Bladder and Bowel UK September Newsletter

Bladder and Bowel UK Newsletter September 2018

UROLOGY AWARENESS MONTH How have you been raising awareness?

OVER £1,800 RAISED FOR BBUK Weatherwell Roofing completed the 'Tour de Mon' event

BACK TO SCHOOL Advice on children's continence problems

Charity number: 224742

Explore Our Key Features Back to school - with a continence problem...............................................................................................4 Visit our online shop...................................................................................................................................7 A workshop for healthcare professionals in the continence field................................................................8 Continence product section of Disabled Living's Supplier Directory........................................................10 We're supporting the 'Be Clear On Cancer' campaign.............................................................................11 Colleagues, we want to hear from you.....................................................................................................12 Loo of the Month.......................................................................................................................................13

Weatherwell Roofing Have Completed Tour De Mon to Raise Money for Bladder and Bowel UK

On Sunday 19th August 2018, Weatherwell Roofing took part in a cycle around Holyhead, Ise of Anglesey to raise money for Bladder and Bowel UK. They have raised an amazing ÂŁ1805.00.

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Back to School – with a Continence Problem

Prevalence of continence problems Continence problems are considered to be one of the most prevalent healthcare issues in children and young people. Functional constipation affects 0.7-29.6% of (Koppen et al 2014); faecal incontinence, which is often secondary to chronic constipation affects 0.8-7.8% of children worldwide (Ambartsumyan & Nurko, 2013); daytime wetting affects 2.8% of 6-14 year olds (Vasconcelos et al 2017); bedwetting is an issue for 15.5% of 7.5 year olds, with 2.6% wetting at night at least twice a week (Butler et al 2005).

Greater percentages of children with additional needs have continence difficulties than do children with typical development (von Gontard, 2015). 20-40% of children and young people with daytime wetting meet the criteria for a disorder of mental health including attentiondeficit hyperactivity, oppositional defiance disorder and anxiety (Vasconcelos eta l (2017).

Why are the numbers of children attending school with continence problems increasing?

With improving healthcare, perinatal mortality rates are falling, but morbidity is increasing.

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This has meant that special schools are receiving children with more complex needs and ever greater numbers of children with some degree of physical disabilities and/or learning difficulties are attending mainstream schools and, for these children, it is often assumed that toilet training will inevitably be delayed.

Toilet training is being taught at a later age than in previous generations (Richardson 2016). This is probably related to the advent of disposable nappies, child-orientated parenting with emphasis on waiting until the child appears ready to toilet train and increasing numbers of children starting school-based nursery at 2 ½ 3 years of age. The combined result of these

factors is increasing numbers starting school without being able to toilet independently (Essity, 2018). There is also evidence that initiating toilet training after two years of age is associated with increased levels of incontinence in childhood (Joinson et al 2009).

Furthermore, young people with anorexia nervosa, obesity and autism spectrum disorders all have a high prevalence of wetting.

Recent reports indicate that 10% of reception children and 20 % of those in year six are obese (NHS Digital 2018). Children with obesity have more functional constipation and faecal incontinence that their peers of normal weight (von Gontard, 2013) and some studies have suggest children with autism also have higher rates of functional constipation (Samsam et al 2014).

What is the impact of continence problems at school?

Daytime continence problems can have a significant impact on self-esteem, well-being and socialisation, as well as learning for the children affected. School staff are not health trained and many do not understand that children can have a medical problem affecting their bladder and/or bowel and are often at a loss to know how to help. If a child starts school in a nappy, the staff may assume that the family have not bothered with toilet training. Many adults do not appreciate that children, particularly younger ones may not be aware that they are wet or have soiled and may assume that the child has a behavioural problem. Rules around access to the toilet and drinks can adversely affect children all children, but tend to have a disproportionate impact on those with continence difficulties and disabilities.

The role of the health care professional This leads to the question of what can healthcare professionals working with

children and young people do to support? The impact of transfer of school nursing and health visiting to a public health role with constraints of commissioning and budgetary restrictions seems to be increasing, but the problem cannot be ignored. There are some simple and fairly quick measures that can be put into place, which are likely to have positive effects: Health visitors can discuss timely toilet training and explain issues around bladder and bowel health with families at developmental checks.

They can signpost to appropriate sources of information, such as those on the Bladder and Bowel UK website (see below) and alert families to early signs of constipation and how to address these.

School nurses can be alert to signs of continence problems at school entry, provide first line advice and refer on if necessary. They can explain continence problems to school staff, ensuring that they understand that inadequate or dirty toilets, which provide poor levels of privacy and where poor student behaviour is unchecked, can discourage students from using them. This may result in pupils avoiding drinking and withholding urine and faeces during the school day. Schools should be encouraged to consider their policies with respect to access to water bottles and toilets during the day. Staff may also need explanations of normal fluid intake in school age children and to be reminded of the educational

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References

and health benefits of children being reminded and encouraged to drink regularly throughout the school day.

Resources to support healthcare professionals, schools and families Guidance provided by the Department for Education on supporting pupils with medical conditions at school (available from https://www.gov.uk/government/publications/su pporting-pupils-at-school-with-medicalconditions--3) and on the Equality Act 2010 (available from https://www.gov.uk/government/publications/eq uality-act-2010-advice-for-schools) set out expectations that include support for those with continence problems and are a useful reference for families and healthcare professionals as well, as for education staff.

Bladder and Bowel UK are able to provide information and support to healthcare professionals and families via our website at: https://www.bbuk.org.uk/children-youngpeople/children-resources/ and our confidential helpline (email bladderandboweluk@disabledliving.co.uk or telephone 0161 607 8219) and are currently involved in creating an information pack for schools on continence problems, which we hope will be available in the next few months.

More details will be provided through the newsletter when they are published.

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Ambartsumyan L & Nurko S (2013) Review of fecal incontinence in children: evaluation and treatment. Expert Review Gastroenterology and Hepatology 7 (7) 657-667 Butler RJ et al (2005) Nocturnal enuresis at 7.5 years old: prevalence and analysis of clinical signs BJU International 96, 404-410 Esity (2018) Bottom of the class are falling hygiene standards failing primary school children? Available from: https://schoolhygieneessentials.co.uk/files/Essity -Bottom-of-the-Class.pdf Joinson C et al (2009) A prospective study of age at initiation of toilet training and subsequent daytime bladder control in school-age children Journal of Developmental and Behavioral Pediatrics 30, 5, 385-392 Koppen IJN et al (2015) Management of functional constipation in children: therapy in practice Pediatric Drugs 17 349-360 NHS Digital (2018) Statistics on Obesity, Physical Activity and Diet - England, 2018 [PAS] Available from https://digital.nhs.uk/data-andinformation/publications/statistical/statistics-onobesity-physical-activity-and-diet/statistics-onobesity-physical-activity-and-diet-england-2018 Richardson D (2016) Toilet training for children with autism Nursing Children and Young People 28, 2, 16-22 Samsam M eta l (2014) Pathophysiology of autism spectrum disorders: revisiting gastrointestinal involvement and immune imbalance. World Journal of Gastroenterology 20, 29 9942-9951 Vasconcelos MMA eta l (2017) Early behavioral risks of childhood and adolescent daytime urinary incontinence and nocturnal enuresis.

Journal of Developmental and Behavioral Pediatrics 38, 9 736-742 Von Gontard A (2013) Urinary incontinence in children with special needs Nature Reviews Urology 10 667-674 Von Gontard A (2015) Nocturnal enuresis, daytime urinary and faecal incontinence in children with special needs Australian and New Zealand Continence Journal 21, 2, 54-58

Urology Awareness Month We've been raising awareness of #UrologyAwarenessMonth via our social media channels.

Take a look in the links below: Twitter Facebook LinkedIn

Visit Bladder and Bowel UK's Online Shop

We are delighted to be working in partnership with Complete Care Shop to provide you with a comprehensive online shopping facility for equipment and products to make life easier.

Complete Care Shop has over 250,000 in stock items at competitive prices offering you choice from a wide range of manufacturers including disposable pads, pants, urinals, bedding protection, disposal and reusable bed and chair pads, wipes, gloves and a whole lot more.

The main advantage of purchasing via the Bladder and Bowel UK website, is the opportunity for you or your clients to speak to Continence Specialists for free impartial help and advice, ensuring unnecessary purchases are not made.

Visit: www.bbuk.org.uk/online-shop/ or call: 0161 607 8219

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NEW COURSE!

In the Dock: A Workshop for Healthcare Professionals

Your competency is under question Your record keeping is being scrutinised Healthcare professionals in the continence field - this includes you!

There are different scenarios which could end up with someone being summonsed as a witness.

Whether it is a coroner's court or a civil negligence case this workshop will help you to understand what will be required and how to improve your practice so that a court appearance will be less intimidating. Using real life scenarios, expert witnesses and solicitors will lead you through the process and highlight areas you can improve and share good practice in.

On this interactive day you will work on a project which culminates in you appearing in the dock in front of a Judge and Jury. Find out how to protect yourself in your reporting and recording at work, what your responsibilities are and how to be confident in your work and not be afraid of being taken to court.

Please visit our website to book your place and for more information.

If you require more information please email: training@disabledliving.co.uk.

Date: Wednesday 13th February 2019 Venue: Manchester Price: Cost: ÂŁ35 + VAT (includes light lunch and refreshments) For more information please visit www.disabledliving.co.uk under 'Our Workshops' in the Training section 8

Vaginal Mesh – NHS England Ruling

For many years now we have been hearing about ladies who have had adverse reactions following the insertion of a vaginal mesh for the management of stress incontinence. This has been a global problem and over recent times has seen a ban or restriction on the procedure in a couple of countries including New Zealand and more locally Scotland.

It appears that the procedure initially envisaged to be simple, non invasive and convenient was anything but.

We must, also, remember that there is still a significant amount of women who the procedure has worked for that have regained confidence and quality of life because they can now take part in activities they want to without experiencing stress incontinence.

However, due to high number of adverse reactions and effects physically and psychologically reported nationally NHS England made the decision in July 2018 to put a pause on the procedure for urinary stress incontinence. As continence specialists we may have ladies presenting in our clinics that are experiencing and suffering from these symptoms.

For more information please visit: https://www.england.nhs.uk/publication/mesh-oversight-group-report/

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Continence Product Section of Disabled Living's Supplier Directory

There is a section on the Disabled Living Supplier Directory dedicated to continence and stoma products. In addition there are a wide range of categories providing information about companies and organisations that provide equipment, products and services to support disabled children, adults and older people.

Access to the Supplier Directory is via the right hand side of the BBUK website.

This month we welcome the following companies to the directory:

https://supplierdirectory.disabledliving.co.uk/category/continence-stoma-products/ 10

News from the BBUK Team Joanne Hoyle went to The National Picture at the Yorkshire ACA mini conference on the 20th September giving an update on what is happening within the speciality of continence nationally to include topics such as the APPG work, EICC and NHS England position on vaginal Mesh surgery.

Joanne is also going to be presenting on the 3rd October at the Continence Care Conference in Wolverhampton.

She will be promoting BBUK services to enhance awareness of the work the team does and how it may benefit you and your patients.

Joanne will, also, be hosting a stand with service leaflets etc and be bale to answer individual questions about the organisation. The programme looks great with dynamic speakers, a follow up will appear in the October newsletter.

Alongside these events Joanne took part in organising and presenting at our own BBUK National Bowel Education Study Day at Redbank House on the 25th September.

Joanne is also going to be presenting on the 3rd October at the Continence Care Conference in Wolverhampton. She will be promoting BBUK services to enhance awareness of the work the team does and how it may benefit you and your patients.

Joanne will, also, be hosting a stand with service leaflets etc and be bale to answer individual questions about the organisation.

The programme looks great with dynamic speakers, a follow up will appear in the October newsletter.

Joanne Hoyle, Continence Specialist Nurse

Colleagues, We Want to Hear from You! We would like to hear and share news of good practice, service development and improvement, staff news and anything you would like to share! Very often nurses and services work in isolation and do not realise that they are working in innovative ways.

However small the news article may be it may help another service to improve patient care delivery, service development or waiting list management.

Don’t be shy come forward with your stories we are waiting to hear from you! Email your news to: bladderandbowel@disabledliving.co.uk

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Loo of the Month - Moscow

Moscow, Russia - May 20, 2018. Modern Russian street toilet on Moscow street in summer day.

Writing on the cabin - city toilet.

Connect with Us on Social Media As you know Bladder and Bowel UK is active on the Twitter, LinkedIn and Facebook social media networks, if you have anything that you wish us to share for you just get in touch, or tag us in.

Please follow us, like us and connect with us!

@Bladder-and-Bowel-UK

@BladderBowelUK Bladder and Bowel UK

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Disabled Living's Services Bladder and Bowel UK is a service of the charity, Disabled Living a charity which provides impartial information and advice about products, equipment (assistive technology) and services for disabled children, adults, older people, carers and the professionals who support them. We have a range of services which you can access via our helpline, through the website or at our Kidz to Adultz Exhibitions.

Watch Our Donkeys to Innovators Film

Equipz The team comprise occupational therapists, trusted assessors, moving and handling specialists, physiotherapists, nurses, continence specialists who together with knowledgeable information co-ordinators offer practical solutions to what may seem like unmanageable problems. The staff, respond to enquiries throughout the UK, primarily via our helpline and website, with some people opting to make an appointment to visit the Disabled Living Centre based in Manchester for a free equipment assessment.

Helpline: 0161 607 8200 Bladder and Bowel UK The team provide information and advice for children, young people and adults with Bladder and Bowel problems. We provide a confidential helpline managed by a team of specialist nurses and knowledgeable information staff. In addition, the website offers a wide range of downloadable free resources.

Helpline: 0161 607 8219 Kidz to Adultz Exhibitions Disabled Living organise the largest FREE UK exhibitions totally dedicated to disabled children, young adults, their families, carers and the professionals who support them. With over 100 exhibitors at each event, offering a ’One Stop Shop’ for equipment products and services to enhance the quality of life. We deliver 5 events throughout the UK in: Farnborough, Bristol, Coventry, Manchester and Edinburgh.

Training Disabled Living provides a comprehensive training programme for professionals and carers. Most of our courses are accredited by Open Awards and others provide CPD opportunities. Our training courses can be ‘tailor made’ to suit your organisations requirements and can be delivered throughout the UK for more detailed information on the courses we provide please visit the Disabled Living website.

www.disabledliving.co.uk

0161 607 8200

Get in Touch with Us

For more information please visit: www.bbuk.org.uk

Bladder and Bowel UK Head Office - Disabled Living, Burrows House, 10 Priestley Road, Wardley Industrial Estate, Worsley, Manchester M28 2LY Tel: 0161 607 8200 Email: info@disabledliving.co.uk Website: www.disabledliving.co.uk