Supporting children with bladder and bowel issues as they return to school

The charities Bladder & Bowel UK(BBUK) and ERIC, The Children’s Bowel & Bladder Charity, have experienced a recent increase in calls to their helplines, from anxious families concerned about how their children’s toileting needs will be met on return to school in September. A survey conducted over the summer by ERIC found that 22% of parents and carers are concerned about sending their child back to school due to their bladder and bowel conditions.

22% of parents and carers are concerned about sending their child back to school due to their bladder and bowel conditions. ERIC survey August 2020. 

Due to the coronavirus outbreak rules schools must now follow, parents are understandably worried that a reduced level of support will impact on their child’s ability to manage their medical condition and that access to toilets will be even more restricted than usual. One parent commented: “It is not the sole reason that my son won’t be returning to school, but I do have deep concerns over how his condition will be managed in line with social distancing measures.”

The Department for Education has released full ‘Guidance for full opening of schools’ and ‘safe working in education, childcare and children's social care settings, including the use of personal protective equipment (PPE)'. BBUK and ERIC are urging families of children starting reception or returning to nursery, school and college in the coming days and weeks, who need help with intimate care or have bladder and bowel issues that require open access to the toilet, to read this guidance and talk to school staff.

Summary of the guidance:

The guidance states that schools are expected to ‘implement sensible and proportionate control measures’ to reduce the risks of transmitting Covid-19 while still delivering a ‘broad and balanced curriculum’ and providing ‘educational and care support for those pupils who have SEND’.

Learners should be washing their hands more frequently than previously, including after using the toilet and toilets should be cleaned regularly. It is not a requirement for schools to allocate different groups their own toilets, nor is it a requirement to restrict groups’ use of toilets to set times. The guidance recognises that keeping groups separate presents challenges, including with cleaning shared spaces such as toilets.

The guidance allows that separating groups and keeping distancing measures in place are not ‘all-or-nothing’ options. They offer benefits, even if they cannot be maintained all the time.

There is recognition that, although adults should minimise the time spent within one metre of anyone, this is not possible if children have complex needs or require ‘close contact care’. The guidance states: ‘These pupils’ educational and care support should be provided as normal… support staff for pupils with SEND should provide interventions as usual’.

With respect to PPE the guidance states this is only needed in education settings where a child or young person becomes ill with Covid-19 or has routine intimate care needs. For children with routine intimate care needs staff should continue to use the same PPE as previously i.e, they should wear plastic aprons and gloves.

Additional Recommendations from BBUK and ERIC

Educational settings should continue to allow open access to drinks and the toilet for all learners who have bladder and bowel issues. Educational settings may want to allow these learners to access the disabled toilets to help keep groups separate. They may wish to set up a system for increased cleaning of disabled toilets.

Educational settings should allocate named persons to assist a child who is not able to manage their toileting/intimate care needs independently. These persons should be provided with disposable gloves and aprons and should ensure that they and the children they support practice good hand hygiene.

More information and support

Having a health care plan in school may be beneficial for some, as they will allow everyone to understand a child’s individual needs and how these should be addressed. School nurses and health visitors should be able to provide information on bladder and bowel issues and individual’s care needs as well as being able to support writing individual health care plans for those with more complex difficulties.

Some children will have access to specialist nurses who are usually very happy to provide information and support to educational establishments about meeting the care needs of those children.

There is guidance, jointly written and published by the two charities, that has been shortlisted for the Nursing Times Continence Care and Children’s Services Awards. It is available to educational establishments: ‘Managing Bladder and Bowel Issues in Nurseries, Schools and Colleges’, sample care plans, intimate care polices and a school toilet charter available on both the Bladder & Bowel UK and ERIC, The Children’s Bowel & Bladder Charity websites at:
https://www.bbuk.org.uk/schools-resources/ and https://www.eric.org.uk/pages/category/help-at-school

Educational establishments are also welcome to contact the Bladder & Bowel UK or ERIC helplines for more support and/or information:

Bladder & Bowel UK 
Email: [email protected] Tel: 0161 607 8219

ERIC's helpline service contact details