Conclusion, resources and PQS requirements
Conclusion
All people working in the healthcare system have a responsibility to use antibiotics wisely. This involves only using them when strictly necessary, at the correct dose, and for the correct duration of treatment. Pharmacists and their teams already have a key role to play in facilitating this process and in enabling good antimicrobial stewardship. Pharmacy First and similar common conditions schemes will only enhance this role still further.
Resources
NICE guideline [NG15], 2015. Antimicrobial stewardship: systems and processes for effective antimicrobial medicine use.
TARGET antibiotics toolkit hub, hosted by RCGP. TARGET stands for Treat Antibiotics Responsibly, Guidance, Education and Tools. It is a toolkit designed to support primary care clinicians to champion and implement antimicrobial stewardship activities. It has a section on discussing antibiotics with patients. There is now a section on resources for community pharmacy.
Antibiotic Guardian and Antibiotic Awareness: key messages on antibiotic use.
Antibiotic Guardian. This encourages healthcare organisations, GP practices, hospitals, community pharmacies, farmers, patients and the public to pledge towards responsible use of antibiotics. It includes useful information, resources and links to toolkits for healthcare professionals and the public.
Pharmacy Quality Scheme
The requirements of the Pharmacy Quality Scheme in England relating to AMS are listed below:
Requirements:
The PQS for 2023-24 states that “pharmacy staff must have reviewed their practice to include two TARGET leaflets: Treating Your Infection – Urinary Tract Infection (UTI) and Treating Your Infection – Respiratory Tract Infection (RTI)” to help them assess patients presenting at the pharmacy for advice who have not already seen a GP or other healthcare professional for the current illness, provide tailored advice and promote awareness of AMR and AMS. Pharmacies received a laminated copy of both leaflets from the UK Health Security Agency (UKHSA) as part of last year’s PQS 2022/23.
By the end of March 2024, all patient-facing staff that provide health advice working in the pharmacy must have become Antibiotic Guardians, and have an awareness of the local antibiotic formulary and how to access it. Available data indicates that most community pharmacy staff have already become Antibiotic Guardians since 2020. The introduction of the Antibiotic Guardian pledge as part of the PQS in 2020/21 led to large increases in pledges from pharmacy teams in England in 2020 (28,369 pledges) and 2021 (27,334 pledges).
By the end of March 2024, community pharmacies must have available an AMS Action Plan for their pharmacy. The Action Plan should include details of how they will promote AMS and how all pharmacy staff involved in the provision of self-care advice will incorporate the principles of AMS into this advice, including reinforcing the messages around appropriate use of antibiotics and the uptake of vaccinations, including the flu vaccine.