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A GP surgery is leading the way in the fight against antibiotic resistance with simple tests that dramatically reduce unnecessary prescribing.
Attenborough Surgery in Bushey, Hertfordshire, was awarded £10,000 “acorn” funding in the 2015/16 NHS Innovation Challenge Prizes to further develop its system of point-of-care fingerprick blood tests which help clinicians decide whether antibiotics are really necessary for patients who visit with respiratory infections.
Spearheaded by Advanced Nurse Practitioner Liz Cross, all patients visiting the surgery with chesty coughs in winter 2015/16 were given the quick blood test, which shows levels of C-reactive Protein (CRP), a biomedical marker of bacterial infections. This allowed nurse practitioners to reduce antibiotics prescribed by 23 per cent.
Following further warnings from Chief Medical Officer Sally Davies about the growing threat of antimicrobial resistance, and the publication of the Lord Jim O’Neill’s report Tackling Drug-Resistant Infections Globally, surgery staff have this week travelled to Westminster to lead workshops with MPs and peers to demonstrate the practical action they are taking. This winter, the Challenge Prize funding will support the team to roll out the testing across ten other sites.
Liz said: “The test gives us the confidence we need to be able to sensibly restrict antimicrobial prescribing, while making sure those who really do have an established bacterial infection get the antibiotics they need.
“Another great thing about carrying out these four-minute tests is that they also give the patient confidence that they are getting the treatment they need despite having no antibiotic prescription, so they are less likely to come back to the surgery for further reassurance. We saw a fall of more than 50% in unscheduled follow-up visits by these patients.”
Lord O’Neill’s report recommends that by 2020 all antibiotic prescribing is informed by data and diagnostics like the CRP test, because inappropriate prescribing in GP surgeries and primary care centres is a big driver of resistance. Almost three quarters of all antibiotics are prescribed in primary care, and the experience at Attenborough surgery adds to evidence that many of these are inappropriate.
Liz said: “We were provided with the equipment we needed as part of the pilot project, so the biggest barrier to wider adoption of these tests is finding an acceptable funding model to support them across a bigger footprint. Although the tests are carried out in general practice, the benefits are reaped in the wider community with reduced prescription costs and less demand for unscheduled care.
“The challenge prize funding means we will be rolling out to 10 further practices this winter; focusing on antibiotics prescribing and unscheduled follow up rates to further strengthen our business case for full roll out across the CCG. Our experience has shown that the testing is definitely worth it!”