24th May 2018

Paul Gimson, Programme Lead, 1000Lives Improvement

Supporting Wales with Antibiotics in Primary Care

SWAP

1. Our Vision

2. Terms of Reference

3. Steering Group

4. How we will achieve this

5. Primary Care Antimicrobial Stewardship – areas of work

6. UTI Friday

7. Next Steps

SWAP

Supporting Wales with Antibiotics in Primary Care

SWAP

WHY?!

SWAP

Our vision is to improve the use of antimicrobial medication in primary care in

order to reduce resistance to antibiotics.

We will do this by supporting pharmacists working in primary care to embed

effective antimicrobial stewardship in a strategic and coordinated manner.

SWAP, through a national community of practice, will deliver educational

programmes, disseminate evidence based guidelines, share resources and

promulgate best practice.

SWAP

Our Vision

• To improve communication between Welsh health boards, GP clusters & primary care pharmacists

• To promote & maintain consistency & continuity of approach in terms of antimicrobial stewardship in primary care

• To evaluate current practice & improve patient outcomes for conditions of infective origin

• To plan & develop ideas, resources & best practice guidance for primary care antimicrobial stewardship

• Develop the role of primary care pharmacists in antimicrobial agenda

• To identify training needs & provide clinical support to SWAP members

• To facilitate health board education in relation to clinical practice & the antimicrobial management of patients with long-term infective conditions

SWAP

Our terms of reference

Chair (Paul Gimson, 1000Lives)

Secretary and Project Lead (Avril Tucker, ABMU UHB)

All-Wales AMR Consultant Pharmacist (Nicholas Reid, PHW)

LHB Primary Care AMR Pharmacy leads

Welsh Centre for Postgraduate Pharmaceutical Education

Community Pharmacy Wales

Royal Pharmaceutical Society

SWAP

Steering Group

• National audit & quality improvement toolkits

• Educational masterclasses

• Annual Primary Care AMR conference

• Dissemination of Evidence (explore a virtual network)

• National Community of Practice

SWAP

How will we achieve this?

• Practice Audits

• Practitioner Education and Training

• Medicines Optimisation –Urinary Tract Infections

• Healthcare Acquired Infections

• Development of GP Computer Templates

• AMR Quality Improvement Projects

• Community Pharmacy Engagement

• Awareness raising and public education

• C-Reactive Protein Testing

• Nursing and Care Home engagement and education

SWAP

Possible areas of work

• 10% of all antibiotics are for UTI

• 1 in 10 care home residents on an abx at any one time

• 52% of those for UTI

• 57% of the 52% (30% overall) are for UTI prophylaxis

• 61% of all UTI are caused by E.coli

• Welsh government had a target to reduce E.coli bacteraemia by 50% for 2020/2021

• Within ABMU, 37% of all E.coli bacteraemia since April 2017 were >80 years, 36% 65-80 years (that’s 73% of all E.coli bacteraemia)

• 2/3 of all E.coli bacteraemia are ‘community acquired’

SWAP

UTI Friday

1. To ensure patients with UTI prophylaxis are reviewed at 6 monthly intervals to encourage appropriate prescribing and minimise long-term repeat prescriptions and side-effects

2. To link Welsh health boards together and drive a co-ordinated All-Wales Quality Improvement project

SWAP

UTI Friday

• Keep spreading the word and growing interest

• Quarterly steering group meetings

• SWAP UTI prophylaxis masterclass

• UTI Friday

• Development of a digital forum

SWAP

Next Steps

SWAP

What do you think?