Scope

All patients must be referred to the Community Continence Advisory Service for a programme of conservative management

• Patients will be assessed in a community based clinic (Mount Gould LCC, South Hams Hospital and Tavistock Hospital)
• Any adult (over 18) with involuntary urinary or faecal loss
• Patients will be holistically assessed and will be supported using a conservative based programme to improve management of their continence problems
• The assessment will include bladder scanning, pelvic floor strengthening and lifestyle which may include advice on fluid intake, diet, and smoking
• Following initial GP assessment, the majority of patients with incontinence will benefit from an assessment at the community continence clinic
• Housebound patients are encouraged to attend the clinic if they are able to access through personal or ambulance transport

Please Note: Pre-Choice Triage is currently active for this specialty and referrals submitted without this information may be returned.

Key pre-referral criteria summary:

Physical examination is indicated prior to referral in order to exclude significant genital prolapse, prostate disease or other significant pathology e.g. malignancy. If physical examination is not appropriate please include reason in referral.

Out of scope

• Symptomatic Prolapse visible at or below the vaginal intriotus, pelvic masses or urogenital fistulae should be referred to secondary care urogynaecology
• Enlarged Prostate, Recurrent UTI should be referred to urology
• Haematuria should be referred in accordance with local guidelines
  • Haematuria guideline
  • 2WW Urology guideline
• A small minority of patients may be deemed unsuitable for onward referral to the clinic e.g. patients at end of life. Please refer to Community District Nurse Service
• Some patients may be unable to be transported to the clinic because they are clinically unable to use ambulance transport. Please refer to Community Continence Clinic
• Patients requiring urinary catheter services. Please refer to District Nurse
• Patients who have a Registered Learning Disability may be referred, following initial GP assessment, to the Learning Disability Service at the Westbourne Unit
• Children (up to 18 years old) should be referred to the Child Development Centre at Scott Business Park 01752 435232
• Recurrent UTI in children should be referred to the Derriford nurse led clinic