In Calderdale, primary care teams are using new generation dual point-of-care testing (POCT) across all five primary care networks’ hubs to distinguish viral vs bacterial respiratory illnesses in patients. This improves clinical confidence, diagnosis and reduces antibiotic use in the community and avoids unnecessary hospital attendance or admissions.

Why winter brings extra pressure

Every winter, respiratory illnesses surge. From coughs and colds to more serious infections, these conditions put growing additional demands on GP practices and hospitals. Often patients expect antibiotics “just in case,” but many respiratory infections are viral, which means this type of treatment would be ineffective. Overprescribing antibiotics fuels antimicrobial resistance (AMR), one of the biggest health threats worldwide.

It was this reliance on antibiotics that drove the Calderdale team to try something different.

Since 2023 the team have been trialing Point of Care Testing (POCT) in their Winter ARI hubs as a quick, reliable way to tell if an infection is bacterial or viral, right there in the consultation room, so they can assess whether antibiotics or other treatments such as anti-virals will be the most effective.

Clinicians in Calderdale offer patients coming to see them with acute respiratory infection symptoms a NICE-approved test called FebriDx. It’s a simple finger-prick blood test that checks two biomarkers (CRP and MxA) to distinguish between viral and bacterial infections. Results are ready in about 10 minutes.

This means clinicians can make evidence-based decisions on whether antibiotics are needed, reducing unnecessary prescriptions and giving patients confidence in their care. It also provides clinicians with additional confidence about their diagnostic decisions and approach.

Statistics for success

Calderdale introduced POCT in its Acute Respiratory Infection (ARI) hubs, which provide same-day appointments across the North East and Yorkshire region for patients with urgent respiratory symptoms. In Calderdale there are five hubs, one for each Primary Care Network.

The results have been dramatic, and have improved year upon year:

• 2023/24:
  • 56 tests performed
  • 4,035 appointments
  • 72% of patients booked received antibiotics
• 2024/25:
  • 1,420 tests performed
  • 4,766 appointments
  • Only 24% of patients booked received antibiotics
• Overall:
  • 61% decrease in antibiotic prescriptions compared to the previous winter

Feedback for the initiative has also been overwhelmingly positive with Clinicians reporting improved confidence and fewer re-consultations and 85% of patients said the test was useful and reassuring.

From the clinician’s point of view the results have been no less impressive – 45% of the time the clinician changed their decision after using point of care test and 96% of the time they were satisfied with the result leading to greater confidence in the new way of working.

Implementation in practice

If a clinician is considering antibiotics, they run the test during the appointment. Patients can wait for results or receive them via text message, along with instructions to collect a prescription if needed.

Supporting the aims of the 10 year plan

In Calderdale this innovation has meant:

• Faster, safer care closer to home
• Fewer unnecessary hospital visits
• Reduced spread and better control of antibiotic resistance
• Happier patients and clinicians

All of which supports the 10 Year Plan’s hospital to community shift

By March 2025, 75% of Calderdale GP practices will use POCT during winter, with full rollout planned by March 2026. Community teams, including care home services and respiratory nurses, are also embedding POCT, allowing more illnesses to be treated without the need for hospital admittance.