Title: A qualitative study of people's experiences of urogynaecology health services in the UK
Funder: Department of Health and Social Care

Abstract: Background Urogynaecology evaluates and treats benign conditions of the female pelvic organs and their supporting structures related to urinary function, including pelvic organ prolapse, urinary incontinence, bladder pain, overactive bladder and recurrent urinary tract infections. Urogynaecological conditions can have considerable adverse medical, psychosocial, emotional and quality of life impacts on affected people. Stigma, shame and guilt can be barriers to accessing appropriate healthcare. The Cumberlege report (2020) highlights serious problems in women s care. There is currently very limited qualitative research exploring patient experience of urogynaecology services in the UK. Aims and objectives Our study aims to understand the experiences of people who have engaged with urogynaecological health services in the UK and identify opportunities to use this learning for improvements. We will develop an understanding of the perspectives, experiences and different treatment outcomes of a wide range of patients regarding urogynaecology services, encompassing both primary care and specialist services, and develop experience-based resources to meet the needs of patients, the public, service providers and policy makers. Methods Narrative and semi-structured interviews (by video call or telephone) will be conducted with a diverse sample of up to 80 individuals with experience of urogynaecological health services in the UK, recruited through GPs, clinics, support groups and snowballing. Our maximum variation sample will include a range of conditions, severities, treatment histories and outcomes, and demographics (age, ethnicities, socioeconomic). Interview transcripts will be analysed thematically to identify the issues that are important to participants. We will produce a Heathtalk.org resource featuring the findings, illustrated with interview extracts. We will co-produce a short film for service improvement. A final event will present findings to policy makers and other stakeholders. Timelines for delivery Months 2-9: Interviewing Months 8-15: Data analysis Months 15-16: Co-produce catalyst film for use in service improvement Months 16-18: Prepare Healthtalk.org resource Month 17: Present study findings and catalyst film at final stakeholder event Month 18: Final report, submit papers Months 19-22: Evaluate and publish Healthtalk.org section Anticipated impact and dissemination The study will provide qualitative data on a wide range of patient's experiences of urogynaecological services in the UK. A final event with policy makers and other stakeholders will ensure that the findings feed into policy and practice. A considerable strength and added value of this study is that findings will be curated for publication as a new section on the award winning, charity run platform Healthtalk.org. The experience-based resource will be designed for people with urogynaecological problems, and to better inform healthcare professionals who support and treat them. The platform hosts over 110 collections, is accessed by 7 million visitors annually, and is used as a learning resource in almost all UK medical schools. We will co-produce a catalyst film based on the interviews which will be distributed for service improvement. Our professional networks, charities and support groups will help to raise awareness of all our study outputs. We will add to the literature with at least three papers, and findings relevant to healthcare professionals will be presented at relevant conferences.

Lay abstract: Aims: To understand the experiences of people who use urogynaecological health services in the UK. This understanding will be used to support patients, inform healthcare professionals, and help shape health services. Background: Urogynaecology, a subspecialty of gynaecology, evaluates and treats conditions of the female pelvic organs, supporting muscles and tissues as related to urinary function. Conditions, like pelvic organ prolapse and urinary incontinence, can physically and emotionally impact on people's mental health, relationships, work, and social lives. There are concerns that the experiences and voices of patients have not always been listened to. There is little research about experiences of urogynaecology health services in the UK. By listening closely to patient voices, better support and information can be offered and services improved. Design and methods: We will interview up to 80 people about what it has been like to have an urogynaecological condition, see healthcare professionals, and have treatments. We want to hear a wide range of different experiences. The interviews will take place online or over the phone. We will look at similarities and differences in what people say, and look for examples of both good and poor care to help us understand how services can be improved. We will make a resource on the website Healthtalk.org to give information and support based on what we learn from participants in the study. The resource will summarise the key findings, and use participants own words from their interviews (with permission). We will also co-produce a short film which can be used to improve healthcare services. In addition, we will undertake interviews with 40 primary care practitioners from across England, to explore their perspectives on and experiences of providing care for women s health in primary care. Patient and public involvement: The study has been designed with the input of five patient partners who have experience of health services for urogynaecological conditions. These women have talked to us about what it was like for them and why they feel this study is important; in particular, they have described some of the barriers to care that they would like to see improved. These women have joined advisory groups and we will invite additional patient partners to join at the start of the study, to work closely with the researchers and advise throughout the project. Dissemination: A considerable strength and added value of this proposal is that the study findings will be assembled for publication as a new section on the award winning, charity-run platform Healthtalk.org. The Healthtalk.org website currently hosts over 110 collections, is accessed by 7 million visitors annually and is used for teaching in almost all UK medical schools. We will make a short film for use in service improvement and present this at a final event for UK policy makers and other stakeholders. We will publish our findings in high-quality journals, and present them at healthcare conferences.

Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: RENAL AND UROGENITAL