NHS England has asked GPs to consider reviewing their prescribing of antibiotics as part of a new drive to tackle antimicrobial resistance (AMR).
In an email bulletin sent to practices today, it suggested that this aims to reduce GP workload.
The bulletin said that infections caused by antibiotic-resistant pathogens are ‘associated with repeat primary care consultations’ as well as poorer health outcomes for patients.
It added: ‘To coincide with World Antimicrobial Awareness Week (18 – 24 November), we are encouraging those working in primary care, including GPs, dentists and pharmacists, to consider taking specific actions to help improve infection prevention, diagnosis and treatment across primary and community care pathways.’
This includes ‘reviewing current prescribing performance and prescribing the shortest effective course of antibiotics’, it said.
NHS England also asked organisations and local commissioners to put in place ‘strategic plans’ for AMR across ‘all care pathways’, it added.
An NHS England letter also sent to GP practices, PCNs and ICB primary care leads today asked them to ‘take time this week to consider’ reviewing their prescribing to ‘further tackle’ AMR.
It said: ‘Prescribers should be supported to prescribe the shortest effective course of antibiotics, following NICE guidelines.
‘Patients should be advised to take antibiotics as directed, not to save for later or share with others, and to return any unused antibiotics to community pharmacies for safe disposal.’
It added that the 2022/23 NHS ‘oversight framework’ for ICBs includes measures of ‘appropriate prescribing of antibiotics and broad-spectrum antibiotics in primary care’.
And ‘all ICBs should review their current performance’ via data published on NHS England’s internal FutureNHS website, it said.
An AMR page on the internal website said: ‘Estimates suggest that as many as half of all patients who visit their GP with a cough or cold leave with a prescription for antibiotics. Viruses cause many of these infections, meaning antibiotics are of little use.’
Meanwhile, NHS England’s letter also said GPs and secondary care colleagues should ‘consider’:
Meanwhile, NHS England’s letter also said GPs and secondary care colleagues should ‘consider’:
- Implementing the national infection prevention and control (IPC) manual for England
- Reviewing the findings of a recent report into ‘improving the blood culture pathway’
- Ensuring ‘timely intravenous to oral antibiotic switch as soon as appropriate’
- Reducing inpatient exposure to certain antibiotics and following Academy of Medical Royal College (AoMRC) guidance on the initial antimicrobial treatment of sepsis
- ‘Encourage staff’ to engage with training resources around infections
- Choose an ‘antibiotic guardian pledge’ and share it on social media platforms
- Promote key AMR messages throughout the winter season to diverse population groups through social media and community networks
- Register their AMR ‘awareness activities’ via an online form to receive a certificate they can display
ICBs should have ‘governance arrangements’ in place to tackle AMR and identify an AMR lead, it added.
The letter said this comes as AMR is a ‘potentially much larger’ problem globally than major diseases like HIV and malaria.
It said: ‘The global burden of bacterial AMR has recently been estimated at almost 5 million deaths associated with, and 1.27 million deaths directly attributable to AMR each year.
‘This puts the magnitude of the problem at a level globally which is at least as large as major diseases such as HIV and malaria, and potentially much larger.’
Last month, the BMA warned that making it easier to access antibiotics is neither good for patients nor the way to reduce GP pressures, following reports that patients will be able to obtain antibiotics from pharmacies without seeing a doctor.
It followed a Government commitment in June to mitigate ‘just in case’ antibiotic prescribing in general practice as part of its strategy to tackle antimicrobial resistance.
Public health officials warned earlier this year of a rise in extremely antibiotic-resistant Shigella sonnei infections, while a separate study showed that GPs practising under pressure were more likely to prescribe broad-spectrum antibiotics.
The Primary Care Respiratory Society published a pragmatic guide in May to support point-of-care C-reactive protein testing as part of moves to cut antibiotic prescribing.
Here’s the deal. You stop prosecuting us for “missing sepsis” , and we’ll become far more judicious in our antibiotic prescribing.
But if you keep on stringing us up every time a patient denied an antibiotic in day 2 landed up in A&E on day 5, forget it.
Sometimes that placebo amoxil is the gossamer layer of protection we need to prevent a knock on the door from the GMC……the wafer-thin difference between “you did all you could” and “you did nothing “.
Patients just need to ask Therese Coffee for one of her spare packs. All sorted and the prescription charge is avoided too.
Nobody seems to talk about antibiotics in British and American poultry. Or the overuse of antibiotics in India and China. Or buying them from supermarkets in Turkey. This is where the real issue leading to resistance is..
A couple of months ago, the CMO wrote to me and told me that my antibiotic prescriptions were more that ‘the average GP.
I was working 9 sessions at the time….
DB – spot on. Long term nebulous risk to society from prescribing v’s immediate risk of litigation / patient complaint when the darlings don’t get exactly what they want. The work force is burnt out with all this crap. Of course they are going to avoid the immediate risk to themselves. Who wouldn’t? (Other than a cardigan wearing antibiotic GPSI specialist sort with a drum to bang)?
But you convinced them that they’re going to die of sepsis. And antibiotics kill everything, even fear. Comedy front seat. Whilst hospitals have zero-monitored hand scripts of co-amoxiclav, which you translate on your name and get done for it.
when they stop putting antibiotics in cow feed (apparently it improves milk yield), then i’ll consider it……….
Aaah NHS England at the cutting edge of treatment. Funny though, after speaking to many consultant microbiologists we are actually not prescribing enough antibiotics in reality. Noticed several cultures for UTI’s that were picking up bugs sensitive to the antibiotics prescribed but the patients were still unwell or symptomatic. Upshot is NICE and NHSE in their virtue signalling re antbiotic prescribing are causing us to undertreat a lot of infections and the staccato treat and re-treat that is now happening in a lot of cases is far more likely to cause resistance. Genius
GMC tribunal.
Why did you not give antibiotics?
Errrr…because I wanted to save the world, and millions of others and future generations.
You dishonest, unsafe, worthless nothing.
Suspended.