Antimicrobial supply will be ‘closely monitored’ following the launch of Pharmacy First, with an evaluation of the service’s impact on antimicrobial resistance to be commissioned by the National Institute for Health and Care Research (NIHR).

In a letter outlining the service, the Department of Health and Social Care (DHSC), NHS England (NSHE) and the sector’s negotiator Community Pharmacy England (CPE) said that they will be ‘closely monitoring the Pharmacy First service post-launch, particularly in relation to antimicrobial supply to guard against the risk of increasing antimicrobial resistance’.

This comes as sector bodies have highlighted the role of community pharmacy teams in antimicrobial stewardship to mark World Antimicrobial Resistance (AMR) Awareness Week, which began at the weekend.

CPE has said that antimicrobial stewardship activities will remain part of the Pharmacy Quality Scheme (PQS) this year, ‘so this continues to be an important focus for community pharmacy’.

Meanwhile, the International Pharmaceutical Federation (FIP) has called for education on AMR and AMS to be strengthened.

Last week, the UK Health Security Agency (UKHSA) published its latest English surveillance programme for antimicrobial utilisation and resistance (ESPAUR) report, which found that the lifting of pandemic restrictions had increased pathogen circulation and antibiotic use.

It also highlighted the results of two NHSE reports into community pharmacy and antimicrobial stewardship (AMS).

In the reports published earlier this year, NHSE said that the results of the PQS and AMS training undertaken by pharmacy teams provided a ‘solid foundation’ of AMS ahead of the launch of Pharmacy First.

The national Pharmacy First service in England, which was set out last week, will see pharmacists able to supply prescription-only medications, including antibiotics where appropriate, for seven common conditions from 31 January.

For World AMR Awareness Week, the Royal Pharmaceutical Society (RPS) shared 10 ways that community pharmacy teams could fight AMR.

This includes checking the appropriateness of prescriptions and advising patients on how to prevent antimicrobial misuse.

And it suggests that advising patients on self-care and self-limiting conditions could help educate patients about the effective use of antimicrobials.

Last week, PAGB, which represents the interests of over-the-counter medication manufacturers, published a report that found that over half of patients seen by a GP (53%) were told to use over-the-counter medicines.

Pharmacist and adviser to PAGB, Mark Burdon said in the report: ‘Consumers may not realise that GPs are now advised against prescribing antibiotics for self-limiting infections such as colds, sore throat and earache.

‘It’s important that we improve awareness and signpost the resources that will give more consumers the confidence to recognise when self-care is appropriate and when more specialist care might be needed.’

And Alastair Buxton, director of NHS Services at CPE, commented that the PAGB report ‘emphasises the vital and expanding role pharmacy teams have in delivering self-care advice.’

The Pharmacists’ Defence Association (PDA) has also encouraged pharmacists to implement antimicrobial stewardship in their day-to-day work, pledge to become an Antibiotic Guardian, and to get involved in World AMR Awareness Week wherever possible.

Highlighting work investigating AMR in Ukraine and other conflict zones, the PDA said: ‘Given the current political climate and issues with climate change, it is important to be aware that AMR issues somewhere else today is likely to be a UK issue tomorrow.’

What did the NHSE reports find about community pharmacy teams and AMS?

In 2020/2021, over 90% of pharmacies said that nearly all their registered staff – 54,399 registered pharmacy professionals – had completed NHS AMS e-learning and Infection Management e-learning.

And in 2022/23, the PQS monitored AMS within urinary tract infections (UTIs) and respiratory tract infections (RTIs) seen by community pharmacy teams.

Over a four-week data collection period, around a third of patients presenting with UTI symptoms were managed by a non-pharmacist member of the team and 78% were managed within the pharmacy.

And nearly all patients (94%) presenting with UTI symptoms received self-care advice rather than antibiotics.

Of those presenting with RTI symptoms, 88% were managed within the pharmacy, while the remaining 12% were escalated to other healthcare providers for urgent medical advice.