UTIs cost NHS hospitals over £600m last year

New data from the UK Health Security Agency (UKHSA) has revealed that treating urinary tract infections (UTIs) cost NHS hospitals in England an estimated £604 million in 2023-24.

UTIs occur when bacteria enter the urinary system including the urethra, bladder or kidneys. Most lower urinary tract infections (those in the urethra or bladder) cause mild discomfort and go away on their own, or may require a short course of antibiotics, but for some can progress to more serious infections, including upper urinary tract infections affecting the kidneys, leading to bloodstream infections and sepsis.

Analysing data from the Hospital Episode Statistics (HES) database using the records of patients with a UTI-related primary diagnosis for the 2023 to 2024 financial year in England, there were nearly 200,000 UTI-related patients. This includes infections acquired in both community and hospital settings. Those admissions resulted in 1.2 million bed days, averaging 6 bed days per infection.

However, one-third of UTI patients were in hospital for less than a day, indicating that other treatment pathways could be considered for these patients.

The findings reflect the well-documented burden of UTIs on older people and women. 52.7% of admissions were patients aged over 70 and 61.8% were female. While females were nearly 5 times more likely to require hospital treatment for a UTI in people under 50 years old (24.7% female compared to 5.3% male), this levelled out in age groups over 50 (37.1% female compared to 32.9% male). This highlights the need for men over 50 to also pay early attention to urinary symptoms and seek treatment that may prevent hospitalisation.

Hospitalisations for UTIs were at their lowest in 2020 to 2021 – possibly influenced by the COVID-19 pandemic. Since then, admissions have increased, climbing by 9% in 2023 to 2024 compared to the previous year.  

The data highlights the clear need to reduce UTIs acquired in the community to help reduce hospitalisations. People can reduce their risk of catching a UTIin the first place by:

• drinking enough fluids regularly, especially in hot weather – more trips to the toilet may be needed, but that shouldn't stop you drinking
• avoiding holding pee - go to the toilet as soon as possible when you need to
• washing, or shower daily where possible especially if you suffer from incontinence* keep the genital area clean and dry, and check and change leakage of urine pads often
• wiping from front to back after using the toilet to prevent bacteria from spreading
• washing genitals before and after sex
• talking to your healthcare professional if you have frequent UTIs, as they may be able to suggest treatments that could help

Detecting and treating a UTI early is also important. Some of the early symptoms of UTI include:

• needing to pee more frequently or urgently than usual
• passing lots of urine at night
• pain or a burning sensation when peeing
• having cloudy-looking urine
• new pain in the lower tummy
• severe kidney pain or pain in the lower back
• blood in the pee
• for some people it can include changes in behaviour, such as acting agitated or confused

UKHSA also recently published updated diagnostic flowcharts to help healthcare professionals manage symptoms and infections.

Dr Colin Brown, Deputy Director at UKHSA responsible for antibiotic resistance, said:

Urinary Tract Infections are a major cause of hospitalisations in this country, but many could be prevented.

We know that the most serious consequences that come from UTIs are more common in people over the age of 50 so we are reminding this group in particular to be aware of the ways they can help reduce their risk of getting poorly. Drinking enough fluids is so important, as well as avoiding holding onto pee. If you have frequent UTIs, talk to your healthcare provider about treatments that may help prevent further infections. If you have a UTI and your symptoms get worse, please call your GP or 111, or go to your nearest A&E to seek assistance as UTIs can develop into more serious, life-threatening infections.

Preventing UTIs is also important in our fight against antibiotic resistance as they are often treated with antibiotics, which drives resistance in bacteria. Reducing the number of UTI infections means bacteria has less chance to develop this resistance, helping to keep antibiotics working for longer.

Dr Joanna Harris RGN PhD, Head of Infection Prevention and Control at UKHSA, said:

UTIs are a significant cause of avoidable harm, particularly among older adults and those with long-term conditions, and can lead to serious complications, including sepsis and death. It's really important that nurses, midwives and social care workers, have the knowledge and tools to reduce the risk of UTIs occurring. When a UTI is suspected, their promotion of early and accurate diagnosis can enable timely and appropriate treatment, helping to limit the impact of the infection.

Professor Matt Inada-Kim, National Clinical Director for Infections Management and Antimicrobial Resistance at NHS England, said:

Urinary tract infections are an increasingly common reason for becoming ill at home and in hospitals. They are more serious in older patients and, in particular, those with catheters, but they can occur at any age and are not often related to poor hygiene.

Antimicrobial resistance continues to grow and it is vital that we do everything we can to manage urinary infections through prevention, education and providing easy access to healthcare – including diagnostic tests and appropriate treatment.

UTIs are typically caused by bacteria, most commonly Escherichia coli (E. coli), and often require antibiotics to treat the infection. As UTIs are so common, there are concerns that the volume of antibiotics prescribed is contributing to the growing risk of antimicrobial resistance (AMR). This is because every antibiotic taken makes the development of resistance more likely. More targeted prescribing of antimicrobials for UTIs is essential as part of the National Action Plan for AMR 2024-2029. However, preventing infections where possible would also decrease antibiotic prescribing and the selective pressure that antibiotics have on bacteria, helping reduce antibiotic resistance.

Patient and campaigner, Caroline Sampson, explains how a chronic UTI has impacted her life:

For 9 years, I have had a chronic UTI. No form of antibiotics has successfully treated it. It has derailed by life in every possible way. The daily symptoms are debilitating and painful. Trying to accomplish the smallest task takes a huge amount of effort. The impact on my mental health has been enormous and I live with daily anxiety that the infection could develop into Urosepsis. The threat of antibiotic-resistant infections to us all cannot be underestimated.