The appropriate use of antibiotics (antimicrobial stewardship) is a national priority to ensure that patients get the correct antibiotics when they need it, but do not get one if they don't. Over-use and inappropriate use of antibiotics leads to antimicrobial resistance, and there is a national action plan aimed at reducing this risk.
In 2021 the North East and North Cumbria ICB was the highest prescriber of antibiotics in the country, with only minimal reductions in prescribing in primary care despite ongoing work being done to target this. The North East and North Cumbria (NENC) ICB and the North East Commissioning Support (NECS) Medicines Optimisation (MO) teams covering County Durham and North Tyneside sub-ICB locations (SICBLs) recognised that new strategies were needed to tackle this agenda in a way to encourage improved engagement from practices and to allow them to target specific areas of prescribing in a focussed way.
The MO teams worked with local partners and stakeholders to commission a new bespoke practice level report. This required a technological solution managed by the NECS business intelligence (BI) and Primary Care Data Quality (PCDQ) teams to extract data from the two GP clinical systems in use within the two SICBLs and input this data into a bespoke report for each of the 86 GP surgeries.
The report compared antibiotic prescribing in the previous 8-week period at a practice level with their prescribing from the same 8-week period the previous year, to show where changes had been made in both patient numbers and percentage of patient population. It also compared total prescribing with their peers across the region, within their SICBL, and in their Primary Care Network (PCN). The report also utilised searches to provide both practice level information and benchmarking against other practices for specific clinical indicators.
It was hoped that the use of the technology to extract this data and provide bespoke reports would add to other data available and support GP surgeries to identify and prioritise on clinical areas of prescribing where their clinical practice and antimicrobial stewardship could be improved.
The report was commissioned for an initial 7 reports, at 2 monthly intervals. So far 5 reports have been sent to all 86 practices in both the County Durham and North Tyneside SICBLs, and their use and engagement at a practice level has been encouraged by the inclusion into the relevant incentive scheme.
Anecdotal feedback has been positive, with many practices utilising the reports to identify clinical areas that could be targeted for improvement within their GP practice. Formal evaluation is currently being undertaken to get qualitative data on user feedback, and to review antimicrobial prescribing in the target clinical areas. It is also being reviewed with an aim to roll-out across the whole ICB in 2023-24.
