The National Institute for Health and Care Excellence (NICE) evaluates new licensed medicines, to determine whether they represent a clinically effective and cost-effective use of National Health Service resources. NICE aims to publish guidance on new medicines as close as possible to the date that the drug receives its marketing authorisation from the Medicines and Healthcare products Regulatory Agency.

NICE published a guideline, Urinary tract infection (recurrent): antimicrobial prescribing, with the reference code NG112, which includes recommendations on treatments for preventing recurrent urinary tract infection, including antibiotic prophylaxis and methenamine hippurate. Recommendations on methenamine hippurate were updated in 2024 following a review of current evidence. This guideline is available at the following link:

https://www.nice.org.uk/guidance/ng112

The recommendations in the guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, NHS professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences, and values of their patients or the people using their service. It is not mandatory for the NHS to apply the recommendations, and the guideline does not override the responsibility of healthcare practitioners to make decisions appropriate to the circumstances of the individual, in consultation with them, and their families and carers or guardian where appropriate. NICE does not manage the delivery of NHS care or monitor compliance with its guidelines.

The Medicines and Healthcare Products Regulatory Agency (MHRA) is an executive agency of the Department and regulates medicine, medical devices, and blood components for transfusion in the United Kingdom, with responsibility for ensuring medicines meet appropriate standards of safety, quality, and efficacy.

At present there are no pending vaccines or new medicines awaiting market authorisation for urinary tract infections by the MHRA. The MHRA is ready to support companies that are looking to introduce new medicines to the United Kingdom market, offering regulatory and scientific advice to help companies at any stage of the product development process. The MHRA has established procedures in place to review any applications we receive to evaluate the benefit risk of a product. The exact timeframe will depend on the type of submission the company makes.

The National Institute for Health and Care Excellence (NICE) evaluates new licensed medicines, to determine whether they represent a clinically effective and cost-effective use of National Health Service resources. NICE aims to publish guidance on new medicines as close as possible to the date that the drug receives its marketing authorisation from the MHRA.

The MHRA and NICE have launched an aligned pathway for the assessment of medicines enabling access for patients three to six months earlier for those medicines using this route.

For any new medicine to be introduced to the United Kingdom market an application to the Medicines and Healthcare products Regulatory Agency (MHRA) is required. The MHRA is ready to support companies that are looking to introduce new medicines to the United Kingdom market, offering regulatory and scientific advice to help companies at any stage of the product development process. The MHRA has established procedures in place to review any applications we receive to evaluate the benefit risk of a product in relation to its quality, safety, and efficacy. The exact timeframe will depend on the type of submission the company makes.

The Department recognises the impact that chronic and recurrent urinary tract infections (UTIs) can have on patients’ quality of life, and is committed to improving awareness, diagnosis, and treatment.

The Government is funding work to understand the research gaps on chronic and recurrent UTIs that matter most to patients, carers, and clinicians.

The UK Health Security Agency and NHS England ran a campaign during July 2025 to highlight UTI prevention messages for older adults, as this age group is more likely than others to be admitted to hospital for UTI.

The National Institute for Health and Care Excellence has published clinical guidance and referral pathways for recurrent UTIs, supporting clinicians to recognise symptoms, carry out appropriate testing, and refer patients for specialist assessment where needed. NHS England supports primary care through clinical guidance, responsible use of antimicrobial drugs, and professional education to improve management of UTIs.

The Department and NHS England recognise the psychological impact of chronic urinary tract infections (UTIs). NHS England published the Excellence in Continence Care framework on 23 July 2018, which is available at the following link:

https://www.england.nhs.uk/publication/excellence-in-continence-care/

This framework brings together evidence-based resources and research as guidance for commissioners, providers, health and social care staff, and it explicitly acknowledges a range of psychological impacts including loss of self-esteem, depression, loss of independence, and impacts on relationships and employment prospects.

Further, NHS England’s existing system wide clinical messaging around UTIs acknowledges behavioural and cognitive impacts, particularly confusion, agitation, and changes in mental state, indicating institutional recognition of psychological and neuro‑behavioural effects associated with UTIs.

NHS England’s national UTI awareness campaign states that UTIs can cause agitation and confusion in older adults, demonstrating the system’s acknowledgement that infection-related symptoms extend beyond physical pain to include cognitive and psychological changes. This ensures clinicians are prompted to consider psychological and cognitive changes as part of UTI presentations. The awareness campaign can be found at the following link:

https://www.england.nhs.uk/2023/10/new-awareness-campaign-to-help-reduce-hospital-admissions-for-urinary-tract-infections/

The Department recognises bacteriophage, or phage, medicines as a promising complementary option for difficult bacterial infections, including recurrent and chronic urinary tract infections (UTIs), and as a potential tool to address antimicrobial resistance (AMR).

However, phage therapy is not yet used routinely in the National Health Service. Although case reports and small studies show benefit in hard-to-treat infections, there is still insufficient largescale, high-quality clinical trial evidence to support widespread adoption.

For UTIs specifically, there is currently no evidence of benefit of phage therapy from randomised controlled trials, the only trial to date showed no effect. The proposed UK Clinical Phage Service will help generate further clinical evidence and support individual patient use where treatment options are limited.

As a result, phage therapy in the United Kingdom is generally accessed only through specialist or compassionate use pathways, typically when conventional antibiotics have failed and expert clinical teams judge it appropriate. This cautious approach ensures appropriate safety, efficacy, and regulatory oversight before routine use.

The National Institute for Health and Care Excellence (NICE) is the independent body responsible for developing evidence‑based guidance for the National Health Service on best practice in the care and treatment of patients with specific conditions.

NICE does not ordinarily define specific clinical conditions. NICE has no current plans to develop guidance on chronic urinary tract infections (UTIs) at this time, and the topic has not been considered by its prioritisation board. However, NICE has produced a clinical guideline on antimicrobial prescribing for recurrent UTIs which provides recommendations on treatments and self-care for the prevention of recurrent UTIs. This guideline is available at the following link:

https://www.nice.org.uk/guidance/ng112

The Department funds research through the National Institute for Health and Care Research (NIHR). The NIHR funds, supports, and carries out high-quality research to improve health outcomes and care services. Over the last five financial years, the Department has provided over £22 million in programme research funding for urinary tract infection (UTI) research, including research on improved treatment for recurrent and chronic UTIs. In addition, NIHR infrastructure is supporting Phase 3 trials on vaccines against Escherichia coli infection in older adults who have a history of UTI, delivered by the NIHR Bristol Clinical Research Facility and the NIHR Wellcome Trust Manchester Clinical Research Facility.

The NIHR also funds the James Lind Alliance, which has run a Priority Setting Partnership (PSP) focused on chronic and recurrent UTIs. This PSP, funded by AMR Action UK and delivered in partnership with Bladder Health UK and The Urology Foundation, has identified the top 10 research priorities in this area. A rolling funding opportunity is available for research projects that align with priorities aligning with PSPs.

The Department has not made a specific assessment. The National Institute for Clinical Excellence’s (NICE) guidelines, such as those for the diagnosis and management of urinary tract infections, are subject to equality impact assessments as part of NICE’s governance processes, which mean that protected characteristics, including sex, are considered as part of the guideline's development.

The Department has not made a specific assessment. There are several sources of guidance regarding the diagnosis of urinary tract infections (UTIs), including from the National Institute for Clinical Excellence and the UK Health Security Agency.

The TOUCAN study was part-commissioned by NHS England as an assessment of future more timely diagnostics, including various point of care tests for UTIs in primary care.

Through the National Institute for Health and Care Research (NIHR), the Department has funded and supported multiple studies investigating urinary tract infections (UTIs), with some funded studies studying the link between UTIs and cognitive outcomes. For example, NIHR has funded the ‘IntraVESical Preparations for REcurrent Urinary Tract Infection Prevention’ (VESPER) study. This study aims to determine whether in-bladder treatments are more effective and cost-efficient than second-line oral antibiotics in reducing recurrent UTIs in women who have not responded to first-line preventative antibiotics. It will connect clinical outcomes with quality-adjusted life year (QALY)-based evaluations that take cognitive changes into account.

NIHR infrastructure is also conducting relevant research that is investigating UTIs and considering cognitive outcomes. The NIHR Southampton Biomedical Research Centre, is leading the ‘DIagnoSing Care hOme UTI’ (DISCO UTI) study which is investigating new ways to accurately diagnose and treat UTIs in care homes, as UTIs can cause symptoms like confusion, resulting in difficulties when diagnosing UTIs in care home residents.

No specific assessment has been made by the Department. The National Health Service treats patients with recurrent urinary tract infections (UTIs) and chronic UTIs using the same care pathway until it becomes evident that symptoms are not resolving. The National Institute for Health and Care Excellence has published guidance for the NHS on the management of recurrent UTIs, which can be found at the following link:

https://www.nice.org.uk/guidance/ng112

The National Institute for Health and Care Excellence’s guidance on prevalence suggests urinary tract infections are more common in women than in men, with men estimated to account for around 20% of all occurrences. Further information on factors related to incidence including those specific to gender is available at the following link:

https://cks.nice.org.uk/topics/urinary-tract-infection-lower-men/background-information/prevalence/

The National Institute for Health and Care Excellence (NICE) has an established prioritisation process overseen by a prioritisation board, for the identification of priorities for guidance development. Anyone can suggest a topic through the NICE website at the following link:

https://www.nice.org.uk/forms/topic-suggestion

NICE has no current plans to develop guidance on chronic urinary tract infections (UTIs) at this time and the topic has not been considered by its prioritisation board. However, NICE has produced a clinical guideline on antimicrobial prescribing for recurrent UTIs which provides recommendations on treatments and self-care for the prevention of recurrent UTIs. This guideline is available at the following link:

https://www.nice.org.uk/guidance/ng112

The Harpenden and Berkhamsted constituency is served by the Hertfordshire and West Essex Integrated Care Board (ICB). The ICB applies the National Institute for Health and Care Excellence’s guidelines for the treatment of urinary tract infections (UTIs) to the treatment of chronic UTIs. The ICB has a defined care pathway which ensures that if primary care management is not sufficient, then patients are swiftly referred to specialist care for more intensive support, including further investigations and management of their symptoms and their pain.

Appropriate treatment and support for people with chronic UTIs are dependent on receiving an accurate diagnosis. Diagnostic tests for chronic UTIs, such as urinalysis and urine culture, are widely available across all pathology networks in England, including Hertfordshire and West Essex. Ensuring accurate diagnostic testing not only aids more effective identification of infection but can also reduce unnecessary prescribing and overprescribing of broad-spectrum antimicrobials, and directly benefit patients in Harpenden and Berkhamsted, who will get the right treatment sooner.

General practitioners can request testing for chronic UTIs via several pathways, including at point-of-care, via community diagnostic centres, or via laboratories. Laboratories across England adhere to stringent quality standards for diagnostic tests, including the UK Accreditation Standard ISO 15189, and implement robust internal and external quality assurance schemes. Together, these measures ensure the accuracy and reliability of diagnostic testing.

Through the National Institute for Health and Care Research, the Department is supporting work to understand the research gaps on UTIs that matter most to patients, carers, and clinicians. This is through a James Lind Alliance Priority Setting Partnership (PSP), led by Antibiotic Research UK, Bladder Health UK, and The Urology Foundation. This partnership will publish its findings in spring 2026. The aim of the Chronic and Recurrent UTI PSP is to identify the unanswered questions about chronic and recurrent UTIs from patient, carer, and clinical perspectives and then to prioritise those that patients, carers, and clinicians agree are the most important for research to address.

NHS England is also supporting research into newer, more accurate point-of-care tests for UTIs, such as via the Toucan study. Further information on the study is available at the following link:

https://www.phctrials.ox.ac.uk/recruiting-trials/toucan-platform-for-uti-diagnostic-evaluation

The 10-Year Plan will set out how we tackle the inequities that lead to poor health. This will include how we will improve access to, and the experience of care for, conditions such as chronic urinary tract infections (UTIs). More tests and scans delivered in the community, better joint working between services, and greater use of apps and wearable technology will all support people to manage their conditions, including chronic UTIs, closer to home.

We are aware that recurrent UTIs are more prevalent in women. The Government is committed to prioritising women’s health as we build a National Health Service fit for the future, and our focus is on turning the commitments in the Women's Health Strategy into tangible actions to improve health for women.

The 10-Year Health Plan will set out how we tackle the inequities that lead to poor health. This will include how we will improve access to and the experience of care for conditions such as chronic urinary tract infections (UTIs). More tests and scans delivered in the community, better joint working between services, and greater use of apps and wearable technology will all support people to manage their conditions, including chronic UTIs, closer to home.

Recurrent UTIs are more prevalent in women. This Government is committed to prioritising women’s health as we build a National Health Service fit for the future, and our focus is on turning the commitments in the Women's Health Strategy into tangible actions to improve health for women.

The National Health Service provides information on the symptoms of urinary tract infections (UTIs), including chronic UTIs, at the following link:

https://www.nhs.uk/conditions/urinary-tract-infections-utis/

The Department currently has no plans to raise public awareness of the symptoms of chronic UTIs. However, the Department, through the National Institute for Health and Care Research (NIHR), is funding research to improve the diagnosis and treatment of UTIs, including chronic UTIs. This research includes the development of antimicrobial-impregnated catheters to reduce episodes of catheter-associated UTIs as well as the TOUCAN study, with further information available at the following link:

https://www.phctrials.ox.ac.uk/recruiting-trials/toucan-platform-for-uti-diagnostic-evaluation

This study is evaluating rapid point of care UTI diagnostic tests in general practice surgeries that not only enable faster detection of UTIs but also provide real-time information on antibiotic resistance, ensuring patients receive the correct treatment.

Appropriate treatment and support for people with chronic urinary tract infections (UTIs) are dependent on receiving an accurate diagnosis. Diagnostic tests for chronic UTIs, such as urinalysis and urine culture, are widely available across all pathology networks in England, including Surrey. Ensuring accurate diagnostic testing not only aids more effective identification of infection but can also reduce unnecessary prescribing and overprescribing of broad-spectrum antimicrobials and directly benefit patients in Surrey Heath who will get the right treatment sooner.

General practitioners can request testing for chronic UTIs via several pathways, including at point-of-care, via community diagnostic centres, or via laboratories. Laboratories across England adhere to stringent quality standards for diagnostic tests, including the UK Accreditation Standard ISO 15189, and implement robust internal and external quality assurance schemes. Together, these measures ensure the accuracy and reliability of diagnostic testing.

Through the National Institute for Health and Care Research, the Department is supporting work to understand the research gaps on UTIs that matter most to patients, carers and clinicians. This is through a James Lind Alliance Priority Setting Partnership (PSP), led by Antibiotic Research UK, Bladder Health UK and The Urology Foundation. This partnership will publish its findings in spring 2026. The aim of the Chronic and Recurrent UTI PSP is to identify the unanswered questions about chronic and recurrent UTIs from patient, carer and clinical perspectives and then prioritise those that patients, carers and clinicians agree are the most important for research to address.

NHS England is also supporting research into newer, more accurate point-of-care tests for UTIs, such as via the Toucan study.

More information on the study is available at the following link:

https://www.phctrials.ox.ac.uk/recruiting-trials/toucan-platform-for-uti-diagnostic-evaluation

The Joint Committee on Vaccination and Immunisation (JCVI) has identified vaccines to prevent recurrent urinary tract infections (UTI). These are currently in development.

During a sub-committee meeting of the JCVI held on 25 November 2024, the pipeline vaccine against recurrent UTIs, known as uromune-MV140, was presented by its manufacturer, Inmunotek. Therapeutic vaccines are considered by the National Institute for Health and Care Excellence (NICE). The committee awaits advice on whether the NICE will review this product. The minutes of the JCVI’s subcommittee meeting have been published on the JCVI website, at the following link:

https://app.box.com/s/wv2uxkv7v9bisuf8ml8mdb19iemnzmv8/file/1808036070368