Children's Continence NORTH ONLY

We are now taking referrals for Locala services. We are working hard to ensure the majority of our services will start to get back to normal from September, but some will take a little longer due to restrictions in response to COVID.  Once your referral has been received, it will be reviewed and a decision made about your possible treatment or care. You will then be contacted by the appropriate team with the relevant information.  At the moment this is taking longer than usual. We understand this has been difficult time for everyone and are grateful for your patience.

Children's Continence

Referral criteria
Child/young person will need to be registered with Locala, North Kirklees GP to access service.
Refer children for faecal soiling. Day and Night enuresis, to Locala.
Refer children over 4 years of age for continence products, to Locala.
Child's details
If contact details are incorrectly input where mandatory the referral cannot be processed
Overseas visitor?
Consent for contact by email:*
Referral discussed with parents:*
Do parents consent to referral?*
Patient consented to information sharing?*
Please tick to confirm that the parent/carer consents to their child receiving assessments and interventions, as is appropriate to this referral:*
The parent/carer should be aware that if at any point they do not want further treatment or interventions, they must inform their clinician:*
EHC plan or statement:
Optional Attachment
Continence Details
Main continence problem:
Has the child ever been dry? (DAY)
Has the child ever been dry? (NIGHT)
Has the child ever been clean? (DAY) (Not Soiling)
Has the child ever been clean? (NIGHT) (Not Soiling)
Has toilet training been tried/in progress?
Does the child wet the bed?
Do they have recurrent urine infections?
Any previous investigations on bladder or bowel?
Urinalysis
Diet (A typical day)
Detail
Does the child experience any pain on bowel movement?
Does the child ask to go to the toilet for a wee or poo?
Toilet fears
If you do not receive an email acknowledgement your referral has not been submitted. Please check that all details are correct, mandatory fields completed and re-submit.