This project marks a significant advance in analysing antibiotic prescribing data within health and justice (H&J) settings, leveraging the Health and Justice Information Service (HJIS) data for the first time.
A comprehensive prescribing dashboard has been developed for all prisons in England, aiming to enhance the surveillance of antibiotic use and address health inequalities in antimicrobial resistance (AMR), aligning with the new 5-year National Action Plan (NAP) 2024-2029.
This initiative emphasises the need for targeted health interventions for individuals in contact with the justice system, identified as a key inclusion group under the CORE20PLUS5 strategy.
The dashboard provides critical insights for quality improvement across different prison sites, facilitating benchmarking and comparisons with primary care prescribing patterns.
The dashboard details antibiotic prescribing data by age, prison category, region, Integrated Care Boards (ICBs), individual prisons, and antibiotic types. It highlights that the most frequently prescribed antibiotics are for skin and soft tissue infections, respiratory tract infections, dental infections, and urinary tract infections (UTIs). Notably, the dashboard reveals areas for quality improvement, such as the excessive use of broad-spectrum antibiotics (currently 11% versus the recommended less than 10%), high rates of acne-related antibiotic prescribing (12% compared to less than 3% in primary care), and longer than NICE recommended durations for antibiotic courses, particularly for amoxicillin, doxycycline, and nitrofurantoin.
Future steps include collaborating with antibiotic champions to enhance the dashboard, developing intervention plans to optimize prescribing practices, sharing patient safety messages, and piloting resources within health and justice settings. These interventions will be monitored through the dashboard, accessible to individual prisons, to ensure their effectiveness. By improving antibiotic stewardship through data-driven insights and targeted actions, the project aims to reduce inappropriate prescribing, mitigate the risk of AMR, and enhance health outcomes for the prison population.
