Embedding lived experience to inform research on accelerating the diagnosis of urinary tract infections and tackling antimicrobial resistance

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Why is this work important? 

Urinary tract infections (UTIs) are very common, especially for older women. These infections account for over 10 million GP consultations and 1 in 5 antibiotic prescriptions each year in the UK. UTIs are often treated with unspecific antibiotics before test results become available as it can take several days of laboratory testing to identify the cause of the infection. This can lead to hospital admission and contributes to antimicrobial resistance (AMR). AMR is a pressing global challenge causing around 1.3 million deaths per year, caused by overuse/misuse of antibiotics.

The Scottish SME Microplate Dx is developing a point-of-care diagnostic platform, RapidPlate™, which aims to identify the optimal antibiotic treatment within 1 hour of collecting a urine sample when used as a point-of-care test. The NIHR HealthTech Research Centre: Diagnostic and Technology Evaluation (HRC DTE) has been collaborating with Microplate Dx since 2022. In 2024, HRC DTE helped the company secure a £1.5 million NIHR Invention for Innovation Product Development Award. During preparation of the funding proposal, the HRC DTE conducted care pathway analysis including interviews with stakeholders to gather views on the test’s usability and accuracy in different clinical settings. They helped to embed a range of patient and public voices throughout the research plans. As part of the award the HRC DTE are supporting Microplate Dx to develop “RapidPlate™ into a clinically validated prototype and generate evidence to support adoption of the technology in the NHS. If rolled out, the technology could contribute to the UK Government’s vision for containing and controlling AMR. 

From Dr Stuart Hannah, Microplate Dx Co-Founder & CEO:

“Antimicrobial resistance is one of the defining healthcare challenges of our time, and better diagnostics are a critical part of the solution. Our collaboration with the NIHR HRC DTE and patient partners ensures that RapidPlate™ is being developed with real-world experiences at its core. By embedding patient perspectives early, we can build technology that delivers faster diagnoses, supports better antibiotic stewardship, and ultimately improves outcomes for people suffering with UTIs’’

How is the NIHR HealthTech Research Centre: Diagnostic and Technology Evaluation helping to tackle this challenge?

HRC DTE in conjunction with Live UTI Free are working in partnership to involve a range of perspectives in the co-design of RapidPlate™’s product and research. HRC DTE is hosted by Newcastle University and Newcastle upon Tyne NHS Foundation Trust, drawing on clinical expertise from across the clinical research landscape, to shape innovations to the needs of the NHS.

HRC DTE facilitated contributions from people within their HRC Insight Panel for patients, public and carers who have lived experience of the NHS and want to help shape diagnostic technologies to support patient care. Live UTI Free is a patient-led research organisation focused on UTI and other women’s pelvic health concerns. 

Through collaborative working they included the perspectives of people with lived experience of recurrent UTIs and first-hand experiences of the current practice and its limitations, including tests available, so that Microplate Dx can develop a better product. To complement this, the HRC Insight Panel offered a broad public view of the potential use of the RapidPlate™ technology in different patient groups, such as older people and patients taking immunosuppressant medications.

Involvement activities for the project have been held through a combination of online and in person meetings, and feedback on written materials over email. For the Live UTI Free Patient Advisory Group (PAG), online meetings were held to involve a group of six people based in different areas of the country. For the HRC Insight Panel, online and in person meetings were held alternately for the group of eight people based in the North East. Over the last fourteen months, this has involved a total of fourteen meetings with contributors (Feb 2025 - April 2026), with presentations and discussions co-led with Microplate Dx to bring the product developers, researchers and patient and public contributors together. 

What progress and outcomes have been generated so far?

The HRC DTE and Live UTI Free PPIE Leads have worked closely to co-ordinate and facilitate a series of PPIE activities to meet the needs of the project. They use a shared PPIE tracker to record all activities including the specific topics discussed, contributor views and suggestions, and their impact on the research and product development. This supported coordination of PPIE findings and captured the key learning outcomes across the different activities that were fed into project and product development decisions.

Feedback on each PPIE activity has been provided to contributors using a ‘you said, we did’ approach where tangible changes based on contributor views and suggestions are shared. The PPIE Leads work to consistent standards, sharing feedback ahead of the next PPIE activity. This regular feedback is supporting the continued engagement of contributors over the duration of the project. 

How have patient and public partners directly supported this project?

The inclusion of different perspectives has enriched the project through informing the study design, further development of the product and the potential clinical implementation approach. Consideration was taken to ensure that individuals from different backgrounds, demographics and accessibility needs were included, with the intention to involve a range of lived experiences and perspectives.  

Specifically, the patient and public partners have helped with:

  • Design of a semi-structured questionnaire for focus group discussions (with healthcare professionals and patients) to explore RapidPlate™ (PAG & Insight Panel) 
  • Sense-checking the interpretation on the views of healthcare professionals on RapidPlate™™ and exploring scenarios for use in primary care (PAG & Insight Panel) 
  • Discussing potential uses for RapidPlate™ in acute and secondary care settings (Insight Panel & PAG)
  • Analysing qualitative data from patients with lived experience of UTIs (PAG) 
  • Reviewing aspects of the UTI care pathway to inform our health economic studies (PAG)
  • Raising public awareness of AMR for World AMR Awareness Week (Insight Panel)
  • Informing product requirements and development priorities.  This included patient perspectives on time to result, species identification and the importance of providing clinically actionable information to support antibiotic selection.

While the clinical impact of RapidPlate™ will be evaluated in future clinical studies, the robust PPIE activities supported by HRC DTE have significantly advanced the likelihood that it is developed and tested in ways that reflect the needs and priorities of patients and healthcare professionals. These findings will inform further device refinement aligned with user requirements, future clinical evaluations, and implementation considerations. The next steps will focus on generating further evidence of integration within existing care pathways to support adoption in routine practice.

From Anna C, member of the PAG: 

“I have had UTIs for the last 8 years and have had to resort to taking an extensive amount of antibiotics and other medications….my involvement with the PAG for Live UTI Free was important to me because if I can help in any way to develop a new test which is accurate, timely and easily available to those in need that would be incredibly rewarding given how debilitating this condition is for so many people. UTIs are a complex area and every member of the PAG had very different experiences which were all invaluable when discussing how the test might work, how it can be implemented into primary care settings and how the focus groups would work.”

How will this shape the future development of RapidPlate™?

Working in partnership to involve a broad range of perspectives is benefiting the design of this research and ensuring that the technology evolves in a way that is meaningful, acceptable, and beneficial to patients. 

Ensuring regular communication between PPIE Leads through meetings and use of shared tools has proved valuable for maximising the value of PPIE activities. A subsequent funding application is planned to build on the current project and explore the application of RapidPlate™ in different clinical settings. Within this, HRC DTE plans to involve a public co-applicant and PPIE activity to shape this research proposal from the earliest stages.

Where can I explore this work further? 

This work is a collaboration between Microplate Dx and  NIHR HealthTech Research Centre in Diagnostic and Technology Evaluation (HRC DTE) as well as Newcastle University, Newcastle upon Tyne NHS Foundation Trust, North East Innovation Lab, Live UTI Free, NIHR i4i, NHS Greater Glasgow and Clyde (NHSGGC) and University of Glasgow. You can find out more on the results of this pre-clinical evaluation once completed by visiting the HRC DTE website.