The Quality Premium is intended to reward clinical commissioning groups (CCGs) for improvements in the quality of the services that they commission and for associated improvements in health outcomes and reducing inequalities. There are new Quality Premium AMR CCG targets for 2017-19, and the guidance sets out the measures for 2017-18 and the levels of improvement for CCGs to achieve in order to qualify for the quality premium.
For more information please visit the NHS England webpage here.
NHS England Quality Premium 2017-19: Reducing Gram Negative Bloodstream Infections (GNBSIs) and inappropriate antibiotic prescribing in at risk groups – updated targets, early performance, and trimethoprim age banded GP practice data now published.
CCG targets to reduce use of trimethoprim in people aged 70+ years by 10% have been updated for all CCGs and recalculated on the same baseline data set; this has happened due to rapid system improvements in the identification of patient age for prescription items. Subsequently patient identifiers are now available for 90% of all dispensed prescriptions, compared to 74% when the 10% reduction targets were published. Use of this more accurate data provides CCGs greater certainty of both reduction targets and performance against those targets. The process by which the baseline data has been adjusted, and the 10% reduction targets calculated, will be published in the updated annex part b.
Some CCGs have boundary changes, GP practice movement and name changes from 1st April 2017 and the antibiotic prescribing targets in part b have been updated in this annex v7. Similar changes to the E.coli BSI targets in part a will be made when PHE have updated their baseline data set, and an amended annex will be uploaded to the NHSE QP website at a later date.
Publication of GP practice level data for the number of trimethoprim items for people aged 70+ years has been calculated for 12 months to Dec 2016 and is accessible via the NHSBSA website. This is an interim solution until the NHSBSA publish the ePACT2 Antimicrobial Stewardship dashboard in June 2017 (April 2017 data) - the NHSBSA will be contacting all CCGs/CSUs to request a nominated AMS lead to allow early access to the AMS dashboard while ePACT2 is rolled out in 2017.
In collaboration with NHS Improvement, the ePACT2 Antimicrobial Stewardship Dashboard is being developed to support the national Antimicrobial Resistance Strategy. The Government is committed to lead the international fight against AMR setting out new ambitions to do this. Following the O’Neill Review of AMR, the Government set the following ambitions:
- 50% reduction of preventable Gram-negative bloodstream infections (GNBSIs) by 2020/21 – the SRO is Dr Ruth May NHS Improvement
- 50% reduction of the number of inappropriate antimicrobial prescriptions by 2020 – the SRO is Dr Keith Ridge NHS England
The Antimicrobial Stewardship Dashboard will support delivery of both of these ambitions, providing prescribing data to support local stewardship activity and reporting, and linking to relevant AMR resources such as the PHE AMR Portal and NICE guidelines.
The 2016/17Antibiotic quality premium monitoring dashboard format will be updated for the 2017/18 AMR Quality Premium, with publication monthly on the NHS England website.
NHS England have published the newly updated CCG improvement and assessment framework 2016/17, this contains the below:
- Two new indicators under the Better Health Section
- Anti-microbial resistance: Appropriate prescribing of antibiotics in primary care
- Anti-microbial resistance: Appropriate prescribing of broad spectrum antibiotics in primary care.
CCGs are expected to demonstrate appropriate use of antibiotics and CCG performance against both indicators is reported in the Antibiotic quality premium monitoring dashboard.
NHS Improvement Preventing healthcare associated Gram-negative bloodstream infections associated Gram-negative bloodstream infections: an improvement resource May 2017.
New MOOC starting on FutureLearn 8th May 2017 - Challenges in Antibiotic Resistance: Gram Negative Bacteria
Identify, diagnose and treat gram negative bacterial infections. Gram negative bacteria (GNB) are a group of bacteria that can cause infection and toxic reaction in patients, yet are difficult to differentiate and treat with antibiotics due to their structure.
This online course - led by experts from the British Society for Antimicrobial Chemotherapy (BSAC) - looks at this challenge. You’ll explore the microbiology of gram-negative bacteria, and find out how to identify, classify, diagnose and treat GNB infections. You’ll also look at occurrences of GNB and antibiotic resistance worldwide, and understand the impact they have on health and economic outcomes.
Antibiotics in Primary Care
New publications below:
- Antibiotics in primary care in England: which antibiotics are prescribed and for which conditions? Journal of Antimicrobial Chemotherapy, Volume 73, Issue suppl_2, 1 February 2018, Pages ii2–ii10. Published: 27 February 2018.
This research by PHE aimed to identify and quantify the appropriateness of GP prescribing of antibiotics in England, and the results have generated the evidence for the baseline that supports NHS ambition to reduce inappropriate antibiotic prescribing by 50% by 2020/21.
- Defining the appropriateness and inappropriateness of antibiotic prescribing in primary care Journal of Antimicrobial Chemotherapy, Volume 73, Issue suppl_2, 1 February 2018, Pages ii11–ii18. Published: 27 February 2018.
- Actual versus ‘ideal’ antibiotic prescribing for common conditions in English primary care Journal of Antimicrobial Chemotherapy, Volume 73, Issue suppl_2, 1 February 2018, Pages 19–26. Published: 27 February 2018.
- Explaining variation in antibiotic prescribing between general practices in the UK Journal of Antimicrobial Chemotherapy, Volume 73, Issue suppl_2, 1 February 2018, Pages ii27–ii35. Published: 27 February 2018.
- Potential for reducing inappropriate antibiotic prescribing in English primary care Journal of Antimicrobial Chemotherapy, Volume 73, Issue suppl_2, 1 February 2018, Pages ii36–ii43. Published: 27 February 2018.
Does a national NHS England incentive scheme to reduce inappropriate antibiotic prescribing in primary care deliver improvement?
NHS Improvement and the NHS BSA have published a poster report of the AMR Quality Premium 2015-17 performance at the PHE conference 11-12th September 2018.
Access the PHE ePoster library for events here
