Written evidence submitted by the Paediatric Continence Forum (COR0044)


About the Paediatric Continence Forum

  1. The Paediatric Continence Forum (PCF) is a group of specialist health professionals, patient and commercial representatives, that engages with the Government and policymakers nationally, to raise awareness of childhood bladder and bowel problems, to improve NHS services in this area of child health.

Prevalence and impact of paediatric continence issues

  1. Approximately 1 in 12 children and young people in the UK have bowel and bladder issues, making them among the most common medical conditions experienced in childhood.  There is limited understanding that wetting and soiling occurs outside the child’s control and are as a result of these bladder and bowel problems.


  1. Where parents or carers consider their child is being lazy, naughty or defiant, punitive responses are common and can cause significant harm. 


The safety net of schooling has been put on hold

  1. Attendance at nursery or school is a key safeguarding mechanism for children and young people. Schools are uniquely placed to understand and raise concerns when a child’s incontinence is not developmentally typical or is causing poor attendance or is impacting on development, education and wellbeing.


  1. Educational establishments are often first to recognize and highlight continence issues, as well as safeguarding concerns. This support and safety-net is currently inaccessible, or not being used, with low attendance of vulnerable children being reported in many areas leaving them unmonitored and unsupported. It is therefore vital that appropriate generic and specialist health services remain accessible to these children and their families. 


The impact of Covid-19 on children with continence issues

  1. Due to the current national emergency some children’s continence nurses have, understandably, been redeployed. We are aware that there are areas where children’s bladder and bowel services have been suspended in their entirety. The resultant lack of appropriate timely assessment, advice and support increases the likelihood of families being left isolated, with a child whose condition is often poorly understood by generic healthcare professionals; many of whom believe the causes are psychological or not age untypical. Furthermore, problems may escalate if left untreated e.g. chronic constipation may become faecal impaction that also impacts on the bladder causing uncontrollable soiling and wetting.


  1. We are aware that the government has provided extra funding to local authority children’s services. However, with the isolation and increased stress of the current crisis and without access to appropriate specialist children’s bladder and bowel services the very real likelihood of abusive responses to a child who is wetting and soiling are increased.


Our recommendations

  1. To ensure that children with continence issues, who have increased vulnerability to abuse, have the best chance of protection from harm we would like to see:
  1. A minimum bladder and bowel service maintained during the pandemic crisis to deliver support to the most vulnerable children, particularly for those subject to protection plans, who are looked after, or where there are high levels of professional concern
  2. A commitment that bladder and bowel services will be re-instated once this crisis is over.


  1. The mental and physical wellbeing of children who’s risk of abuse is heightened due to bladder and/or bowel continence issues and the current national response to Covid-19 must be safeguarded.

April 2020