Quality statement 2: Review after initial advice is given

Quality statement

Children and young people have an agreed review date if they, or their parents or carers, are given advice about changing their daily routine to help with bedwetting.

Rationale

It may be appropriate to offer initial advice to children and young people, and their parents or carers, about making changes to their daily routine based on the comprehensive initial assessment of bedwetting. This could include advice on fluid intake, diet and toileting patterns, as well as approaches to lifting and waking, and reward systems. It is important to agree a date to review progress to avoid children and young people continuing with the agreed plan indefinitely with no real improvement in their bedwetting.

Quality measures

Structure

Evidence of local arrangements to ensure that a review date is agreed for children and young people if they, or their parents or carers, are given advice about changing their daily routine to help with bedwetting.

Data source: Local data collection.

Process

Proportion of children and young people who have an agreed review date if they, or their parents or carers, are given advice about changing their daily routine to help with bedwetting.

Numerator – the number in the denominator who have an agreed review date.

Denominator – the number of children or young people who are given advice about changing their daily routine to help with bedwetting.

Data source: Local data collection.

Outcome

Detection of unresolved bedwetting in children and young people who are given initial advice.

Data source: Local data collection.

What the quality statement means for service providers, healthcare professionals and commissioners

Service providers (such as GPs and NHS trusts) ensure that systems are in place for a review date to be agreed for children and young people if they, or their parents or carers, are given advice about changing their daily routine to help with bedwetting.

Healthcare professionals (such as GPs, school nurses and community nurses) agree a review date for children and young people if they, or their parents or carers, are given advice about changing their daily routine to help with bedwetting.

Commissioners (such as clinical commissioning groups, local authorities and NHS England area teams) ensure that they commission services from providers who agree a review date for children and young people if they, or their parents or carers, are given advice about changing their daily routine to help with bedwetting.

What the quality statement means for children, young people, parents and carers

Children and young people who are bedwetting who are given advice about changing their daily routine to help with bedwetting (or whose parents or carers are given advice) have an agreed date to review how they are getting on and if any other treatment is needed.

Source guidance

  • Nocturnal enuresis (NICE clinical guideline 111), recommendations 1.5.1 to 1.5.7, 1.6.1, and 17.1 to 1.7.3.

Definitions of terms used in this quality statement

Advice about changing their daily routine

This involves providing information and advice on fluid intake, toileting, lifting and waking and the use of reward systems. [Adapted from NICE clinical guideline 111 recommendations 1.5 to 1.7]

Equality and diversity considerations

Healthcare professionals should take into consideration the cultural and communication needs of children and young people (and their parents or carers if appropriate) when carrying out a review.

Healthcare professionals should fully assess bedwetting in children and young people with developmental or learning difficulties or physical disabilities because symptoms can be improved with the correct support and treatment.

The quality statement does not cover children younger than 5 years. The decision about whether to formally manage bedwetting in children younger than 5 years would be a clinical judgement; it would not be appropriate in all cases.