Warning alert

This page contains materials produced by Hounslow and Richmond Community Healthcare NHS Trust (HRCH). On 1 July 2024, all adult and children’s community services in the London Borough of Hounslow provided by HRCH transferred to West London NHS Trust. Whilst we are in the process of re-producing these materials, patients and referrers can still refer to the information contained within them.

Our nurse-led Continence Service provides an integrated bladder and bowel dysfunction service to all adult patients registered with a Hounslow GP.

The service provides three main activities for patients:

  • Community-based specialist continence and bladder and bowel dysfunction (BBD) clinics - aimed at continence promotion, improvement or resolution of the health complaint.
  • NHS incontinence products for patients unsuitable for active treatment, or who have failed to respond to active treatment (including care homes).
  • Telephone advice, education and support for the local community and healthcare/social care services.

Continence-trained nurses provide several outpatient clinics across Hounslow and, where patients are assessed, investigated and treated.

Problems the service covers

  • Urinary frequency, urgency, nocturia (waking up at night time), urgency incontinence, stress incontinence, nocturnal enuresis (bedwetting), passive incontinence, reflex incontinence
  • Mild to moderate vaginal/anal prolapses
  • Perineal tears (i.e. third degree tear)
  • Lower urinary tract symptoms
  • Recurrent female urinary tract infections/cystitis advice
  • Day/night time polyuria advice (passing too much urine)
  • Constipation, faecal urgency, faecal incontinence, chronic diarrhoea, diverticular disease and irritable bowel syndrome advice
  • Catheter-related complications for urethral, suprapubic, intermittent catheters
  • Trials without catheters
  • Management of catheter complications advice

Diagnostic tools

We provide a wide range of useful diagnostic tools to formulate diagnosis of the health complaint, including:

  • A wide range of charts and patient-questionnaires
  • Bladder volume and residual urine ultrasound measurements
  • Uroflow traces and interpretation
  • Urinalysis
  • Bloods requests
  • Direct referrals for specific ultrasonic investigations
  • Urine microscopy/culture/sensitivity requests
  • Biofeedback (both as a diagnostic and therapeutic tool)
  • The Continence service provide a wide range of interventions aimed at curing or improving the bladder/bowel complaint.


The continence service provide a wide range of interventions aimed at curing or improving the bladder/bowel complaint.

  • Pelvic floor muscle exercises with or without aids (i.e. vaginal cones)
  • Intra-urethral devices
  • Basic electrical stimulation and biofeedback
  • Bladder retraining (or bladder drill)
  • Advice on lifestyle, fluids, weight loss, skin care
  • Advice on bladder emptying techniques
  • Advice on prevention of female recurrent urinary infections
  • Advice on toileting regimes
  • Advice on nighttime problems
  • Teaching intermittent catheterisation
  • Advice on the management of indwelling (long-term) catheters including drainage systems, valves etc.
  • Advice on the prevention of catheter associated infections and other complications
  • Advice on management of small/moderate prolapses
  • Independent prescribing in partnership/on behalf of GPs
  • Advice regarding a wide range of incontinence gadgets and appliances for men and women

We also manage the provision of NHS incontinence products (pads) for the local community and provide nurse-led continence clinics for patients seeking NHS incontinence products provision.

We provide continence services and incontinence products to all patients living in residential homes. Nursing home continence services are provided in the borough of Hounslow only.

The Continence Service works in close partnership with urological, gynaecological consultants, women health/musculoskeletal physiotherapists.

The Continence Service provides direct referrals to some consultants and liaises directly with GPs and other services for feedback/further treatment advice as required by individual circumstances.



Patients registered with either Hounslow or Richmond GPs can be referred to this service, by:

Contacting Hounslow Single Point of Access (SPA) service on 020 8630 3943/1442

Emailing hounslowandrichmond.spa@nhs.net

Directly to the service using the Continence Service referral form