Guidance for integrated care boards (ICBs) and NHS providers on delivering the antimicrobial prescribing targets set out in the UK 5-year action plan for antimicrobial resistance 2024 to 2029, and related national policy.
Purpose
This guidance supports ICBs and NHS providers with improvements towards:
- for all settings: the antimicrobial prescribing reduction targets set out in the UK national action plan (NAP) on antimicrobial resistance (AMR) 2024-2029
- for ICBs: the expectations set out in the Medium Term Planning Framework for ICBs’ five-year plans to support reducing exposure to antibiotics to meet milestones to be set out in this guidance
- for NHS trusts and NHS foundation trusts: the requirements of the NHS Standard Contract 2026/27 to safely reduce overall antibiotic use and increase the proportion of antibiotic use from the WHO Access Category
- for primary care providers: The NHS Oversight Framework metric for the percentage of children (aged 0 – 9) prescribed antibiotics in the last 12 months
As 70% of antibiotics are prescribed in general practice and 20% in hospitals, the strategies included in this guidance are primarily directed towards these settings, although many of the strategies are suitable for use in other care settings. Community and mental health trusts are invited to adopt the fundamental principles set out below, appropriate to each setting, and to develop local key performance indicators.
The associated recommendations are intended for antimicrobial stewardship (AMS) teams, commissioners, medical directors, chief pharmacists, directors of infection prevention and control, infection prevention and control (IPC) teams, consultant medical microbiologists and infectious diseases consultants, as well as executive leadership teams.
Resources to support implementation of these strategies are detailed in the appendix.
2. Context
The second UK National Action Plan on Antimicrobial Resistance, Confronting antimicrobial resistance 2024 to 2029, builds on previous progress and sets out commitments to help deliver the 20-year vision to contain, control, and mitigate AMR. The plan includes 2 targets for antimicrobial use:
- Target 4a: Reduce total antibiotic use in human populations by 5% from the 2019 baseline by 2029
- Target 4b: Achieve 70% of total antibiotic use from the Access category by 2029
Ambitions are set out below separately for ICBs and acute trusts, recognising the different characteristics of patients presenting to primary and secondary care, and to allow tracking of progress within each care setting.
A particular focus on reducing avoidable exposure to antibiotics in children under the age of 10 years is reflected in the NHS Oversight Framework for 2026 to 2027, including an ambition for further reduction to 25% or below (compared to 27% or below for 2025 to 2026).
The table below presents performance data for primary care and hospitals for the 2024-25 financial year alongside projections aimed at meeting NAP targets by 2029. Since the majority of antibiotic prescribing occurs in primary care, while the demand for broad-spectrum antibiotics (Watch and Reserve categories) is higher in hospitals, target allocations for percentage Access have been adjusted accordingly and reflect baseline positions.
Target 4a: by 2029, we aim to reduce total antibiotic use in human populations by 5% from the FY 2019-2020 baseline
| NHS consumption of antibiotics in primary care and hospitals in England Defined Daily Doses per 1000 inhabitants per day (DIDs) | 2019-2020 baseline value | 2024-2025 performance | Where we need to be to meet National Action Plan 2029 targets |
|---|---|---|---|
| Target 4a: by 2029, we aim to reduce total antibiotic use in human populations by 5% from the FY 2019-2020 baseline | |||
| Total | 17.892 | 17.310 | 16.997 |
| Primary Care | 14.208 | 13.491 | 13.498 |
| Hospital | 3.682 | 3.819 | 3.499 |
Target 4b: by 2029, we aim to achieve 70% of total use of antibiotics from the Access category
| NHS consumption of antibiotics in primary care and hospitals in England Defined Daily Doses per 1000 inhabitants per day (DIDs) | 2019-2020 baseline value | 2024-2025 performance | Where we need to be to meet National Action Plan 2029 targets |
|---|---|---|---|
| Total | 60.8% | 62.2% | 70% |
| Primary Care | 63.4% | 65.1% | 73% |
| Hospital | 50.6% | 52.3% | 61% |
Data supplied by UK Health Security Agency.
3. Recommended strategies to meet the NAP ambitions
Target 4a: Strategies to reduce total antibiotic consumption
Reducing unnecessary antibiotic exposure in children
NHS Oversight Framework 2025-26 – Children aged 0-9 prescribed antibiotics in primary care: ICBs are expected to reduce children’s antibiotic exposure in primary care to at or below 25% by March 2026. Performance is reported here: NHS Oversight Framework 2025-2026 – ICB performance dashboard: Children prescribed antibiotics in primary care, with resources to support improvement (Futures collaboration platform, log in is required) and patient information also available.
Prescribing the shortest effective treatment course
Dashboards to support optimising antimicrobial duration in primary care have been developed by the NHS England AMR Programme using NICE antimicrobial stewardship guidance content. Performance is reported here: Antimicrobial stewardship. Resources supporting improvement are published on the Futures collaboration platorm and within the TARGET toolkit. Indicative targets for these metrics have been set for achievement by March 2029. Targets are based on the mean performance of the top performing quartile, and are as follows:
- Amoxicillin 500mg capsules – at least 80% of items for 5-days
- Doxycycline 100mg capsules – at least 55% of items for 5-days
- Flucloxacillin 500mg capsules – at least 40% of items for 5-days
- Phenoxymethylpenicillin 250mg tablets – at least 50% of items for 5-days
- Clarithromycin 500mg tablets – at least 50% of items for 5-days
- Lymecycline 408mg capsules – less than 20% of patients treated for longer than 24 weeks
Optimising antimicrobial duration in secondary care: NICE antimicrobial stewardship guidance recommends use of shorter antibiotic courses in infections commonly treated in secondary care. Resources supporting improvement are published on Futures. At present, performance cannot be routinely assessed using a national dataset so providers should use local audit and quality improvement approaches to drive improvement. This should include effective stewardship of discharge prescriptions and pre-packs to avoid oversupply.
Implementing the Antibiotic Review Kit for Hospitals (ARK)
Evidence from a stepped-wedge cluster-randomised trial across 39 NHS hospitals shows that implementation of ARK led to sustained reductions in antibiotic consumption with no adverse effects on mortality. Use of the ARK decision aid, with a mandatory 72-hour hard stop on antibiotic prescriptions unless reviewed, was associated with reductions in mortality over time. These findings support the use of ARK as a safe and effective intervention to reduce antibiotic overuse in acute hospital settings
Target 4b: Strategies to increase proportion of Access antibiotics to 70% across the human health system
This will be achieved by reaching a minimum of 73% Access antibiotic use in primary care and 61% in secondary care by 2029, through the following actions:
Reduce inappropriate prescribing of long-term azithromycin
Optimising azithromycin use in people with chronic obstructive pulmonary disease (COPD): NICE guidance NG115 recommends reviewing prophylactic azithromycin at least every 6 months, continuing only if benefits outweigh risks (including resistance and smoking status). TARGET resources supporting implementation are published here: Antibiotic stewardship tools, audits and other resources: Antibiotic stewardship tools, audits and other resources | RCGP Learning
Promote doxycycline as an alternative to macrolide antibiotics
Where clinically appropriate for adults with a proven penicillin allergy NICE antimicrobial stewardship guidance recommends doxycycline for 5 days as an alternative to macrolides in adults with penicillin allergy.
Implementing the recommendations from “Reducing Watch and Reserve antibiotic consumption in hospitals – lessons learned from real-world practice”
Informed by thematic analysis of interviews with staff from trusts that successfully achieved a 10% reduction in prescribing of Watch and Reserve antibiotics:
- Strategy: develop a targeted antimicrobial stewardship strategy with a clear focus on reducing Watch and Reserve use, supported by a workplan to deliver reduction
- Guidelines: review and update prescribing guidelines to prioritise narrow-spectrum antibiotics for empirical therapy, include clear intravenous-to-oral switch guidance, specify evidence-based course lengths and improve accessibility of guidelines for point-of-care use which may include use of software applications
- Data: use data to identify areas of high Watch and Reserve use where there is limited antimicrobial stewardship or infection specialist oversight, to help target improvement efforts effectively
- Digital: optimising digital infrastructure to support antimicrobial stewardship, aligned with recommendations in the Digital Vision for Antimicrobial Stewardship
- Workforce: benchmark performance and ensure adequate antimicrobial stewardship resourcing
- Leadership (clinical): ensure antimicrobial stewardship team visibility in clinical areas by building strong, trusted relationships with frontline staff and making effective use of multidisciplinary expertise
Implementing timely IV to Oral Switch (IVOS) in secondary care
Timely IVOS is a key, evidence-based, antimicrobial stewardship intervention that supports delivery of national AMR action plan targets by improving patient outcomes and optimising NHS resources. Organisations should implement timely IVOS by adopting the national antimicrobial IVOS criteria. Resources to support implementation are available on Futures
4. System implementation
In line with the “Act now: protect our present, secure our future” letter sent to trust and ICB Chairs and CEOs in November 2025, systems and providers should develop and deliver an implementation plan for this guidance with clear annual milestones and performance reporting, supported by strong board-level oversight, including regular reporting from Infection Prevention and Control (IPC) and Antimicrobial Stewardship (AMS) teams on progress, risks, and required actions.
The Model Health System Antimicrobial Resistance dashboard includes metrics to support implementation of the national action plan and the NHS Oversight Framework.
Appendix 1: Resources to support implementation
Resources to support delivery of antimicrobial medicines optimisation strategies
| Resource | Supports delivery of: |
|---|---|
| NICE antimicrobial prescribing guidance | Optimising guideline content to promote appropriate use of Access category antibiotics Optimising antibiotic duration Promote delayed prescribing where suitable Provide self-care and safety netting advice Promote antibiotic sparing strategies (hydrogen peroxide cream for impetigo, analgesic ear drops for otitis media, methenamine for UTI prophylaxis, nasal corticosteroids for sinusitis)use appropriate diagnostics promptly Maximise use of clinical decision support and risk assessment tools (e.g. FeverPAIN, CURB-65) |
| UK Paediatric Antimicrobial Stewardship (UKPAS) network guidance | Optimising guideline content Ooptimising antibiotic duration |
| PrescQIPP NHS Oversight Framework 2025-2026 – ICB performance dashboard: Children prescribed antibiotics in primary care | Reducing unnecessary antibiotic use |
| Resources to support paediatric Antimicrobial Stewardship on Future NHS; including key messages for prescribers, patient information, training packs and webinars, point of prescribing alert templates, and back up prescribing resources. | Reducing unnecessary antibiotic use optimising antibiotic duration Promote delayed prescribing where suitable provide self-care and safety netting advice Maximise use of clinical decision support and risk assessment tools (for example, FeverPAIN) improve guideline adherence via digital tools, audit, and feedback |
| The Healthier together website contains resources to help parents and professionals recognise, prevent, and manage childhood infections. | Provide self-care and safety netting advice |
| Caring for children with coughs parent and carer information leaflet | Provide self-care and safety netting advice |
| PrescQIPP Optimising antimicrobial duration dashboards | Optimising antibiotic duration |
| Resources to support using the shortest effective course length on FutureNHS including key messages for prescribers, evidence to support use of shorter courses, infographics, guides to support implementation of point of prescribing alerts, and best practice case studies | Optimising antibiotic duration |
| Antibiotic Review Kit ARK Resources to support ARK implementation including education for healthcare professionals, a prescribing decision aid, data collection and feedback tools, a patient information leaflet and a champions networking forum. | optimising antibiotic durationimplement timely IV to Oral Switch (IVOS)maximise use of clinical decision support toolsestablish effective 48 to 72 hour review processes to reassess diagnosis and ongoing need for antimicrobials at in secondary care.improve guideline adherence using digital tools, audit, and feedback |
| Strategies to reduce Watch and Reserve antibiotic consumption in hospitals | Optimising guideline content Optimising antibiotic duration Implement timely IV to Oral Switch (IVOS)improve guideline adherence via digital tools, audit, and feedback Maximise use of clinical decision support tools Use diagnostics promptly and appropriately Establish effective 48 to 72 hour review processes |
| National antimicrobial IVOS criteria | Implement timely IV to Oral Switch (IVOS) |
| Resources to support timely appropriate IV to oral switch (IVOS) | Implement timely IV to Oral Switch (IVOS) Improve guideline adherence using digital tools, audit, and feedback |
| Digital vision for antimicrobial stewardship in England | Maximise use of clinical decision support tools Improve guideline adherence via digital tools, audit, and feedback |
| Antibiotic Prescribing Improvement Scheme Concepts to Enhance antimicrobial Stewardship (PISCES) | Optimising antibiotic duration Improve guideline adherence via digital tools, audit, and feedback Maximise use of clinical decision support tools |
| Back-up antibiotic prescribing: Good practice guide – All Wales Therapeutics and Toxicology Centre | Promote delayed prescribing where suitable |
| NHS England » NHS vaccination strategy | Increase vaccination uptake to prevent infections and reduce infection severity |
| TARGET toolkit 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 | Provide self-care and safety netting advice Maximise use of clinical decision support and risk assessment tools (for example, FeverPAIN, CURB-65)improve guideline adherence using digital tools, audit, and feedback Maximise adherence to antimicrobial guidelines – audit tools |
| TARGET ‘How to…?’ series supports primary care teams to review the appropriateness of antimicrobials in the evidence-based treatment and prevention of recurrent UTI, acne vulgaris, and COPD. | Reducing risk of recurrent infection Optimising antibiotic duration |
| Blood culture pathway | Use appropriate diagnostics promptly |
Appendix 2: ICB current performance and targets for 2029
ICB boundaries updates will be reflected in future performance updates.
East of England Region
| ICB | Percentage of children aged 0 to 9 years prescribed antibiotics in primary care; latest 12 months to Jan 2026 (target at or below 25%) | Current % Access as DDDs single month data; Jan 2026 (target 73% or above) |
|---|---|---|
| NHS Bedfordshire, Luton and Milton Keynes Integrated Care Board | 39.39% | 67.62% |
| NHS Cambridgeshire and Peterborough Integrated Care Board | 24.64% | 70.36% |
| NHS Hertfordshire and West Essex Integrated Care Board | 29.99% | 66.76% |
| NHS Mid and South Essex Integrated Care Board | 35.81% | 69.12% |
| NHS Norfolk and Waveney Integrated Care Board | 28.24% | 71.94% |
| NHS Suffolk and North East Essex Integrated Care Board | 27.02% | 68.28% |
London Region
| ICB | Percentage of children aged 0 to 9 years prescribed antibiotics in primary care; latest 12 months to Jan 2026 (target at or below 25%) | Current % Access as DDDs single month data; Jan 2026 (target 73% or above) |
|---|---|---|
| NHS North Central London Integrated Care Board | 24.21% | 66.79% |
| NHS North East London Integrated Care Board | 30.95% | 66.90% |
| NHS North West London Integrated Care Board | 25.58% | 68.47% |
| NHS South East London Integrated Care Board | 26.77% | 69.17% |
| NHS South West London Integrated Care Board | 27.30% | 64.69% |
Midlands Region
| ICB | Percentage of children aged 0 to 9 years prescribed antibiotics in primary care; latest 12 months to Jan 2026 (target at or below 25%) | Current % Access as DDDs single month data; Jan 2026 (target 73% or above) |
|---|---|---|
| NHS Birmingham and Solihull Integrated Care Board | 31.40% | 69.66% |
| NHS Black Country Integrated Care Board | 33.15% | 71.17% |
| NHS Coventry and Warwickshire Integrated Care Board | 24.16% | 67.59% |
| NHS Derby and Derbyshire Integrated Care Board | 27.41% | 74.26% |
| NHS Herefordshire and Worcestershire Integrated Care Board | 29.15% | 69.99% |
| NHS Leicester, Leicestershire and Rutland Integrated Care Board | 26.24% | 70.31% |
| NHS Lincolnshire Integrated Care Board | 26.04% | 69.76% |
| NHS Northamptonshire Integrated Care Board | 24.71% | 70.37% |
| NHS Nottingham and Nottinghamshire Integrated Care Board | 24.94% | 68.61% |
| NHS Shropshire, Telford and Wrekin Integrated Care Board | 27.84% | 73.07% |
| NHS Staffordshire and Stoke-on-Trent Integrated Care Board | 35.29% | 70.81% |
North East and Yorkshire Region
| ICB | Percentage of children aged 0 to 9 years prescribed antibiotics in primary care; latest 12 months to Jan 2026 (target at or below 25%) | Current % Access as DDDs single month data; Jan 2026 (target 73% or above) |
|---|---|---|
| NHS Humber and North Yorkshire Integrated Care Board | 28.16% | 67.79% |
| NHS North East and North Cumbria Integrated Care Board | 28.41% | 68.24% |
| NHS South Yorkshire Integrated Care Board | 29.76% | 69.01% |
| NHS West Yorkshire Integrated Care Board | 31.20% | 66.93% |
North West Region
| ICB | Percentage of children aged 0 to 9 years prescribed antibiotics in primary care; latest 12 months to Jan 2026 (target at or below 25%) | Current % Access as DDDs single month data; Jan 2026 (target 73% or above) |
|---|---|---|
| NHS Cheshire and Merseyside Integrated Care Board | 29.65% | 67.04% |
| NHS Greater Manchester Integrated Care Board | 29.56% | 69.04% |
| NHS Lancashire and South Cumbria Integrated Care Board | 29.61% | 70.86% |
South East Region
| ICB | Percentage of children aged 0 to 9 years prescribed antibiotics in primary care; latest 12 months to Jan 2026 (target at or below 25%) | Current % Access as DDDs single month data; Jan 2026 (target 73% or above) |
|---|---|---|
| NHS Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board | 25.05% | 64.51% |
| NHS Frimley Integrated Care Board | 33.11% | 66.15% |
| NHS Hampshire and Isle of Wight Integrated Care Board | 23.88% | 67.59% |
| NHS Kent and Medway Integrated Care Board | 25.89% | 68.26% |
| NHS Surrey Heartlands Integrated Care Board | 28.88% | 66.86% |
| NHS Sussex Integrated Care Board | 23.62% | 68.10% |
South West Region
| ICB | Percentage of children aged 0 to 9 years prescribed antibiotics in primary care; latest 12 months to Jan 2026 (target at or below 25%) | Current % Access as DDDs single month data; Jan 2026 (target 73% or above) |
|---|---|---|
| NHS Bath and North East Somerset, Swindon and Wiltshire Integrated Care Board | 23.74% | 71.20% |
| NHS Bristol, North Somerset and South Gloucestershire Integrated Care Board | 17.94% | 66.99% |
| NHS Cornwall and the Isles of Scilly Integrated Care Board | 25.77% | 72.48% |
| NHS Devon Integrated Care Board | 22.91% | 69.50% |
| NHS Dorset Integrated Care Board | 22.40% | 70.88% |
| NHS Gloucestershire Integrated Care Board | 22.52% | 66.55% |
| NHS Somerset Integrated Care Board |
Appendix 3: Acute trust current performance and targets for 2029
East of England Region
| Trust | Total DDDs 2019/20 baseline (target at or below baseline)* | Latest performance (12-month rolling data to Q3 2025/26) | Current % Access (latest data Q2 2025/26 – target 61% or above) |
|---|---|---|---|
| Bedfordshire Hospitals NHS Foundation Trust | 751,901 | 742,069 | 35.54% |
| Milton Keynes University Hospital NHS Foundation Trust | 340,347 | 393,931 | 46.55% |
| Cambridge University Hospitals NHS Foundation Trust | 680,496 | 890,086 | 45.25% |
| North West Anglia NHS Foundation Trust | 554,884 | 754,558 | 42.39% |
| Royal Papworth Hospital NHS Foundation Trust | 200,401 | 177,934 | 26.95% |
| East and North Hertfordshire NHS Trust | 492,957 | 609,954 | 44.40% |
| The Princess Alexandra Hospital NHS Trust | 372,165 | 335,122 | 40.95% |
| West Hertfordshire Teaching Hospitals NHS Trust | 415,434 | 469,697 | 42.93% |
| Mid and South Essex NHS Foundation Trust | 1,411,637 | 1,442,182 | 42.58% |
| James Paget University Hospitals NHS Foundation Trust | 270,732 | 278,105 | 46.95% |
| Norfolk and Norwich University Hospitals NHS Foundation Trust | 685,913 | 739,844 | 48.30% |
| The Queen Elizabeth Hospital, King’s Lynn, NHS Foundation Trust | 253,941 | 274,419 | 51.20% |
| East Suffolk and North Essex NHS Foundation Trust | 791,899 | 942,021 | 46.20% |
| West Suffolk NHS Foundation Trust | 284,156 | 328,928 | 46.67% |
London Region
| Trust | Total DDDs 2019/20 baseline (target at or below baseline)* | Latest performance (12-month rolling data to Q3 2025/26) | Current % Access (latest data Q2 2025/26 – target 61% or above) |
|---|---|---|---|
| Great Ormond Street Hospital for Children NHS Foundation Trust | No data | 109,888 | 20.30% |
| Moorfields Eye Hospital NHS Foundation Trust | 147,477 | 134,307 | 69.06% |
| Royal Free London NHS Foundation Trust | 1,448,427 | 1,635,567 | 49.86% |
| Royal National Orthopaedic Hospital NHS Trust | 48,365 | 52,982 | 41.41% |
| University College London Hospitals NHS Foundation Trust | No data | 767,679 | 55.26% |
| Whittington Health NHS Trust | 340,165 | 547,976 | 43.06% |
| Barking, Havering and Redbridge University Hospitals NHS Trust | 726,472 | 682,903 | 48.05% |
| Barts Health NHS Trust | 1,757,142 | 1,702,672 | 44.33% |
| Homerton Healthcare NHS Foundation Trust | 429,800 | 463,777 | 71.90% |
| Chelsea and Westminster Hospital NHS Foundation Trust | 1,129,695 | 2,338,441 | 89.56% |
| Imperial College Healthcare NHS Trust | 1,182,548 | 1,274,080 | 48.08% |
| London North West University Healthcare NHS Trust | 930,673 | 1,159,184 | 47.49% |
| The Hillingdon Hospitals NHS Foundation Trust | 346,883 | 413,676 | 47.20% |
| Guy’s and St Thomas’ NHS Foundation Trust | 1,596,423 | 1,581,319 | 51.01% |
| King’s College Hospital NHS Foundation Trust | 1,237,295 | 982,303 | 52.33% |
| Lewisham and Greenwich NHS Trust | 872,400 | 879,237 | 59.24% |
| Croydon Health Services NHS Trust | 513,792 | 588,183 | 55.09% |
| Epsom and St Helier University Hospitals NHS Trust | 630,218 | 591,975 | 50.69% |
| Kingston Hospital NHS Foundation Trust | 472,837 | 511,594 | 64.20% |
| St George’s University Hospitals NHS Foundation Trust | 606,792 | 647,716 | 45.69% |
| The Royal Marsden NHS Foundation Trust | 238,714 | 298,948 | 53.47% |
Midlands Region
| Trust | Total DDDs 2019/20 baseline (target at or below baseline)* | Latest performance (12-month rolling data to Q3 2025/26) | Current % Access (latest data Q2 2025/26 – target 61% or above) |
|---|---|---|---|
| Birmingham Women’s and Children’s NHS Foundation Trust | 176,508 | 65,392 | 36.65% |
| The Royal Orthopaedic Hospital NHS Foundation Trust | 48,607 | 61,474 | 63.30% |
| University Hospitals Birmingham NHS Foundation Trust | 2,011,854 | 2,032,709 | 48.60% |
| Sandwell and West Birmingham Hospitals NHS Trust | 427,938 | 367,768 | 59.49% |
| The Dudley Group NHS Foundation Trust | 547,550 | 573,058 | 60.26% |
| The Royal Wolverhampton NHS Trust | 539,961 | 598,836 | 60.06% |
| Walsall Healthcare NHS Trust | 292,056 | 360,141 | 73.34% |
| George Eliot Hospital NHS Trust | 212,397 | 300,890 | 49.13% |
| South Warwickshire University NHS Foundation Trust | 339,933 | 407,519 | 50.37% |
| University Hospitals Coventry and Warwickshire NHS Trust | 687,989 | 681,355 | 49.02% |
| Chesterfield Royal Hospital NHS Foundation Trust | 366,968 | 414,192 | 49.61% |
| University Hospitals of Derby and Burton NHS Foundation Trust | 1,047,043 | 1,217,489 | 52.73% |
| Worcestershire Acute Hospitals NHS Trust | 573,525 | 642,681 | 58.60% |
| Wye Valley NHS Trust | 196,639 | 217,698 | 55.76% |
| University Hospitals of Leicester NHS Trust | 1,106,423 | 1,141,205 | 48.27% |
| United Lincolnshire Teaching Hospitals NHS Trust | 597,238 | 733,034 | 43.71% |
| Kettering General Hospital NHS Foundation Trust | 339,347 | 433,027 | 53.72% |
| Northampton General Hospital NHS Trust | 413,724 | 438,203 | 60.64% |
| Nottingham University Hospitals NHS Trust | 1,046,669 | 1,254,527 | 54.62% |
| Sherwood Forest Hospitals NHS Foundation Trust | 414,900 | 379,725 | 53.31% |
| Shrewsbury and Telford Hospital NHS Trust | 457,827 | 470,117 | 66.93% |
| The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust | 39,373 | 39,629 | 56.65% |
| University Hospitals of North Midlands NHS Trust | 847,334 | 1,053,435 | 59.67% |
North East and Yorkshire Region
| Trust | Total DDDs 2019/20 baseline (target at or below baseline)* | Latest performance (12-month rolling data to Q3 2025/26) | Current % Access (latest data Q2 2025/26 – target 61% or above) |
|---|---|---|---|
| Harrogate and District NHS Foundation Trust | 227,489 | 282,261 | 70.33% |
| Hull University Teaching Hospitals NHS Trust | 677,279 | 774,947 | 68.88% |
| Northern Lincolnshire and Goole NHS Foundation Trust | 550,194 | 646,876 | 45.90% |
| York and Scarborough Teaching Hospitals NHS Foundation Trust | 607,724 | 738,052 | 69.12% |
| County Durham and Darlington NHS Foundation Trust | 573,902 | 662,091 | 52.87% |
| Gateshead Health NHS Foundation Trust | 300,906 | 335,411 | 68.14% |
| North Cumbria Integrated Care NHS Foundation Trust | 359,124 | 386,862 | 63.46% |
| North Tees and Hartlepool NHS Foundation Trust | 430,095 | 481,364 | 60.27% |
| Northumbria Healthcare NHS Foundation Trust | 557,874 | 656,153 | 57.85% |
| South Tees Hospitals NHS Foundation Trust | 583,781 | 709,467 | 50.13% |
| South Tyneside and Sunderland NHS Foundation Trust | 724,335 | 841,488 | 65.26% |
| The Newcastle Upon Tyne Hospitals NHS Foundation Trust | 1,011,566 | 1,084,835 | 52.20% |
| Barnsley Hospital NHS Foundation Trust | 420,770 | 391,434 | 51.50% |
| Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust | 573,710 | 670,013 | 54.95% |
| Sheffield Children’s NHS Foundation Trust | 110,508 | 122,131 | 47.46% |
| Sheffield Teaching Hospitals NHS Foundation Trust | 1,085,208 | 1,098,307 | 53.07% |
| The Rotherham NHS Foundation Trust | 329,215 | 334,284 | 54.06% |
| Airedale NHS Foundation Trust | 218,936 | 258,383 | 63.88% |
| Bradford Teaching Hospitals NHS Foundation Trust | 500,540 | 537,515 | 55.59% |
| Calderdale and Huddersfield NHS Foundation Trust | 502,056 | 604,879 | 57.52% |
| Leeds Teaching Hospitals NHS Trust | 1,054,604 | 1,109,675 | 55.32% |
| Mid Yorkshire Teaching NHS Trust | 765,499 | 883,714 | 60.11% |
North West Region
| Trust | Total DDDs 2019/20 baseline (target at or below baseline)* | Latest performance (12-month rolling data to Q3 2025/26) | Current % Access (latest data Q2 2025/26 – target 61% or above) |
|---|---|---|---|
| Alder Hey Children’s NHS Foundation Trust | 117,969 | 120,560 | 40.94% |
| Countess of Chester Hospital NHS Foundation Trust | 322,729 | 355,747 | 46.65% |
| East Cheshire NHS Trust | 234,403 | 200,418 | 67.55% |
| Liverpool Heart and Chest Hospital NHS Foundation Trust | 161,762 | 127,883 | 28.37% |
| Liverpool University Hospitals NHS Foundation Trust | 1,255,445 | 1,516,611 | 70.87% |
| Liverpool Women’s NHS Foundation Trust | 440,861 | 63,665 | 75.45% |
| Mersey and West Lancashire Teaching Hospitals NHS Trust | 992,951 | 1,024,868 | 63.59% |
| Mid Cheshire Hospitals NHS Foundation Trust | 302,449 | 353,907 | 63.02% |
| The Clatterbridge Cancer Centre NHS Foundation Trust | 25,794 | 140,441 | 60.39% |
| The Walton Centre NHS Foundation Trust | 33,106 | 40,894 | 53.85% |
| Warrington and Halton Hospitals NHS Foundation Trust | 323,381 | 403,664 | 62.37% |
| Wirral University Teaching Hospital NHS Foundation Trust | 379,178 | 395,034 | 45.96% |
| Bolton NHS Foundation Trust | 413,347 | 375,051 | 53.89% |
| Manchester University NHS Foundation Trust | 1,980,119 | 2,090,315 | 57.24% |
| Northern Care Alliance NHS Foundation Trust | 1,206,217 | 1,180,309 | 54.00% |
| Stockport NHS Foundation Trust | 428,178 | 361,857 | 62.90% |
| Tameside and Glossop Integrated Care NHS Foundation Trust | 276,211 | 349,017 | 60.73% |
| The Christie NHS Foundation Trust | 192,854 | 264,061 | 47.79% |
| Wrightington, Wigan and Leigh NHS Foundation Trust | 313,954 | 270,853 | 48.86% |
| Blackpool Teaching Hospitals NHS Foundation Trust | 481,226 | 548,106 | 56.95% |
| East Lancashire Hospitals NHS Trust | 665,848 | 796,544 | 62.11% |
| Lancashire Teaching Hospitals NHS Foundation Trust | 570,334 | 629,172 | 57.92% |
| University Hospitals of Morecambe Bay NHS Foundation Trust | 384,206 | 485,297 | 56.28% |
South East Region
| Trust | Total DDDs 2019/20 baseline (target at or below baseline)* | Latest performance (12-month rolling data to Q3 2025/26) | Current % Access (latest data Q2 2025/26 – target 61% or above) |
|---|---|---|---|
| Buckinghamshire Healthcare NHS Trust | 408,560 | 438,840 | 55.51% |
| Oxford University Hospitals NHS Foundation Trust | 856,050 | 925,027 | 57.21% |
| Royal Berkshire NHS Foundation Trust | 454,507 | 471,458 | 64.36% |
| Frimley Health NHS Foundation Trust | 820,715 | 875,428 | 59.43% |
| Hampshire Hospitals NHS Foundation Trust | 531,262 | 630,629 | 62.14% |
| Isle of Wight NHS Trust | 160,808 | 176,935 | 56.93% |
| Portsmouth Hospitals NHS Trust | 642,811 | 736,232 | 55.18% |
| University Hospital Southampton NHS Foundation Trust | 746,622 | 852,564 | 49.39% |
| Dartford and Gravesham NHS Trust | 465,671 | 449,466 | 61.10% |
| East Kent Hospitals University NHS Foundation Trust | 716,353 | 793,741 | 48.28% |
| Maidstone and Tunbridge Wells NHS Trust | 544,268 | 677,992 | 59.49% |
| Medway NHS Foundation Trust | 348,669 | 415,631 | 40.64% |
| Ashford and St Peter’s Hospitals NHS Foundation Trust | 332,130 | 367,597 | 53.36% |
| Royal Surrey County Hospital NHS Foundation Trust | 302,734 | 354,782 | 45.80% |
| Surrey and Sussex Healthcare NHS Trust | 433,528 | 522,160 | 48.81% |
| East Sussex Healthcare NHS Trust | 447,981 | 523,763 | 49.72% |
| Queen Victoria Hospital NHS Foundation Trust | 56,010 | 66,530 | 42.14% |
| University Hospitals Sussex NHS Foundation Trust | 1,211,214 | 1,417,485 | 63.61% |
South West Region
| Trust | Total DDDs 2019/20 baseline (target at or below baseline)* | Latest performance (12-month rolling data to Q3 2025/26) | Current % Access (latest data Q2 2025/26 – target 61% or above) |
|---|---|---|---|
| Great Western Hospitals NHS Foundation Trust | 430,562 | 448,338 | 53.21% |
| Royal United Hospitals Bath NHS Foundation Trust | 398,360 | 474,902 | 61.68% |
| Salisbury NHS Foundation Trust | 277,522 | 302,160 | 52.05% |
| North Bristol NHS Trust | 427,162 | 501,319 | 58.29% |
| University Hospitals Bristol and Weston NHS Foundation Trust | 736,962 | 716,737 | 51.73% |
| Royal Cornwall Hospitals NHS Trust | 397,290 | 544,099 | 69.40% |
| Royal Devon University Healthcare NHS Foundation Trust | 725,127 | 898,060 | 69.09% |
| Torbay and South Devon NHS Foundation Trust | 387,232 | 450,631 | 63.16% |
| University Hospitals Plymouth NHS Trust | 629,671 | 783,370 | 50.95% |
| Dorset County Hospital NHS Foundation Trust | 181,719 | 233,404 | 55.01% |
| University Hospitals Dorset NHS Foundation Trust | 700,018 | 762,946 | 61.23% |
| Gloucestershire Hospitals NHS Foundation Trust | 626,549 | 645,814 | 54.29% |
| Somerset NHS Foundation Trust | 719,892 | 773,284 | 73.81% |
*An admissions-based denominator is no longer used to align this metric to the population-based targets in the AMR national action plan, to account for inclusion of antibiotic consumption in both inpatient admissions and outpatient, and urgent and emergency care attendances and expected changes in admission volumes arising from the NHS 10 Year Plan shift of care into community settings. It also supports more timely and accurate data availability owing to limitations in admissions data quality.
Publication reference: PRN02449iii