NHS in Wales promised £1m a year to transform pelvic health treatment

^{Health secretary Vaughan Gething wants pelvic health services to focus on prevention and conservative therapies}

The announcement, on 8 May, was in response to a Welsh government-commissioned report on the use of vaginal synthetic mesh tape and sheets for stress urinary incontinence and pelvic organ prolapse.

Physiotherapy and specialist services for continence should be prioritised for incontinence and prolapse, with surgery as a last resort, the report says. It wants this approach to be part a new ‘pelvic health and wellbeing pathway’.

Care pathway

This initial care pathway will include access to multidisciplinary teams of clinicians offering continence care, physiotherapy, pain management and where appropriate psychology skills.

Patients need better information to make sure they can make fully-informed and decisions about treatment options, the document recommends. In addition, GPs must have direct access to specialist advice so they can provide better support for patients.

Fundamental change

Mr Gething said: ‘What is particularly clear to me after reading this report is that we need a fundamental change in the way the NHS supports women with pelvic health problems, moving to a focus on prevention and conservative therapies.’

The team which produced the report was chaired by Simon Emery, a consultant in obstetrics and gynaecology at Singleton hospital, Swansea, and included two physiotherapists. Both based in Cardiff, they are Gillian McCabe, a specialist in pelvic health with a private practice, and Carol Broad, clinical lead physiotherapist for women’s health at University Hospital Wales.

Ms McCabe said: ‘What emerged during our discussions was that often GPs do not consider physiotherapy as an appropriate treatment for this patient group and make referrals for surgery before physiotherapy has been pursued.

Education first

‘There is work to do in standardising education and training for women’s pelvic health physiotherapy across Wales. We need to make sure that new graduates or less experienced physiotherapists are not undertaking this specialist treatment. They need to be educated first.’

The report highlights a lack of data about the treatment for pelvic problems. It calls for improvements to data capture about interventions, complications and access to specialist support.

An implementation group, which will provide the health secretary with regular progress reports, will be set up ‘without delay’. In the meantime, Mr Gething said he expected all health boards to read the report and consider what local improvements they could make immediately.

In a separate development, on 3 May women’s health specialist Sundeep Watkins, pictured, was interviewed on BBC Radio Leicester on the role of physiotherapy in treating pelvic pain. ‘It was a fantastic platform to get the message out to the public to seek help for common symptoms such as pelvic pain and incontinence that don’t have to be lived with and can be managed with physiotherapy intervention,’ she said.

Listen to the interview -- at 40 minutes