NHS England launches national programme to combat antibiotic overusage

NHS England has today launched the world’s largest healthcare incentive scheme for hospitals, family doctors and other health service providers to prevent the growing problem of antibiotic resistance.

Launched against the backdrop of the International Patient Safety Conference taking place at Lancaster House in London today, funding will be made available to hospitals and other providers that reduce the inappropriate use of antibiotics.

Antibiotic resistance is one of the most significant threats to patients’ safety worldwide and is driven by overusing antibiotics and prescribing them inappropriately. Infections with antibiotic-resistant bacteria increase levels of disease and death, as well as the length of time people stay in hospitals. As resistance in bacteria grows, it will become more difficult to treat infection, and this affects patient care.

The World Health Organisation has estimated that antimicrobial-resistant infections currently claim at least 50,000 lives each year across Europe and the US. A review  by Jim O’Neil last year found that unless action is taken then there could be 10 million worldwide deaths each year attributable to antrimicrobial resistance in coming decades.

The NHS’ new programme, which goes live in April 2016, will offer hospitals incentive funding worth up to £150 million to support expert pharmacists and clinicians review and reduce inappropriate prescribing. In addition, a typical local Clinical Commissioning Group with a population of 300,000 people could receive up to £150,000 a year to support GP practices improve their antimicrobial prescribing.

Clinical commissioning groups are being supported to reduce the number of antibiotics prescribed in primary care by 4%, or to the average performance levels of 2013/14. Hospital trusts will also receive payments for gathering and sharing evidence of antibiotic consumption and review within 72 hours of the beginning of treatment. Information will be available for commissioners to review on a dedicated website and will allow them to directly monitor progress. Further payments will be made for reducing the use of specific types of drug which are used to treat a wide range of bacteria. These so-called ‘broad spectrum’ antibiotics need to be reserved to treat resistant disease and should generally be used only when standard antibiotics are ineffective.

The payments form part of two schemes that reward excellence and quality improvement in the NHS: the 2016/17 Commissioning for Quality and Innovation (CQUIN), where it will be worth an extra 0.25% of trusts’ budgets; and the Quality Premium scheme, which is paid per patient to clinical commissioning groups that successfully deliver the proposed measures.

Simon Stevens, Chief Executive of NHS England, said: “Antimicrobial resistance is a major threat to patient safety and the quality of care. These measures will build on the vital work the NHS is already doing to tackle the overuse and inappropriate prescription of antibiotics, so that in years to come patients can continue to be protected from otherwise lethal infections.”

Professor Dame Sally Davies, Chief Medical Officer for England, said: “The NHS, governments and industry all have key role to play in combating antimicrobial resistance which poses a catastrophic global threat. These measures will put the NHS at the forefront of meeting this challenge.”

Paul Cosford, ‎Director for Health Protection and Medical Director at Public Health England, said: “Tackling antimicrobial resistance is rightly a national and international priority. One key action in work to slow resistance is ensuring all antibiotics are appropriately prescribed and that these prescriptions are regularly reviewed. I am delighted the NHS is taking action to address this through its Commissioning for Quality and Innovation guidance. Public Health England will work with NHS England to support the effective implementation of this guidance and we will continue to improve antimicrobial prescribing and stewardship programmes across the wider health system.”


  1. kevin riley says:

    All these initiatives are concealing the reality that the NHS is now no longer “national” since the removal of the NHS from democratic control as a result of the fundamental changes introduced by the last Conservative led Government in 2013.
    Even NHS England cannot guarantee that any identified “improvements” are actually implemented by the now “independent” NHS Foundation trusts and Clinical Commissioning Groups – neither can Jeremy Hunt or the Department of Health.

  2. Ah-fee Chan says:

    Very good initiative
    Difficult problem but needs to be addressed Sadly we do not have a single good marker of infection and over the years how to look after the immune system have been ignored
    I reckon educating people to look after their immune system will save us millions on antibiotics
    Very fine line between infection and inflammation

    There is overuse of antibiotic no doubt one of the most abused drugs in the NHS

  3. Paul Crouch says:

    Cutting directly prescribed items is a distraction from the main culprit in antibiotic resistance.

    The independent Jim O’Neil report concluded that the amount of antimicrobials used in food production internationally is at least the same as that in humans, and in some places is higher. For example, in the US more than 70% of antibiotics that are medically important for humans are used in animals.

    Full report available

  4. Wendy Thompson says:

    How will these funds be made available to reduce antibiotic prescribing in primary dental care? You will be aware that in some parts of the country- especially in the NorthWest of England – general practice dentists account for around 10% of all NHS antibiotic prescriptions. Yet commissioning is not via CCGs. Could some of the funds be allocated to the Central Commissioning Board for this purpose?

  5. Chris Reid says:

    I have never heard or read a poorer excuse for making cuts in in prescription cost’s. Surely it is the GP’s judgement as to what medication is to be prescribed. If antibiotics are needed then so be it.
    Since when was it the area of expertise of accountants to decide what doctors can prescribe. Maybe the members of the NHS England team should ask themselves if they have not sold their souls from being medics to accountants. Why not allow the free prescription of a suicide pill it will save the NHS a fortune. This type of interference in medical prescribing shows that money is more important than people. This continuous dripping of government propaganda will back fire.
    Yours sadly
    Chris Reid

    • Sue Hickman says:

      If antibiotics are genuinely needed then of course they should be prescribed – the correct antibiotic, correct dose and duration. This does not always happen. A simple audit of antibiotic prescribing, e.g. co-amoxiclav, in any GP practice will confirm this.
      When comments such as ‘probably viral gave antibiotics anyway’ are recorded in patient notes, it is clear antibiotics are not being prescribed ‘with expertise’.
      It is very cynical of Chris Reid to suggest that the risk of antibiotic resistance is being promoted to save money.