their condition more independently and reducing the need for face-to-face appointments

The benefits of reducing face-to-face appointments and using a digital solution also include: reducing administrative workload in the NHS, avoiding missed work / school for parents and children and importantly reducing embarrassment for children and young people in communicating these sensitive issues.

Nurse-led service

Looking to the future, Welsh Government support for an ‘Advanced Clinical Practice MSc’ is enabling Powys Teaching Health Board to train continence specialists and develop a completely nurse-led childhood continence service, in line with the values of prudent healthcare.

It is hoped that by working with partners such as ERIC, The Children’s Bowel and Bladder Charity, and health technologists Aparito, Powys Teaching Health Board can provide support and innovative solutions for children and young people facing continence issues across the region. A regional ERIC roadshow will take place in Powys on 6 June 2019 to train health and care professionals in how to manage and treat childhood continence issues.

This joint initiative ensures that no childhood needs to be blighted by a bowel or bladder issue and that young people can live free from shame and isolation.

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