Introduction to the pelvic floor during pregnancy

The Pelvic mesh complications elearning programme has been developed to support General Practitioners by providing up-to-date information on pelvic mesh complications and the services available to women affected by them. The programme focuses on ensuring women are appropriately assessed and referred to specialist services, and that GPs feel confident in supporting women through the care pathway.

The programme covers a range of core topics, including an introduction and background to pelvic floor disorders in women, a review of the history of pelvic mesh use in the UK, an overview of pelvic mesh complications, and detailed information on the referral process into Specialist Mesh Centre services. Learning is supported through a case study exploring the experience of a woman with pelvic mesh complications. There are no formal prerequisites for this programme and the content is designed to be completed as a single, cohesive learning experience.

On completion of the programme, learners will understand that women presenting with pelvic mesh complications may have complex histories. Learners will develop a clear understanding of the referral process to Specialist Mesh Centres, the role of the multidisciplinary team, and how GPs can support women in accessing appropriate specialist care. The programme also aims to increase confidence in explaining care pathways and available treatment options, helping to improve both access to services and the overall care experience for women. The primary audience for this programme is General Practitioners working in primary care.

The programme has been developed in response to long-recognised complications associated with some pelvic mesh implantation surgeries. Reports of complications related to vaginal mesh implants emerged internationally, with women in the UK self-reporting adverse outcomes to the Medicines and Healthcare products Regulatory Agency (MHRA). These concerns contributed to the First Do No Harm report, published in July 2020 following the Baroness Cumberlege review, which made a number of recommendations including the establishment of Specialist Mesh Centres.

This training package has been designed to ensure clinicians have access to consistent, accurate and current information about pelvic mesh complications and the services now in place to support women. The programme has been created in partnership with NHS England and Improvement and Health Education England, with expert input from clinicians, professional bodies and patient voice representatives involved in pelvic floor health and specialist mesh services.

By improving awareness, confidence and understanding among GPs, the programme supports safer referral, improved access to specialist services and a more informed, compassionate care experience for women affected by pelvic mesh complications. The focus on specialist pathways, multidisciplinary care and informed decision-making aligns with wider NHS priorities around patient safety, learning from harm and improving outcomes for women’s health. Further information and supporting resources can be accessed within the programme via the NHS Learning Hub.