Asked by: Fleur Anderson (Labour - Putney)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will make it his policy to ensure that any point-of-care diagnostic tests for urinary tract infections approved by NICE are made available to women in (a) rural, (b) deprived and (c) other areas.
Answered by Will Quince
NHS England and the Anti Microbial Resistance Programme is working to support the development and deployment of point-of-care diagnostic tests approved by National Institute for Health and Care Excellence for urinary tract infection (UTI) diagnosis, and education on the use of these tests will form a key part of ensuring equitable accesses to women, including in rural and deprived areas.
NHS England are also working with industry partners, charities, pathology and clinicians to understand the clinical need for new point of care diagnostics as this will help ensure the future pipeline of UTI diagnostics are fit-for-need.
Asked by: Fleur Anderson (Labour - Putney)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the potential merits for reducing antimocrobial resistance of speeding up regulatory approval for new urinary tract infection point-of-care diagnostics such as Lodestar DX and UTRiPLEX.
Answered by Will Quince
The speed of regulatory approval is reliant on the device manufacturer's ability to submit required documentation for registration with the Medicines and Healthcare products Regulatory Agency (MHRA), which includes evidence that it conforms to United Kingdom legal requirements as described by the UK Medical Devices Regulations. The MHRA will check the documentation and revert with a registration letter that enables the point-of-care diagnostic devices to be placed on the market in the UK. Manufacturers of innovative products can also seek advice from the MHRA through its Innovation Accelerator.
NICE has published an article describing the potential merits for reducing antimicrobial resistance with four innovative tests for diagnosing urinary tract infections which include Lodestar Dx and UTRiPLEX.
Asked by: Sarah Olney (Liberal Democrat - Richmond Park)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, with reference to UTI testing, what steps he is taking to support (a) better pain management, (b) treatment options and (c) additional education for the medical profession for that type of testing.
Answered by Gillian Keegan - Secretary of State for Education
The National Institute for Health and Care Excellence (NICE) guidance has provided guidance for clinicians to improve the diagnosis, treatment and management of urinary tract infections (UTIs), which includes advice on self-care and pain management. In October 2018, NICE published ‘Urinary tract infection (recurrent): antimicrobial prescribing’ in order to improve treatment, which is available at the following link:
https://www.nice.org.uk/guidance/ng112
NHS England and NHS Improvement and the Accelerated Access Collaborative are working with NICE and the National Institute for Health and Care Research to identify the technologies which could potentially be accelerated into adoption in the National Health Service in England.
In addition, NHS England and NHS Improvement’s RightCare Programme have developed a dashboard incorporating metrics relevant to monitoring the quality of care of patients with UTIs. This dashboard supports senior leaders in integrated care systems in assurance and oversight of UTI care and health professionals with quality improvement. NHS England and NHS Improvement’s UTI workstream focuses on developing a co-ordinated pathway-based approach to improving the prevention, diagnosis, treatment and management of UTIs.
Health Education England’s e-learning for healthcare has also added a new session to the Antimicrobial Resistance and Infections eLearning programme, which is available at the following link:
Asked by: Kim Leadbeater (Labour - Batley and Spen)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether he is taking steps to review (a) public health policy, (b) funding, (c) testing and (d) treatment options for women diagnosed with Urinary Tract Infections.
Answered by Gillian Keegan - Secretary of State for Education
The Department have no plans to do so. Funding for treatment of urinary tract infections (UTIs) is derived from individual clinical commissioning group budgets. However, the forthcoming Women’s Health Strategy will address a range of women’s health issues, including UTIs.
National Health Service commissioners in England are responsible for urinary continence care based on the available evidence and taking into account guidance from the National Institute for Health and Care Excellence (NICE). In most instances, testing for UTIs is carried out by a general practitioner, with a referral to a specialist for persistent UTIs. NICE has produced a range of guidance for clinicians to support them in the diagnosis, treatment care and support of people with UTIs. In October 2018, NICE published guidance on antimicrobial resistant prescribing. NHS England and NHS Improvement are also conducting research on UTIs and antimicrobial resistance.
Asked by: Stephen Metcalfe (Conservative - South Basildon and East Thurrock)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether PHE plans to update its guidance on UTIs to recommend the use of a dipstick to diagnose UTI patients with suggestive symptoms and to reflect Scotland’s guidance SIGN 88: Management of suspected bacterial urinary tract infection in adults.
Answered by Edward Argar - Minister of State (Ministry of Justice)
The Public Health England (PHE) diagnostic urinary tract infection (UTI) guidance was last updated in October 2020 and will be reviewed again in November 2021. The current guidance is available at the following link:
https://www.gov.uk/government/publications/urinary-tract-infection-diagnosis
PHE recommends dipstick testing in patients with one or fewer of the key UTI diagnostic symptoms (new nocturia, dysuria, or cloudy urine). The Scottish Intercollegiate Guidelines Network approach recommends using dipsticks in a slightly larger subset of patients. PHE will keep the emerging evidence on dipstick use within UTI diagnosis under review in order to inform future guidance updates.
Asked by: Chris Green (Conservative - Bolton West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what plans Public Health England has to update its guidance on the diagnosis of urinary tract infections to reflect changes in remote diagnostic techniques.
Answered by Edward Argar - Minister of State (Ministry of Justice)
The current Public Health England (PHE) diagnostic urinary tract infection guidance features a diagnostic flowchart for over 65 year olds, which can be followed during remote consultation such as telephone or video consultations and does not recommend urine dipsticks.
The flowchart for under 65 year olds encourages diagnosis based on three symptoms that can be assessed remotely. Current guidance advises that patients with only one of these are tested using a urine dipstick, this could be facilitated by patients providing a urine sample from home for testing.
The guidance advises that clinicians should consider in patients with milder symptoms a back-up antibiotic prescription with appropriate pain relief. This would reduce the need for patients to attend the surgery. This guidance was last updated in October 2020 and will be reviewed again in November 2021. The recently updated guidance is available at the following link:
https://www.gov.uk/government/publications/urinary-tract-infection-diagnosis
PHE is collaborating with the Royal College of General Practitioners to develop training materials on antibiotic prescribing in remote consultations.
Asked by: Catherine West (Labour - Hornsey and Wood Green)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what plans his Department has to improve the (a) reporting and (b) tracking of urinary tract infections in the NHS; and if he will make a statement.
Answered by Seema Kennedy
NHS Digital’s Hospital Episodes Statistics publishes data on finished consultant episodes with a primary or secondary diagnosis of urinary tract infection broken down by financial year, rather than by calendar year.
Asked by: Graham Brady (Conservative - Altrincham and Sale West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment he has made of the efficacy of different methods of testing for lower urinary tract infections; and if he will make it his policy to encourage the establishment of clinics for lower urinary tract infections in each Health Authority.
Answered by Steve Brine
In England, it is the responsibility of National Health Service commissioners to make decisions on individual treatments and methods of testing for urinary tract infections on the basis of the available evidence, taking into account guidance from the National Institute for Health and Care Excellence (NICE) where available. NICE guidance is always evidence based, adhering to the latest clinical thinking and research to determine the best treatment for patients.
The majority of large teaching hospitals in England do have specialist urology centres embedded within which provide effective assessment and management advice for people with urinary symptoms. Such centres have the advantage of the ability to check for a range of conditions, and are best placed to ensure an accurate diagnosis so that appropriate treatment can be offered.
Asked by: Justin Madders (Labour - Ellesmere Port and Neston)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what steps he is taking to improve diagnosis of urinary tract infections.
Answered by Steve Brine
In June 2017 Public Health England updated the Diagnosis of Urinary Tract Infections: Quick Reference Guide for Primary Care, which gives primary care givers, including doctors, nurses and pharmacists, simple, effective, economical and empirical approach towards the diagnosis and treatment of urinary tract infections.
Asked by: Justin Madders (Labour - Ellesmere Port and Neston)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what recent assessment he has made of the effectiveness of the recommended antibiotic treatment for urinary tract infections.
Answered by Steve Brine
The National Institute for Health and Care Excellence (NICE) produced a Quality Standard (QS90) in 2015 in order to advise upon the diagnosis, management and treatment of urinary tract infections in adults to a high quality of care. It includes assessment, antibiotic treatment and referral for specialist assessment. It describes high-quality care and priority areas for improvement.
NICE reviewed the Quality Standard in 2016 and determined that it was still effective and up to date.