Chronic Urinary Tract Infections

Caroline Johnson Excerpts

Wednesday 21st May 2025 Westminster Hall

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

It is a pleasure to serve under your chairmanship, Sir Desmond. I congratulate the hon. Member for Sutton and Cheam (Luke Taylor) on an excellent speech that graphically explained how this condition has a horrific impact on those who suffer with it. I also congratulate him on securing this important debate to raise awareness.

As we have heard, urinary tract infections are common infections affecting the bladder and kidneys, and the tubes connected to them. Anyone can get them, but they are particularly common in women. The NHS estimates that 14 million people in the UK experience some kind of urinary incontinence, too, a figure that is expected to rise due to an ageing population. Most urinary tract infections, although painful, clear up in a few days and can be treated with antibiotics.

The earlier a urinary tract infection is identified, and the earlier a patient can receive appropriate treatment, the more they will be able to manage their condition, maximise their quality of life and reduce the risk of chronic infection. For many, UTIs are not a fleeting inconvenience but a chronic, recurrent, life-limiting illness. Short-term antibiotic treatments fail, standard urine tests might not detect infections, and persistent symptoms can severely diminish a patient’s quality of life. I hope this debate will raise awareness of the issue of chronic UTIs, which some patients have said have shaped their whole lives.

We know that women are 30 times more likely to get a urinary tract infection than men, and that UTIs are agonising and occasionally fatal. NHS data shows that there were over 1.8 million hospital admissions involving UTIs between 2018-19 and 2022-23. UTI rates increase when women reach 45 and are in the perimenopause. Studies suggest that over half of all women will experience a UTI at some point in their lives, with many enduring recurrent infections. There are several physiological and hormonal factors that make women more susceptible to UTIs, including that they have a shorter urethra than men. Hormonal fluctuations during menopause lead to a decrease in protective vaginal flora, making older women more prone to infections. Pregnancy’s shifts in hormones and pressure on the bladder also exacerbate vulnerability.

The Chronic Urinary Tract Infection Campaign estimates that up to 1.7 million women suffer from chronic UTIs, yet as we heard, this is a neglected area of research—indeed, women’s conditions in general are not as researched and treated as they ought to be. The last Government recognised the need to target women’s health conditions specifically and launched the women’s health strategy in 2022, which was successful in tackling issues that disproportionately affect women. Will the Minister commit to the continuation of that programme?

I want to briefly discuss children—I should declare that I am a children’s doctor in the NHS. The hon. Member for Sutton and Cheam talked about his constituent, who was three when symptoms first occurred. Urinary tract infections are common in children; symptoms vary in severity and treatment requires different approaches depending on age, sex, and each individual patient’s condition. There are NICE guidelines on this issue, which also recommend imaging for children with UTIs, including a DMSA scan and an ultrasound depending on their condition. Can the Minister say what she has done to assess the number of children being treated for UTIs, the waiting times for scans, and whether there are sufficient radiology staff to both perform and report these procedures within the timeframes recommended by NICE?

The Government have recently pointed to research being carried out by NHS England, along with the industry, to horizon-scan for new innovations in point-of-care tests for diagnosing UTIs, in order to guide better treatment options. With the impending abolition of NHS England, will that research continue, and if so, who will now be responsible for leading it? In 2023, the Department of Health and Social Care, NHS England and the UK Health Security Agency launched a campaign to raise awareness of UTI symptoms and available NHS treatments. Will the Government continue that initiative, to ensure ongoing public awareness of UTIs and prevent hospital admissions? Has the Minister evaluated that campaign’s success in improving early detection, reducing hospital admissions and reducing the incidence of chronic UTIs?

For those suffering from UTIs, their first point of contact with the healthcare system is often their local pharmacy. Those services are conveniently located in the heart of many communities and are staffed by highly skilled professionals with years of experience under their belts. As we have already heard, the previous Government launched the Pharmacy First initiative, through which community pharmacists can treat women aged 16 to 64 with uncomplicated UTIs, offering rapid treatment and advice. A report from the Company Chemists’ Association in January 2025 found that nearly a third of all Pharmacy First consultations each week are for urinary tract infections.

What assessment has the Minister made of the impact of Pharmacy First on people affected by UTIs and other common conditions? My hon. Friend the Member for Farnham and Bordon (Gregory Stafford) has called on the Government to provide financial incentives for GPs to work with community pharmacies to support referrals into Pharmacy First. As the spending review draws near, will the Government consider that proposal, so that more people affected by UTIs can access support from Pharmacy First?

At the time of its inception, concerns were raised about the Pharmacy First initiative, relating to an increased risk of antimicrobial resistance to standard antibiotics. Now that it has been running for a year, does the Minister have any assessment of whether that is a risk that we should continue to be concerned about? The Chronic Urinary Tract Infection Campaign estimates that 20% to 30% of patients do not improve with initial antibiotic treatment. What research are the Government planning to carry out to see what further treatment can be offered to those patients?

The hon. Member for Sutton and Cheam raised the issue of NICE and SIGN guidance. I can say as a clinician that both are very useful to doctors and other clinicians in guiding their practice, and they are written by experts in the field. Does the Minister plan to speak to those running NICE about whether specialists in this field could come up with some consensus-based, evidence-based guidance on chronic UTIs? As we have heard today, that could support patients who are suffering terribly.

I want to touch on continence care. Adopting a personal, clinician-led approach to product provision can allow users to manage their conditions and lead to improved outcomes for both patients and the wider healthcare system. What steps are the Government taking to prioritise patient dignity and outcomes in continence care? The Government have also stated that support for those affected by UTIs is currently commissioned by integrated care boards. However, we know that ICBs are facing budget reductions of 50%, and many are planning to merge over the next two years. Can the Minister confirm whether the responsibility for supporting those affected by UTIs will remain with ICBs, or whether she intends for this function be transferred elsewhere?

To close, UTIs can be managed with increased public awareness of symptoms and treatment, early diagnosis, preventive measures, research and improvements in NHS care. We have heard how life-changing that could be for many, particularly women. All those factors could reduce the burden of chronic and recurrent infections and ensure that every patient receives the care they deserve. I hope the Minister will take all this into account, because she could help to alleviate the suffering of many women and other people.