Community Specialist Paediatric Bladder and Bowel Service

Who we are:

  • The Community Children and Young People's Bladder and Bowel Service support children and young people with complex bladder and bowel conditions.
  • We are part of the children's community nursing team with specialist knowledge in bladder and bowel conditions affecting children and young people.
  • Our aim is to achieve full continence but where this is not possible, to enable the child, young person, or their carers to manage their condition in the best possible way.
  • We provide advice, care plans and treatment to children registered at a GP in Cumbria, and are split into 2 teams described as North and South Cumbria. 

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Referral criteria/eligibility

We accept referrals from health care professionals and allied health workers for children from the age of 4 to 18 years for:

  • Constipation and soiling
  • Daytime wetting or bladder issues such as urgency and frequency (3.5 years to 18 years)
  • Night time wetting (5 to 18 years)
  • Continence products (5 to 18 years)

Prior to referral all children should have a physical examination from a medically trained health care professional.  For example: GP, paediatrician, advance nurse practitioner.


  • Children who are constipated must have been examined by a GP or health care professional.
  • Constipated children have received tier 1 advice and commenced on an oral macrogol treatment for 3-6 months. 


  • Children over the age of 3.5 years, that have been examined by a GP, with no underlying organic cause identified and have received tier 1 health promotion advice.
  • Children over the age of 5 years with nocturnal enuresis, that have had tier 1 health promotion advice and have tried an alarm/desmopressin with no improvement.


  • Children with bladder dysfunction that require intervention such as catheterisation. We can support with training and support as directed by the tertiary consultant.
  • We offer a core training package for school of up to 2 teaching assistants if required.


  • Following referral from the consultant we and work in conjunction with the relevant services as required.

Toileting and continence products

  • Children over the age of 5 years who have limited toileting skills are entitled for an assessment of bladder and bowel function. This does not automatically entitle them to supplementary continence products.
How children are reviewed
  1. Once a referral is received it will be triaged and actioned accordingly to local policy.

  2. Acceptance letter and relevant charts requested to be completed by parents/guardian.
    • For a full assessment further information is required, such as, fluid and/or stool charts.  These are sent with instructions on how to complete and a time scale to be returned by.

  3. Once returned, an appointment with a bladder and bowel specialist nurse will be arranged, usually in the next available face to face clinic.
    • There are several clinic locations and the closest to your home would usually be offered.

  4. If there is no contact or engagement within 1 month the referral will be closed and referrer and family informed.
    • We do require engagement from parents and request information is provided to be able to make a full assessment and offer support to improve and resolve continence issues.

  5. Active referrals will continue to receive support, which can be provided in a variety of settings.  Once agreed and goals are achieved, the patient will be returned to the GP for continued management.  Where needed, the patient is transitioned to adult services.
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Page last reviewed: 19/07/2023

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