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Partners in improving local health

Initiatives to support primary care antibiotic

prescribing in the North East and Cumbria

Deborah Giles, Anne Henry, Alastair Monk

Medicines Optimisation Team

NHS North of England Commissioning Support

Commissioners guide to the prevention of Antimicrobial Resistance

6th March 2015

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Background

CarlisleMiddlesbrough

Durham

Newcastle

upon Tyne

Berwick upon

Tweed

Barrow-in-Furness

North of

Tyne

CumbriaDurham &

DarlingtonTees

South of Tyne

& Wear

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Antibiotic prescribing in the North East and Cumbria

The Guardian 11 Jun 2013

UK map shows areas where GPs are most, or least, likely to prescribe antibiotics to patients.

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UK 5 year AMR strategy

Key elements for primary care

� Antibiotic guideline

� Public/professional awareness campaign

� Educational resources

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NECS Medicines Optimisation Team

� Over 100 pharmacists,

technicians and specialist

support staff

� Covering 13 CCGs in North East

and Cumbria

� Commissioning support and

practice support

� Workstream groups for key

areas of medicines optimisation,

including antibiotics and

antimicrobial resistance

CarlisleDurham

Newcastle upon

Tyne

Berwick upon

Tweed

Middlesbrough

Barrow in Furness

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Creating the climate for change…engaging with key stakeholders

North East Antimicrobial

Pharmacists Group North East

Microbiologists

Group

NECS

Communications &

Engagement Team

NECS Web

Development

Team

NECS IT

Training

Team

NECS Medicines

Optimisation Team

Public Health

England

Clinical

Senate

CCG

Forum

CCG Prescribing

Leads

Area Prescribing CommitteesDurham & Darlington APC

Gateshead MMCNorth of Tyne APC

South of Tyne MMCTees MMC

Gateshead &

North of Tyne

HCAI Reduction

Partnership Group

Hospital Trusts

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The interventions – a collection of multifaceted

interventions for individual prescribers, practices and CCGs

A single, easy to follow and

easily accessible guideline for

use across primary care

settings in the North East and

Cumbria

A single, easy to follow and

easily accessible guideline for

use across primary care

settings in the North East and

Cumbria

North East & Cumbria antibiotic prescribing

guideline for primary care

North East & Cumbria antibiotic prescribing

guideline for primary careEducation and training

Education and training

Awareness campaign

Awareness campaign

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Implementing the new guideline and embedding into practice

� Continued engagement with

stakeholders

� Engaging with practice based

medicines optimisation teams

and CCG prescribing leads

� Making the guideline easily

accessible

� NECS Medicines

Optimisation website

� Microguide smartphone appMicroguide

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Education and training initiatives

eLearning

� Focus on prescribing

strategies for primary care

� Incentivised through CCG

prescribing engagement

schemes

Workshops

� CCG time outs, practice

pharmacist team meetings

� Delivered to GPs,

pharmacists, nurses

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Public communications campaign

� Coverage 1.38 million

people (53% of North East

population)

� High profile TV adverts

� Digital and online

advertising

� Self-care patient

booklets

� Distribution to all North

East & Cumbria GP

practices and

community pharmacies

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Involving the whole organisation

� Endorsement and support

from Executive Team

� Messages delivered to

700+ staff at Autumn

Conferences

� Discussion in the work

place

� Follow up staff survey

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Challenges and Successes

� Initial resistance from some stakeholders

� Wariness about a new organisation – NECS?

� Engagement with secondary care colleagues

� Collaboration

� Across geography

� Across organisational boundaries

� Buy in from key stakeholder

� Multifaceted approach

� Keep persevering and maintain momentum

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http://medicines.necsu.nhs.uk

deborah.giles@nhs.net

anne.henry@nhs.net

a.monk@nhs.net

Thank you. Questions?