1. Bladder & Bowel Service – A Nurse Led Service; Trafford NHS Provider Services Diane McNicoll Continence Advisor/Service Manager Delamere Centre (pt advisory line mon to fri)
Open referral
system
Triage:
urgent – within 2 working days
Non urgent – within 3 weeks
Clinic or home visit
Exclusions:
Haematuria
Proven recurrent UTI
(>2 in 6/12)
Out of area GPs
Male patients where
underlying pathology
has not been ruled out
Ca pathway
Referral criteria:
frequency, urgency of micturition with or without
urinary incontinence.
Stress incontinence
Functional incontinence
Constipation
Voiding difficulties
Bowel dysfunction associated with laxative therapy
Assessment Process:
Specialist level nurse
Assessment -
Symptom analysis
Analysis of bladder/bowel
diary
Medication review
Pelvic floor assessment
Bladder scan
MSU/swabs
Relevant past med/surg
history
QOL questionnaire
Treatments:
Life style changes
Fluid intake advice
Behaviour modification/
Toileting advice
Pelvic floor exercises
Recommendations to GP
For specific medication
Review of infection status
Retention specific treatments
written advice sent to GP
during treatment or
at discharge
Note:
Compliance with NICE at conservative
treatment level
Direct referral pathway to Urogynaecology,
Physiotherapy Or Urology at TGH including
access to mdt advice