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If NICE wants to crack down on antibiotic prescribing, why don’t they target patients first?



I’m wondering if I’ve detected the first cracks in the Daily Mail’s campaign to have all GPs shot. Because today’s front page headline was noticeable for its unusual ploy of using underlining for emphasis. Thus, and I quote, ‘GPs get another bonus…for doing their job.’

This may mean that their headline writers have actually run out of words to emphasise how crap we are, and are now resorting, instead, to typographical quirks. Presumably, once they’ve gone through capitals, and bold, and some powerpoint flashing neon animations, they’ll hopefully give up and go and terrorise someone else.

Anyhow, you want to know why ‘WE’RE getting another (flash) bonus (flash)’? Oh, apparently, it’s all about carrots to persuade GPs to prescribe antibiotics more rationally. Except what I’ve read actually seems to be more about sticks.

Perhaps literally. Because we’re promised local ‘antimicrobial stewardship teams’ to review prescribing, ‘individualised feedback’, and targeting of areas where there has been ‘inappropriate’ prescribing. In other words, the DH’s fixers are coming around to give us a good kicking.

Listen chaps, can I offer in our defence a couple of simple truths? If people didn’t attend, I wouldn’t give them antibiotics. It’s not like I’m out on the streets proactively ramming amoxicillin down the necks of unsuspecting passers-by. And if, when they do come, and I decline to offer that prescription, they wouldn’t threaten to complain to the GMC, or pin me to the wall so I can feel their hot breath mouthing the words, ‘Just give me the effing ciprofloxacin and no one will get hurt’, I wouldn’t cave in.

So if NICE is going to form vigilante groups, can I suggest it directs whatever form of retribution it has in mind at the actual source of the problem. Not profligate GPs, but antibiotic-demanding patients. If they’re serious about solving this issue, the ‘stewardship teams’ should round up the offending punters, stick them in concrete boots and chuck them in the nearest river. Bish bash splosh – problem solved.

Then I could get on with my job. And that really would be a bonus.

Dr Tony Copperfield is a GP in Essex. You can follow him on Twitter @DocCopperfield.