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The Paediatric Continence Forum (PCF) has published a manifesto ahead of the general election calling on all parties to sign up to a pledge to ensure that all children and young people have access to high quality continence care.

Approximately 1 in 12 children and young people are affected by continence problems, causing them significant difficulties in terms of family and social relationships, as well as the risk of medical complications. Constipation and bedwetting are now the most common reasons for referral to paediatric outpatient clinics.

Yet research performed by the PCF in August 2014 revealed that clinical commissioning groups (CCGs) in England are failing to provide proper integrated paediatric continence services. Only 32% of CCGs who responded to our Freedom of Information (FOI) request said that they commission all the four main continence services (covering bedwetting, daytime wetting, toilet training and constipation/soiling) – with just over 22% of responding CCGs commissioning services that are fully "joined-up”.

The PCF has released a manifesto which identifies actions in four key areas to help children across the country access high quality care:

  1.  All children should have access to timely and effective treatment – whether they are suffering from bedwetting, daytime wetting, or constipation and soiling, there is a need for prevention, early detection and effective intervention to improve health outcomes and prevent potential emotional difficulties.

  2. All areas should have an integrated paediatric continence service which provides the four key services (bedwetting, daytime wetting, toilet training and constipation/soiling) - a single, integrated, community-based service under the leadership of a specialist paediatric continence adviser provides the best quality of care.

  3. The Paediatric Continence Forum’s Commissioning Guide should be used widely to improve the quality of services - accredited by NICE and endorsed by the RCPCH, the RCN and the CPHVA, this Guide provides clear advice to commissioners and healthcare professionals on how to commission proper integrated, community-based paediatric continence services.

  4. Continence should be considered when making policy on childhood health, disability and education - this includes issues such as the effect upon children with disabilities, the impact of continence on educational opportunities and the need for each school to have a written continence policy, plus good quality toilet and washroom facilities.

The PCF is calling for candidates from all parties to sign up in support of the manifesto. Whichever parties form the Government after the next election, action needs to be taken to improve the quality and consistency of continence care for children and young people across the country.

Dr Penny Dobson MBE, Chair of the PCF, commented: "Good quality paediatric continence services ensure that children get the care they need at a crucial stage of their development. Access to such services prevents problems such as emotional distress, bullying and disruption to education. It also saves the NHS money through reducing complications such as kidney infections and chronic constipation/ impaction which may require hospital admission. We are calling on all parties to pledge to support action to improve the quality of services during the next Parliament.”

The full copy of the manifesto can be found here.


1. The PCF is an independent group of healthcare professionals that engages with the Government and healthcare organisations, with the aim of improving paediatric continence services nationally. Formed in 2003, the PCF has close links to the charities ERIC (Education and Resources for Improving Childhood Continence) and PromoCon. Its membership includes paediatricians and specialist nurses, with formal representation from the Royal College of Paediatrics and Child Health (RCPCH), the Royal College of Nursing (RCN) and the Community Practitioners’ and Health Visitors’ Association ( CPHVA).

2. In September 2014, the PCF published a comprehensive guide, called the Paediatric Continence Commissioning Guide, which provides clear information and guidance to commissioners and healthcare professionals on how to commission integrated, community- based paediatric continence services. The guide was accredited by NICE and was formally launched in conjunction with the NICE Nocturnal Enuresis Quality Standard.

3. For further information, please contact Frances Powrie on [email protected] / 020 7793 2537