Abstract
Background: In order to tackle the public health threat of antimicrobial resistance, improvement in antibiotic prescribing in primary care was included as one of the priorities of the Quality Premium (QP) financial incentive scheme for Clinical Commissioning Groups (CCGs) in England. This paper briefly reports the outcome of a workshop exploring the experiences of antimicrobial stewardship (AMS) leads within CCGs in selecting and adopting strategies to help achieve the QP antibiotic targets. Methods: We conducted a thematic analysis of the notes on discussions and observations from the workshop to identify key themes. Results: Practice visits, needs assessment, peer feedback and audits were identified as strategies integrated in increasing engagement with practices towards the QP antibiotic targets. The conceptual model developed by AMS leads demonstrated possible pathways for the impact of the QP on antibiotic prescribing. Participants raised a concern that the constant targeting of high prescribing practices for AMS interventions might lead to disengagement by these practices. Most of the participants suggested that the effect of the QP might be less about the financial incentive and more about having national targets and guidelines that promote antibiotic prudency. Conclusions: Our results suggest that national targets, rather than financial incentives are key for engaging stakeholders in quality improvement in antibiotic prescribing.
Highlights
Clinical Commissioning Groups (CCGs) were established in the English National Health Service (NHS) in April 2013 as the statutory bodies responsible for the planning and commissioning of health care services for their local area [1]
Our paper summarises the strategies and activities reported by a selection of CCGs in England to facilitate antibiotic stewardship in primary care practices towards achieving the Quality Premium (QP) antibiotic targets
We demonstrated possible pathways for the impact of QP on antibiotic prescribing in the conceptual model co-developed with CCG antimicrobial stewardship (AMS) leads who are important users of AMS policy evaluation research
Summary
Clinical Commissioning Groups (CCGs) were established in the English National Health Service (NHS) in April 2013 as the statutory bodies responsible for the planning and commissioning of health care services for their local area [1]. Antibiotics 2020, 9, 44 improving antibiotic prescribing in primary care practices was included as one of the QP national priorities in the 2015/16 guidance [2] with specific antibiotic targets set each financial year [3]. This paper briefly reports the key findings from a workshop with antimicrobial stewardship (AMS) leads, which aimed to explore the experiences of selecting and adopting strategies within CCGs to help achieve the QP targets on improving antibiotic prescribing. In order to tackle the public health threat of antimicrobial resistance, improvement in antibiotic prescribing in primary care was included as one of the priorities of the Quality Premium (QP) financial incentive scheme for Clinical Commissioning Groups (CCGs) in England. This paper briefly reports the outcome of a workshop exploring the experiences of antimicrobial stewardship (AMS) leads within CCGs in selecting and adopting strategies to help achieve the QP antibiotic targets. The conceptual model developed by AMS leads demonstrated possible pathways for the impact of the QP on antibiotic prescribing
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