Urinary tract infections (UTIs) are among the most frequently diagnosed bacterial infections in both primary and secondary care. While acute, uncomplicated cases may be managed effectively, recurrent and chronic UTIs often present a more complex challenge. For many people, these infections have a significant impact on their daily lives, disrupting personal routines, work, and intimate relationships. Accessing timely, joined-up care can be frustratingly difficult.
While some people eventually find their way to specialist UTI management clinics, many others spend months or even years navigating a healthcare system that can struggle to provide consistent, joined-up care for recurrent infections. Variation in clinical engagement, knowledge, and awareness of up-to-date treatment and prevention options, compounded by overstretched services, can leave both patients and healthcare professionals uncertain about the best next step.
Some individuals, whose UTIs could be managed more effectively in primary care or with self-care strategies, often find themselves unsure of what to try next. They navigate a confusing landscape of treatments, with uncertainty over what should be prescribed, what’s available over the counter, and the associated costs – all while struggling with varying levels of evidence supporting different remedies.
To help address the gap in support for those navigating this challenging landscape, we developed a nurse-led UTI Information Service through The Urology Foundation. The service is designed to complement NHS care, offering individuals evidence-informed information, signposting, and practical guidance to help them move toward effective treatment.
Why the service was needed
The idea for the UTI Information Service emerged from our engagement with patients and their families. A common theme emerged from these conversations: the need to be listened to, taken seriously, and supported through what is often a long and difficult journey toward specialist care.
It became clear that many individuals, particularly women at all life stages, were struggling to access appropriate investigations, treatment, or referral. We heard from patients who had experienced symptoms for months without a urine culture. Others had been prescribed repeat antibiotics with little long-term benefit, or told their symptoms were unrelated to infection despite a strong history of UTIs. Many were unaware of preventative approaches such as vaginal oestrogen or methenamine hippurate or had never been offered lifestyle or self-care advice.
As a team, our extensive clinical experience in urology, coupled with a background in the charity sector, digital health, and patient education were key to developing a service aimed at improving patient experience and outcomes.
How the service works
The UTI Information Service offers a freephone telephone and email support line, led by an experienced urology nurse. The public can access the service for support, information, or simply a listening ear – particularly when they are unsure of their next steps or awaiting referral.
Conversations are grounded in clinical knowledge and current levels of evidence. The goal is not to diagnose or prescribe, but to help individuals understand their symptoms, ask informed questions, and feel more confident in navigating their care.
The service is underpinned by clear policy and governance standards, and membership of the Helplines Partnership, ensuring quality, safety, and accountability in how we deliver support. The Board of Trustees at The Urology Foundation including, notably, our Chair Mary Garthwaite and CEO Rebecca Porta, add strategic oversight and clinical governance, ensuring the service aligns with the Foundation’s values of excellence, integrity, and patient-centred care.
Resources
We are developing a growing suite of patient resources, including written and digital materials that cover a range of topics: symptom recognition, testing and diagnosis, treatment options, recurrent infections, menopause-related changes, intimacy and UTIs, catheter care, and red flag symptoms. Infographics are a key feature of these resources, offering clear, visual explanations that help patients navigate complex topics and make informed decisions about their care.
Additionally, we are creating a set of tools and resources for healthcare professionals, including quick reference guides, to promote best practices in primary and secondary care. We are also developing a dedicated online course for care workers and nurses in nursing homes. This course will focus on UTI prevention, catheter and drainage system care, recognising atypical presentations in older adults, safe antibiotic use, and appropriate escalation.
Furthermore, we offer workshops and webinars for the public, carers, and healthcare professionals on a wide range of UTI-related topics, such as recurrent infections, understanding test results, symptom management, navigating the healthcare system, menopause and bladder health, catheter care, and non-antibiotic options. These sessions are designed to provide practical information, peer support, and a safe space to share experiences, ensuring people feel heard, informed, and empowered to take an active role in their own healthcare discussions.
What patients ask us
The support line has provided valuable insight into where people are struggling in their experiences of UTI care. Common themes include:
“Why do I keep getting UTIs?”
People want to understand whether hormonal changes, bladder issues, hygiene practices, or an embedded infection might be contributing. We offer a balanced overview and suggest questions to raise with their clinician.
“My test was clear, but I still have symptoms – what now?”
Many struggle to reconcile their symptoms with negative dipstick or culture results. We explain the limitations of current testing methods and why clinical judgement still matters.
“What else can I try apart from antibiotics?”
Individuals are often eager to learn about alternative approaches. We explain the evidence for products like D-mannose, methenamine hippurate, probiotics, and vaginal oestrogen.
“How do I prepare for my specialist appointment?”
For those referred to a UTI clinic, we offer guidance on documenting symptoms, what to expect at the consultation, and how to make the most of that opportunity.
“I feel embarrassed and anxious”
The emotional toll of recurrent UTIs is significant. People often describe shame, isolation, and an impact on relationships. Simply acknowledging this and offering a safe space to talk is powerful.
Impact and reflections
Caller feedback has highlighted the value of being listened to, supported, and better informed. People often report increased confidence when discussing their care with clinicians, and greater clarity around the steps they can take while waiting for tests or referrals.
Clinicians, too, have welcomed the service – particularly as a referral option for patients with persistent or complex symptoms who need more time and explanation than a routine consultation can provide. The suite of patient resources and professional tools that we are putting together is supporting consistent, evidence-based care across multiple settings.
The UTI Information Service bridges a critical gap in care – offering practical, nurse-led support to people at a time when they often feel alone, dismissed, or confused.
TAKE HOME MESSAGES
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Many patients with recurrent or chronic UTIs face delays, inconsistent care, and mental and emotional distress.
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The UTI Information Service supports people as they navigate their journey toward appropriate diagnosis and specialist input.
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The service does not replace NHS care but offers guidance, signposting to self-care strategies, evidence-based treatment options, and educational resources.
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A growing suite of patient resources helps individuals manage symptoms, understand their options, and feel more empowered in making informed decisions about their care.
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Separate resources for healthcare professionals – including an online course for care staff in nursing homes – aim to improve consistency and early intervention in UTI care.
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The service is underpinned by robust governance and membership of the Helplines Partnership
The UTI Information Service has been kindly supported by The Champniss Foundation and The Champniss Charitable Trust.
Further reading
1. NICE. Urinary tract infection (lower): antimicrobial prescribing. NG109. National Institute for Health and Care Excellence; 2018.
2. NICE. Lower Urinary Tract Infection (lower) - Women. Scenario: Recurrent UTI (no haematuria, not pregnant, not catheterised) Clinical Knowledge Summary. National Institute for Health and Care Excellence; 2025.
3. NICE. Urinary tract infection (recurrent): prophylaxis and prevention. Clinical Knowledge Summary. National Institute for Health and Care Excellence; 2023.
4. NICE. Urinary tract infection in adults. Clinical Knowledge Summary. National Institute for Health and Care Excellence; 2022.
5. Harding C, Mossop H, Homer T, et al. Alternative to prophylactic antibiotics for the treatment of recurrent urinary tract infections in women: multicentre, open label, randomised, non-inferiority trial. BMJ 2022;376:e068229.
6. O’Neill E, Taneja S. Use of vaginal oestrogen in postmenopausal women with recurrent UTIs: a practical guide for primary care. Br J Gen Pract 2021;71(704):238–9.
7. SIGN. Management of suspected bacterial urinary tract infection in adults. SIGN 88. Scottish Intercollegiate Guidelines Network; 2020.
8. Public Health England. Diagnosis of urinary tract infections: quick reference tool for primary care. Public Health England; 2018.
9. Helplines Partnership. Quality Standards for Helplines. Helplines Partnership.
Declaration of competing interests: None declared.
