Does a national NHS England incentive scheme to reduce inappropriate antibiotic prescribing in primary care deliver improvement?
PHE ePoster Library. Beech E. Sep 10, 2018; 221168; 19
Elizabeth Beech
Elizabeth Beech
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Abstract
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Abstract Antimicrobial resistance is a national and global threat and one of the UK Antimicrobial Resistance Strategy objectives is optimising antimicrobial prescribing practice. How effective has use of the NHS England 'Quality Premium' incentive scheme been at reducing inappropriate antibiotic prescribing in primary care? All 209 NHS Clinical Commissioning Groups (CCGs) participated in both FY2015/16 (Year1) and FY2016/17 (Year2), to reduce: antibiotic prescribing rates (Antibacterial Items/STAR-PU), and the number and proportion of broad spectrum antibiotic items, to individual CCG and national targets in each year from a fixed 2013/14 baseline. Year1: 201/209 (96%) CCGs met/ exceeded the 1% reduction target from baseline, delivering an 8.3% all-England reduction in Antibacterial items/STAR-PU; equivalent to a 2.7 million antibiotic prescription item reduction in Year1 from 37,033,310 to 34,337,167 items. The CCG median item reduction was 7.1%; range -15.9% to + 8.1%. Two CCGs increased antibiotic prescribing items by 4.8% and 8.1%. Year2: 183/209 (88%) CGGs met/exceeded the greater 4% reduction target from baseline, or remained 'at or below' the national target. 174/209 (83%) CCGs met/exceeded their reduction target for broad spectrum antibiotics. After 2 years 201/209 (96%) CCGs had reduced antibiotic prescribing, delivering an all-England reduction of 2,714,126 antibiotic prescription items; and 152/209 (73%) CCGs were at or below the national Antibacterial items/STAR-PU target. Broad spectrum antibiotic prescribing reduced by 23%; a reduction of 904,881 items, and the median CCG reduction was 21% (range -47.9% to + 8.3%).The NHS England Quality Premium successfully reduced inappropriate antibiotic prescribing in most NHS Clinical Commissioning Groups
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