Chronic Urinary Tract Infections

Baroness Blackwood of North Oxford Excerpts

Friday 28th October 2016 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (Nicola Blackwood)]

I thank the hon. Member for Hornsey and Wood Green (Catherine West) for securing this important debate and for all the hard work she, alongside the Cystitis and Overactive Bladder Foundation, or COB, does in campaigning on behalf of people with urinary tract infections. I know that this issue concerns colleagues from across the House and I am pleased to see a number of them here, and welcome the right hon. Member for Islington North (Jeremy Corbyn) to the debate. It demonstrates the importance of this subject for so many of our constituents.

Interstitial cystitis, often referred to as painful bladder syndrome, or PBS, is a debilitating and lifelong condition which affects over 400,000 people in this country. Its effects not only cause great and often frequent physical pain, but, as those affected often have to urinate up to eight times an hour, it can also threaten their ability to sleep, work, attend school and maintain a social life. This in turn can, of course, have an adverse effect on the quality of life and even the mental wellbeing of those with the condition. It is therefore clearly crucial that those presenting with symptoms consistent with PBS are diagnosed as quickly and accurately as possible in order to receive the most effective treatment to minimise the devastating effects of the condition. We are alive to that.

I understand that PBS can be a challenging condition to diagnose and that both the hon. Lady and COB have concerns over the effectiveness of the NHS tests for diagnosing urinary tract infection using dipsticks in the urine and mid-stream urine specimens. I am also aware of the work of Professor Malone-Lee and the research that he and his team of researchers at University College London have carried out in this area. I know that she recently invited Professor Malone-Lee to speak to MPs on this matter and I am grateful to her for raising awareness of his findings, as this is one of the most effective ways of sharing best practice and changing behaviours.

I am the first Minister for public health and innovation, and I am always interested to hear of any new developments that could lead to more effective diagnosis and better outcomes for NHS patients. Enhancing the quality of life for people with long-term conditions is hugely important to this Government and an overarching indicator in the NHS outcomes framework. The earlier a condition such as PBS can be identified and receive the appropriate treatment, the more the patient will be able to manage their condition and maximise their quality of life.

Our National Institute for Health Research invests around £1 billion each year, and finding innovative solutions to help patients better manage chronic conditions is a vital part of this investment. The NIHR recently awarded about £l million to the University of Newcastle to run a trial looking at alternatives to prophylactic antibiotic treatment for recurrent UTIs. Another study is looking at the effectiveness and acceptability of urine collection devices to reduce contaminated urine samples in women presenting with symptoms of UTI. That is designed to improve accuracy of diagnosis.

We know that UTIs can be a serious burden for individuals and for the healthcare system, and we believe that clinician-led NHS commissioning should be responsible for making decisions about individual treatments on the basis of the available evidence, taking into account the relevant guidance from the National Institute for Health and Care Excellence as appropriate. NICE publishes quality standards to define clinical best practice for the diagnosis and treatment of conditions. These standards are designed to help those commissioning and providing services to understand what a good-quality service looks like and to identify where improvements can be made. NICE published a quality standard on urinary tract infections in adults in June 2015. The quality standard comprises quality statements concerning the diagnosis, treatment and management of urinary tract infections. Quality statements 1 and 2 offer specific guidance on ensuring more accurate diagnoses of UTIs in adults. However, I understand that NICE has not yet addressed the specific issues relating to detecting UTIs raised by Professor Malone-Lee and his team of researchers.

As hon. Members will no doubt be aware, NICE guidance is kept up to date through periodic assessments of new evidence. The evidence surveillance team at NICE has been asked to take into account any publications emerging from Professor Malone-Lee’s work when it next considers the relevant guidance for review. I would encourage Professor Malone-Lee, the Cystitis and Overactive Bladder Foundation and the hon. Lady to take this opportunity to ensure that NICE is kept updated with the latest research, whether it is existing work or research that is produced in future, as I have no doubt that it will be helpful in improving guidance in this area. Furthermore, NICE is an independent body—fiercely independent—and if there are any concerns about an existing NICE quality standard or other guidance, I would encourage those concerns to be taken up with NICE directly.

In more general terms on continence care, NHS England published new guidance in November 2015 to help to improve the care and experience of people with continence issues. This includes the most up-to-date evidence to support commissioners and providers. Once again, I am grateful that this important matter has been brought to my attention, and I hope that any further research will be considered by NICE in any future guidance so that we can continue to make improvements in the diagnosis and treatment of people with such a painful and debilitating condition. I will of course be happy to meet the hon. Lady and patient representatives to ensure that we can make the necessary progress in this area.

I know from personal experience the impact that a chronic, difficult-to-diagnose and hard-to-manage condition can have on a patient’s quality of life. An early and clear diagnosis and a clear treatment pathway can truly be the light at the end of a very dark tunnel for many who are suffering with PBS. I hope that, as a result of the dogged championing of this cause by the hon. Lady and many others, and of the more robust evidence of innovative treatment options that NICE can evaluate, we will be able to offer the genuine hope and certainty that is clearly so urgently needed.

Question put and agreed to.