Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps he is taking to support people with bladder and bowel control conditions in Devon.

All providers in Devon are asked to follow the formulary within the services they provide. The formulary provides information on continence care, with further information available at the following two links:

https://southwest.devonformularyguidance.nhs.uk/formulary/chapters/18-continence

https://northeast.devonformularyguidance.nhs.uk/formulary/chapters/18-continence

As part of focused work in gynaecology, NHS Devon is in a project development phase to design and implement improved pathways for women with stress urinary incontinence and overactive bladder conditions.

Livewell Southwest provides a continence service, offering assessments to adults, those aged 17.5 years old and above, living in Plymouth, West Devon, and South Hams. Livewell provides a holistic continence assessment, including routine observations, bladder scans, and skin integrity checks, as well as reviewing past medical history, medication, mobility, carer support, and diet and fluid. They offer ongoing support and products for any bowel and/or bladder issues that are identified and may refer patients to specialist nurses for further support or district nurses for ongoing care.

Conservative advice is always given as first line management options during assessments, such as pelvic floor exercises for stress urinary incontinence, or bladder training and fluid intake advice for an overactive bladder. Livewell also liaises with general practices to request medication and to request ongoing referrals to secondary care specialists if needed. Livewell works closely with the other community teams. All patients are offered an annual reassessment.

For children and young people, there is a team of specialist children’s nurses and specialist nursery nurses who provide assessment, treatment, support, and advice for children and young people with bladder and/or bowel difficulties. They provide continence promotion, and healthy bladder and bowel advice for children with additional needs. They see and assess children who are eligible for continence products because of a learning or physical disability.

Devon has commissioned a paediatric integrated community nurse led bladder and bowel service for children and young people up to the age of 19 years old, to improve quality of life, to support effective self-management where appropriate, and to prevent chronic conditions developing and needing treatment or surgery in secondary care where possible.