The Scalpel's Blog

28.11.18

Turning the tide on antimicrobial resistance

Professor Gillian Leng, deputy chief executive and director of health and social care at NICE, provides her view of the institute’s newly published impact report on antimicrobial resistance.

Around 700,000 deaths occur every year worldwide due to infections that we cannot treat due to antimicrobial resistance (AMR). This number is set to increase to 10 million by 2050. As World Antibiotic Awareness week recently highlighted, there is much more that we can all do to tackle AMR and significantly decrease the number of deaths.

Challenging the rise of AMR has been a priority for NICE over the years. Since publishing our first piece of guidance on antibiotic use in 2008, we have produced a range of evidence-based guidance, standards, and resources on AMR. These aim to change prescribing practice, slow the emergence of AMR, and ensure that antimicrobials remain an effective treatment for infection.

What progress are we making to achieve these important goals?

This is something that our new AMR impact report seeks to address. It highlights how NICE guidance is being used in practice and the progress we as a health and care system are making in the fight against antimicrobial resistance.

One area that the report explores is antibiotic prescribing in primary care and what is being done to reduce this. We found that, since the publication of the UK Five Year Antimicrobial Resistance Strategy, a number of incentives, alongside NICE guidance, have been put in place to encourage appropriate prescribing in primary care.

For example, NHS England’s Quality Premium, which rewards clinical commissioning groups (CCGs) for improvements in the quality of the services they commission, introduced a focus on appropriate antibiotic prescribing in 2015. This requires CCGs to reduce the number of antibiotics prescribed and the percentage of those prescriptions which are for broad spectrum antibiotics.

Data suggests that this is having a positive effect. By the start of 2018, over 80% of CCGs had reduced their antibiotic prescribing levels to below the 2013 England average.

This is good news and demonstrates that primary care professionals are making significant changes to how they prescribe antibiotics. However, our report also points out that there remains wide variation in the prescribing of antibiotics in different areas of England, suggesting that there is still room for improvement in many areas.

Another important focus of our report is antimicrobial stewardship (AMS) in secondary care. Unlike in primary care, the overall use of antibiotics in hospitals has been rising in recent years. In light of this, there have been significant developments made across the health and care system. For example, in our NICE AMS guideline (2015), we recommend that organisations establishing AMS teams should ensure that core members include an antimicrobial pharmacist and a medical microbiologist.

A survey carried out by Public Health England as part of the 2017 ESPAUR report demonstrated that all AMS committees had implemented this recommendation. The survey also showed that the NICE AMS guideline was discussed by 93% of trust AMS committees and 83% had completed its baseline assessment tool.

This shows us that AMS teams across the country are working hard to change the culture of antimicrobial use in our hospitals to preserve their future effectiveness.

Overall, our report demonstrates that in the past five years there has been promising movement across both primary and secondary care to tackle AMR head-on. But the scale of the problem means there is a huge amount of work still to be done.

So we must continue to work together – patients and professionals – to transform a culture of antimicrobial waste, overuse and misuse. We must also support the development of new antimicrobial medicines and encourage companies to develop them. And only then will the tide really begin to turn on this global problem.

To access the full AMR impact report, please go to the NICE website.

Comments

There are no comments. Why not be the first?

Add your comment

 

national health executive tv

more videos >

latest healthcare news

Two NHS trusts spent a third of the year on highest ‘Opel 4’ pressure alert

12/12/2018Two NHS trusts spent a third of the year on highest ‘Opel 4’ pressure alert

Two NHS trusts spent more than a third of the year under extreme pressure and on the highest level of alert. An investigation by the BBC fou... more >
Financially struggling NHS trust appoints fifth chief executive in just five years

12/12/2018Financially struggling NHS trust appoints fifth chief executive in just five years

The financially troubled West Hertfordshire Hospitals NHS Trust has appointed Christen Allen as its newest chief executive – marking its fi... more >
Quarter of trusts spent no money on cyber security last year as NHS’s ‘alarming’ cyber training inconsistencies revealed

12/12/2018Quarter of trusts spent no money on cyber security last year as NHS’s ‘alarming’ cyber training inconsistencies revealed

One in four NHS trusts in England and Wales are spending no money on specialist cyber security or training and trusts are consistently failing to... more >

editor's comment

25/09/2017A hotbed of innovation

This edition of NHE comes hot on the heels of this year’s NHS Expo which, once again, proved to be a huge success at Manchester Central. A number of announcements were made during the event, with the health secretary naming the second wave of NHS digital pioneers, or ‘fast followers’, which follow the initial global digital e... read more >

last word

Hard to be optimistic

Hard to be optimistic

Rachel Power, chief executive of the Patients Association, warns that we must be realistic about the very real effects of continued underfunding across the health service. It’s now beyond doubt or dispute, other than in government, that the NHS is inadequately funded. Even the secretary of state has argued that it will need more mon... more > more last word articles >

the scalpel's daily blog

The robots are here at East Suffolk and North Essex

12/12/2018The robots are here at East Suffolk and North Essex

Lauren Hockney, senior communications officer at East Suffolk and North Essex NHS FT (ESNEFT), outlines how her trust is embracing the digital and automation revolution. Robots have arrived at the ESNEFT, and they are giving back hundreds of hours to staff so they can spend more time helping patients. The trust, which includes Colche... more >
read more blog posts from 'the scalpel' >
332 304x150 NHE Callout banner.

comment

Creating a volunteer 'passport'

12/12/2018Creating a volunteer 'passport'

By utilising the health service’s volunteers, we can deliver better care for everyone, argues Kay Fawcett OBE, clinical project lead at Hel... more >
Right people, right place, right now

12/12/2018Right people, right place, right now

Sean Duggan, chief executive of the Mental Health Network, raises concerns around the mental health workforce and shares some best practice from ... more >
Breaking down barriers to integration

12/12/2018Breaking down barriers to integration

Anne Marie Morris, member of the Public Accounts Committee (PAC) and MP for Newton Abbott, outlines the committee’s recent report on the ba... more >
An attack on them is an attack on us all

12/12/2018An attack on them is an attack on us all

Chris Bryant MP discusses the new law he championed that came into effect in September, which doubles jail time for anyone who assaults emergency... more >

health service focus

View all News

interviews

How can winter pressures be dealt with? Introduce a National Social Care Service, RCP president suggests

24/10/2018How can winter pressures be dealt with? Introduce a National Social Care Service, RCP president suggests

A dedicated national social care service could be a potential solution to surging demand burdening acute health providers over the winter months,... more >
RCP president on new Liverpool college building: ‘This will be a hub for clinicians in the north’

24/10/2018RCP president on new Liverpool college building: ‘This will be a hub for clinicians in the north’

The president of the Royal College of Physicians (RCP) has told NHE that the college’s new headquarters based in Liverpool will become a hu... more >
Duncan Selbie: A step on the journey to population health

24/01/2018Duncan Selbie: A step on the journey to population health

The NHS plays a part in the country’s wellness – but it’s far from being all that matters. Duncan Selbie, chief executive of Pu... more >
Cutting through the fake news

22/11/2017Cutting through the fake news

In an era of so-called ‘fake news’ growing alongside a renewed focus on reducing stigma around mental health, Paul Farmer, chief exec... more >