Report reveals unmet demand for pelvic health care

A new report from Health Innovation Kent Surrey Sussex calls for low-cost pelvic health support to be built into routine NHS care, following a pilot that attracted twice as many participants as originally funded.

Improving pelvic health pathways in primary and community care shares findings and recommendations from a pilot of MUTU, a digital pelvic health and core rehabilitation programme, delivered through Medway Women’s Health Hub and Reach Healthcare primary care network.

MUTU provides education, progressive exercises and self-management support for women experiencing concerns including urine leakage, pelvic organ prolapse and diastasis recti. The programme supports women across different stages of life, from pregnancy and the postnatal period through to perimenopause and menopause.

Demand exceeded the number of funded places

A 2024 evaluation of MUTU found statistically significant improvements in pelvic health symptoms, with 91% of participating NHS physiotherapy patients and 66% of NHS GP patients saying they would recommend MUTU to others.

A follow-up pilot, which ran in 2025, initially funded 50 MUTU licences, but 100 women signed up after eligibility was widened. MUTU provided access for those above the funded number at no additional cost.

Of the 96 women who completed a baseline survey:

• 57% reported urine leakage
• 29% said something did not feel right
• 18% reported pelvic organ prolapse
• 18% reported diastasis recti.

Only 12% had previously been offered NHS treatment or physiotherapy. The report also found that 47 women had looked online or on social media for help, while 27 had done nothing.

The initial offer focused on women up to one year after giving birth. More women responded when this was extended to those up to four years postnatal, indicating that the need for pelvic health support continues well beyond the first year. Poor pelvic health can have a major impact on lifestyle and mental wellbeing, for example worries about urine leakage can restrict working and social life.

Communication and onboarding affected participation

The pilot identified several practical barriers that prevented some women from using the programme.

Busy mothers have many calls on their time, so access to the digital tool has to be quick, easy and trustworthy. The pilot found that women were more likely to respond when communication came from their GP practice rather than an unfamiliar supplier. The report recommends keeping a trusted GP practice, clinician or NHS service involved throughout recruitment and onboarding.

Feedback gathered through a small patient audit suggested that some women found the programme useful but struggled to make time for it. One participant described MUTU as “user friendly” and “helpful to dip in and out of when you got a chance”. Another reported that the exercises helped with urine leakage and that all of their symptoms had gone.

Follow-up data was limited

The report is clear about the limits of the pilot data. Only five participants completed the four-week survey, meaning there were not enough follow-up responses to draw conclusions about clinical outcomes across the full group. Busy mothers did not have time for surveys, so impact was hard to measure.

The report recommends recording offers, uptake and outcomes in patient records and combining this information with data from the digital platform. This could provide a more reliable picture of demand and impact without relying mainly on participants completing additional surveys.

Recommendations for health services

The report recommends that commissioners and health services:

• integrate digital and home-based support into clinically owned pelvic health pathways, alongside community physiotherapy
• establish clear processes for referral, onboarding, monitoring and escalation
• use GP practice or NHS-branded communication to recruit and support participants
• consider women up to four years after birth, women with incontinence symptoms, mild prolapse or diastasis recti, and those waiting for physiotherapy
• build data collection into routine patient care
• provide suitable alternatives for women who cannot or do not want to use a digital programme
• take account of language, literacy, cultural barriers and digital exclusion
• measure changes in symptom awareness, confidence, quality of life and everyday activities, as well as financial outcomes.

It argues that these services need sustainable funding and clear clinical ownership if they are to develop beyond short-term pilots. It also highlights the difference in access between women who can pay privately for support and those who depend on NHS provision.

From pilot to pathway

Health Innovation Kent Surrey Sussex Head of Portfolio – Innovation & Enterprise, Jenny Partridge –

 

“This pilot uncovered a level of need that is often hidden, as pelvic health can be considered a taboo subject. Women came forward with symptoms that affected their daily lives, yet very few had previously been offered NHS treatment or physiotherapy. We now need to use what we have learned to make earlier pelvic health support easier to access through trusted NHS services.”

The Medway pilot found a clear demand for accessible pelvic health support, but it also showed that digital access on its own is not enough. Communication must come from a source women recognise and trust, joining instructions must be clear, and data collection must not create another obstacle to participation.

In conjunction with the full report, Health Innovation Kent Surrey Sussex is sharing two sets of recommendations: one for NHS audiences and one for public health audiences.

Read the full report

Read recommendations for the NHS

Read recommendations for public health