Derbyshire Footprint Community Paediatric Continence Service Level 2 for children & young people aged 0 -18 years

NHS Arden & Greater East Midlands Commissioning Support Unit (NHS Arden & GEM CSU) on behalf of the Derbyshire CCGs including NHS North Derbyshire CCG (who is acting as lead Commissioner for this process), NHS Hardwick CCG, NHS Erewash CCG and NHS Southern Derbyshire CCG are inviting bids from suitably qualified providers capable of delivering a Derbyshire footprint Community Paediatric Continence Service Level 2 for children and young people aged 0 -18 years (or 19 when attending a special school) who are registered with member GP Practices of NHS North Derbyshire, Hardwick, Erewash and Southern Derbyshire CCGs for which they are the responsible commissioner.

The generic term "continence" is interchangeable with the terms "bladder and bowel difficulties", "bladder and bowel dysfunction" or "wetting and soiling problems".

Continence problems are believed to be caused by biological, developmental, genetic and environmental factors. Structural or anatomic causes are rare. They occur at a formative time for children and influence their health, their wellbeing, and their emotional development. There is evidence that they are associated with emotional and behavioural problems, including a strong association with bullying, both as recipients and perpetrators (NICE Clinical Guideline CG99, 2010: 5; CG111, 2010: 4). They can also reduce self-esteem at a crucial time for a child or young person's emotional development and risk their exclusion from normal social interaction.

Continence problems are treatable and it is therefore important that Children and Young People are diagnosed and managed early. Continence problems are more prevalent among children and young people with learning and physical disabilities, who have a higher risk of underlying pathology and may take longer to achieve continence. There is also a higher prevalence of continence problems among children and young people in local authority care.

The indicative benchmark for a paediatric continence service is 0.8% or 800 per 100,000 population aged 19 years and under. This equates to 1,889 children and young people across the Derbyshire footprint, of which approximately 50% may progress into a Level 2 service.

This service is designed to meet the needs of Children and Young People to achieve complete continence, or to manage the condition discreetly and effectively if full control is not clinically possible. This will be achieved through;

• Clinical assessment of continence need of each child, • Clinical oversight of suitable continence products • Facilitation of obtaining products from current supplier and distribution to patients

Additional information: The overarching aims of the Derbyshire Community Paediatric Continence service will be to: • Treat children and young people from birth -19 years with the full spectrum of bladder and bowel dysfunction, run by a community based multi-disciplinary team and led by a Paediatric Continence Nurse Specialist. • Have an effective referral and care pathways to medical assessment and intervention at primary, secondary/ tertiary care levels, education, Child and Adolescent Mental Health Services (CAMHS) and to social services • Respond effectively to the physical, psychological and social needs of Children and Young People with bladder and bowel dysfunction and toileting difficulties in a way that prevents inappropriate referral to secondary care. Where specialist intervention is required, to transfer care back to the community as soon as appropriate. • Have a seamless pathway where Children and Young People would be escalated to Paediatricians in the community or secondary care for the level 3 service and de-escalated to the Public Health commissioned Level 1 service.

The overall Service level outcomes will be;

• All children and young people are seen within, 8 weeks maximum wait time for first appointment. • Reduction in the rates of A&E attendances and unplanned admissions for constipation and urinary tract infections and reduction in consultant led outpatient appointments. • The service will increase confidence and ability of appropriate school/settings staff and parents/carers to be able to become an integral part of the care of children with continence needs. • Following involvement with the service, children and young people will be enabled to improve their access to the national curriculum. • The service will demonstrate the effectiveness of the work it carries out, including comprehensive and routine use of Patient Reported Outcome Measures (PROMs) and validated, reliable and reproducible quality-of-life (QoL) measures.

If you wish to express an interest please register on the Bravo Portal https://ardengemcsu.bravosolution.co.uk. The ITT reference is ITT_1084.

Once registered please complete the questions in the Qualification & Technical envelope. Please note the deadline for responses is by 12pm (noon) on 12th October 2018.