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NHS England acts to combat antibiotic overuse

NHS England has launched the world’s largest healthcare incentive scheme for hospitals, family doctors and other health service providers to prevent the growing problem of antibiotic resistance.
Under the scheme, funding will be made available to hospitals and other providers that reduce the inappropriate use of antibiotics.
Antibiotic resistance is one of the most significant threats to patients’ safety worldwide and is driven by overusing antibiotics and prescribing them inappropriately. Infections with antibiotic-resistant bacteria increase levels of disease and death, as well as the length of time people stay in hospitals. As resistance in bacteria grows, it will become more difficult to treat infection, and this affects patient care.
The World Health Organisation (WHO) has estimated that antimicrobial-resistant infections currently claim at least 50,000 lives each year across Europe and the US. Last year a review by Jim O’Neil
found that unless action is taken there could be 10 million worldwide deaths each year attributable to antimicrobial resistance in coming decades.

The new NHS programme, which goes live in April 2016, will offer hospitals incentive funding worth up to £150 million to support expert pharmacists and clinicians to review and reduce inappropriate prescribing. In addition, a typical local Clinical Commissioning Group (CCG) with a population of 300,000 people could receive up to £150,000 a year to support GP practices in improving their antimicrobial prescribing.

CCGs are being supported to reduce the number of antibiotics prescribed in primary care by 4%, or to the average performance levels of 2013/14. Hospital Trusts will also receive payments for gathering and sharing evidence of antibiotic consumption and review within 72 hours of the beginning of treatment. Information will be available for commissioners to review on a dedicated website and will allow them to directly monitor progress. Further payments will be made for reducing the use of specific types of drugs which are used to treat a wide range of bacteria. These so-called ‘broad spectrum’ antibiotics need to be reserved to treat resistant disease and should generally be used only when standard antibiotics are ineffective.

The payments form part of two schemes that reward excellence and quality improvement in the NHS: the 2016/17 Commissioning for Quality and Innovation (CQUIN), where it will be worth an extra 0.25% of Trusts’ budgets; and the Quality Premium scheme, which is paid per patient to CCGs that successfully deliver the proposed measures.

Simon Stevens, Chief Executive of NHS England, says: “Antimicrobial resistance is a major threat to patient safety and the quality of care. These measures will build on the vital work the NHS is already doing to tackle the overuse and inappropriate prescription of antibiotics, so that in years to come patients can continue to be protected from otherwise lethal infections.”

Professor Dame Sally Davies, Chief Medical Officer for England, adds: “The NHS, governments and industry all have key role to play in combating antimicrobial resistance which poses a catastrophic global threat. These measures will put the NHS at the forefront of meeting this challenge.”

Paul Cosford, ‎Director for Health Protection and Medical Director at Public Health England, concludes: “Tackling antimicrobial resistance is rightly a national and international priority. One key action in work to slow resistance is ensuring all antibiotics are appropriately prescribed and that these prescriptions are regularly reviewed. I am delighted the NHS is taking action to address this through its Commissioning for Quality and Innovation guidance. Public Health England will work with NHS England to support the effective implementation of this guidance and we will continue to improve antimicrobial prescribing and stewardship programmes across the wider health system.”