Failing antibiotics are everybody’s problem

In the latest of our series of blogs marking World Antibiotic Awareness Week, Sally Kingsland, NHS England (London) Clinical Quality Manager and Infection Prevention and Control Lead Nurse, and Lauren Mosley, NHS England Patient Safety Systems and Liaison Manager, examine the threat posed by antimicrobial resistance:

Sally Kingsland: As lead nurse for infection prevention and control in London I see the impact of antimicrobial resistance on a daily basis.

The public are very aware of MRSA and the great work that has been done to reduce the spread across our health services. However, there are an increasing number of organisms that are developing resistance to antibiotics – this is a significant challenge to all health and social care providers.

The requirement for enhanced patient screening and isolation requirements related to these organisms are, and will, continue to place a huge burden on services. Bed or ward closures are a common occurrence, as are delayed discharges for patients colonised with drug resistant organisms while appropriate packages of care are agreed.

Listening to patient stories gives you a real sense of the significant impact of the spread of antibiotic resistance on the quality of individual patient care and the ripple effect that this has on other services in terms of capacity, facilities and treatments available, as well as personal and financial costs. As this pressure increases, the impact is felt by all health and social care providers – this makes this issue very much everybody’s problem.

In London I am working to make sure that antimicrobial resistance is discussed across all relevant platforms including clinical networks, finance, contracts and performance teams to look at creative ways of addressing tomorrow’s crisis in today’s actions. The role of nurses in antimicrobial stewardship is key and we are working with Public Health England to explore how we can promote awareness and innovation.

Across London we are also looking at creative ways of managing our current issues. One example being the recent identification of a London lead to facilitate the transfer of patients colonised with antimicrobial resistant organisms from acute trusts to appropriate neuro-rehabilitation services. This will ensure there are no delays or disruption to the patient’s rehabilitation or recovery.

Pragmatic patient focused work is required if we are to support our services to provide good quality safe care.

Lauren Mosley: Having started my career working as part of the medicines safety team within an acute hospital trust, I have been fortunate enough to work alongside colleagues leading work to improve antimicrobial stewardship across a large organisation. Their hard work ensured this became a key priority for the organisation and their determination to change perception and behaviour resulted in significant changes to practice.

Working as part of NHS England’s national Patient Safety Domain, I see similar efforts reflected across the healthcare system and this – together with the work of national healthcare safety and policy leads – has no doubt contributed to the improvements we have seen in relation to, for example, the reduction and spread of C. diff and MRSA infection.

What is clear, however, is that working independently of one another will only ever get us so far and we need to adjust our focus.

Matters relating to the responsible use of antibiotics are not isolated to certain patient groups, services or conditions. Neither are these matters relevant to healthcare professionals alone; too often antibiotics are seen as the readily available ‘fix all’ medicine and this must not be the case.

As patients, members of the public, healthcare and/or policy professionals we cannot afford to overlook the risks associated with using these lifesaving drugs in an irresponsible way. It is terrifying to think of the number of common conditions, treatments and interventions that will become life-threatening if we do.

Working with national antimicrobial resistance (AMR), policy and safety leads I will continue to seek the most effective tools and levers that are available to us to promote and address this vitally important agenda across professional and organisational boundaries.

We must work together to protect against the misuse of these vitally important medicines. The consequences are too great if we don’t.

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Sally Kingsland

Sally Kingsland is the Clinical Quality Manager for North Central and East London and Infection Prevention and Control lead for NHS England (London).

She qualified as a nurse in 1996 and has a degree and Masters in Public Health.

Sally has worked across the acute, community, social care and health and justice sectors and her current role within NHS England’s nursing directorate is to support the quality improvement, system leadership, direct commissioning and assurance functions of the organisation.

She is a member of the national Infection Prevention and Control Steering Group and the NHS England Antimicrobial Resistance Strategy Implementation Group.

Lauren Mosely

Lauren Mosely joined the NHS England Patient Safety Domain in 2013 where she works as Patient Safety Systems and Liaison Manager, contributing to a wide variety of programmes.

She is also responsible for the development of national policy associated with the management of Serious Incidents and, more recently, working with the NHS England Antimicrobial Resistance (AMR) team to support the development of the NHS England Strategy and work plan to address UK AMR priority areas.

Lauren has a Masters in pharmaceutical science and previously worked as a medicines safety coordinator at United Lincolnshire Hospitals Trust, where she worked to deliver projects to improve the safe prescribing and administration of medicines.