This informal CPD article, ‘Optimising the Use of Antimicrobials: Identify, Protect, and Contain’, was provided by Knowlex, whose activities centre on delivering educational activities for the “whole health economy”.
The UK’s AMR National Action Plan for 2024-2029 is centred on a global threat known as antimicrobial resistance that makes infections more difficult to treat. The major objective is to maintain the efficacy of antibiotics and other antimicrobials. The UK’s AMR National Action Plan for 2024-2029 addresses this by focusing on strategies to identify, protect, and contain resistance. With other collaborators, NHS England is undertaking efforts to emphasise the system approach to stewardship of antimicrobials, infection prevention, and control measures.
What is AMR, and Why is it Important?
Antimicrobial resistance is a process by which bacteria, viruses and certain other microorganisms tend to be insensitive to the antimicrobial agents usually applied to get rid of them. AMR is a threat in healthcare because minor operations become high risk because of resistant infections. This resistance is easily transmissible through human-animal contact with the environment and is a global concern.
The UK’s AMR National Action Plan protects antimicrobials through smarter use and continuous assessment. NHS England is responsible for delivering results that meet the NAP's goal to ensure that antibiotics are used for as long as possible.
Commitment 1: Antimicrobial Stewardship and Disposal
One of the action plan's priorities is stewardship, which is the responsible use of antimicrobials to reduce the emergence of resistance.
Better Prescribing Practices
NHS England and other partners are trying to change prescribers’ behaviour to address this issue. Antibiotics should only be given when necessary, and clinical decision-support tools guide doctors to prescribe appropriately. As a result, the likelihood of resistance is greatly minimised when prescriptions are not given unnecessarily.
Safe Disposal of Antimicrobials
Antimicrobials must be disposed of properly to avoid polluting the environment. NHS England insists on proper waste disposal in healthcare institutions and individuals; people are advised to return unused antibiotics to the pharmacy instead of disposing of them. This avoids the release of antibiotics into water systems and soils, which would only contribute to resistance.
Public Awareness and Behavioural Interventions
Antimicrobial stewardship is an important concept in public education. Programs such as “Keep Antibiotics Working” aim to educate people on the right use of antibiotics. They also decrease the public demand for antibiotics from doctors and change the perception about the use of antimicrobials.
By these measures, the UK hopes to minimise the cases of unnecessary use of antibiotics in human and animal health. NHS England leads these efforts in human health, and similar action is encouraged for animal health through collaboration with veterinarians and farmers.
Commitment 2: Building a Skilled Workforce
Proper staff education is critical to the proper use of antimicrobials. The UK is developing this capacity through training and capacity building in healthcare, veterinary services, and agriculture.
Training for Healthcare Workers
NHS England continues to train doctors, nurses, and pharmacists on AMR and how to prescribe antimicrobials effectively. AMR information aimed at healthcare professionals provides them with the necessary information and could thus help reduce the risk of antibiotic resistance.
Improving Veterinary and Agricultural Practices
Consequently, antibiotics are commonly used in animal farming as a preventive measure, which makes their proper application in such cases extremely important. The action plan also provides some recommendations for veterinarians and farmers, with the main message being only to use antimicrobials when required. Good animal hygiene and biosecurity measures replace the use of antibiotics in the animals’ treatment.
Enhanced Governance and Policies
NHS England and partner organizations are developing improved policies for antimicrobial stewardship in healthcare facilities. The policies provide specific recommendations concerning the management of antimicrobials, act as surveillance to assure proper usage and create common strategies in hospitals and healthcare facilities.
How the NHS is Tackling AMR
The NHS Long-term plan also explains how the NHS is involved in combating AMR. Under the NAP, NHS England guarantees the availability of the right antimicrobials, maintains preventive measures such as vaccines, and provides diagnostics in hospitals and community health care. Infection prevention and antimicrobial stewardship are key areas in the LTP that will have clinical resources for subject matter experts and leadership.
NHS England has established a national AMR program to advance the NAP's human health goals. The program is organized into several workstreams:
- Antimicrobial Subscription Model: Implementing a payment structure for a sustainable procurement of essential antimicrobials.
- Antimicrobial Prescribing and Medicines Optimisation: Enhancing the appropriate use of antimicrobials to reduce the amount of time patients are on these drugs.
- Data Management: Improving the data gathering and exchange process to track the development of AMR.
- Diagnostics: Backup tools that can help diagnose infections and treat them as early as possible.
- Infection Prevention and Control: Measures that can help avoid spreading infections.
- Urinary Tract Infections: To look at the antibiotic use for UTIs, which are recurring infections normally treated with antibiotics.
A senior responsible officer chairs every work stream, and the NHS England National Medical Director, Prof Sir Stephen Powis, chairs the NHS AMR Board. The NHS also supports AMR leads throughout its seven regions to offer local support for antimicrobial stewardship and infection control.
Advancements in AMR Surveillance and Data Sharing
Another is enhancing data acquisition and dissemination. Accurate data enables healthcare providers and policymakers to make appropriate decisions and address AMR trends appropriately. NHS England and other stakeholders have embarked on efforts to improve the surveillance of AMR in real time.
The UK has good technology for early detection of resistant strains, such as genome sequencing. This “One Health” approach combines human, animal, and environmental health to allow the UK to track resistance patterns and change policies as necessary.
The Road Ahead
Even though the NHS has led the way in AMR, it remains difficult and important. NHS England and partner organisations have a vested interest in ensuring that the goals mentioned in the National Action Plan are achieved through training healthcare workers, improving the practice of veterinarians, and devising better ways of sharing data. This means that the UK is on the right trajectory in ensuring antimicrobials' sustainability for generations through stewardship, the right workforce, and better systems.
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References:
- England, N. (n.d.-a). NHS England » Antimicrobial resistance (AMR). https://www.england.nhs.uk/ourwork/prevention/antimicrobial-resistance-amr/#AMRnationalactionplan
- Department of Health and Social Care. (2024, May 8). UK 5-year action plan for antimicrobial resistance 2024 to 2029. GOV.UK. https://www.gov.uk/government/publications/uk-5-year-action-plan-for-antimicrobial-resistance-2024-to-2029
