The Specialist Continence service

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The Specialist Continence service

• Sue Chadburn
• Nurse Consultant

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Who we are

• The continence team is a nurse led service
• We consist of 1 lead Nurse/Nurse Consultant
• 1 Adult Nurse
• 1 Physiotherapist
• .5 WTE Occupational Therapist
• 1.2 WTE Childrens Nurses

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Where we cover/ business hours

• We are a South of Tees Service and cover all
  clients belonging to GP practices in
  Middlesbrough, Redcar and Cleveland.
• We work between 9-5pm Monday to Friday in a
  variety of locations providing care closer to
  home.

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Our referral criteria

• We take referrals from GPs, Secondary Care,
  Social Services, Community Nurses, Carers, and
  self.
• Our focus is on treatment and prevention of
  continence problems
• We are not at present on choose and book and a
  referral form is available for the practices.

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Referral criteria (continued)

• Our referrals are for all aspects of treatment of
  continence problems. We work within NICE
  guidance.

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Treatment offered

• We offer assessment management and treatment of
  clients with a continence problem.
• We have dedicated bio feed back and pelvic floor
  clinics for Females and Males
• We offer fluid advice
• Medication and medication reviews following the
  prescribing guidelines

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Treatment

• Enuresis Clinics for children
• Constipation clinics
• Catheter advice
• Flow rates
• Bladder scans for residual volume of urine
• Product advice
• OT assessment for complex continence problems

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Products

• We hold the continence product budget but this is
  devolved to community nursing we do not assess
  for continence products.
• We do not promote products as a first line option
  and have strict criteria for products supplied to
  clients.
• We can provide practices with a breakdown of
  clients receiving products and cost to the
  practices

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Care pathways

• Work within NICE we should take all clients with
  a stress/ urge incontinence problem to ensure
  that NICE has been complied with and that pelvic
  floor exercises and medication has been tried
  before referral to secondary care.
• Pathway documents were distributed to practices
  in July 2007

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Interface with secondary care

• We have good relationships with secondary care
  consultants however at present we are seeing to
  many patients referred to secondary care to begin
  with who are then referred back to our service
  for management and treatment who never then
  return to secondary care

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Issues for the patient /yourselves

• 1Pateint has to tell their story twice.
• 2 They need time off work twice
• 3 Hospital visit inconvenient sometimes at North
  Tees
• 4 GPs have to pay a tariff for the hospital
  visit. This could be a new person tariff x2 if
  the client was discharged after the first
  appointment and subsequently needs re referring.
• 5 We are part of a block contract

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Waiting times

• 4 weeks across our service
• Locations
• One life, Eston clinic, Redcar Health Centre,
  East Cleveland
• Our clinics are dedicated Adult or Children.

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Any questions

• Thanks for listening our contact details are
• One life
• Linthorpe Road
• TS1 3QY
• 01642 737737