New NHS vision for antimicrobial stewardship focuses on digital solutions

Healthcare professionals should be trained in digital antimicrobial stewardship (AMS) technologies, new guidance from NHS England has said.

This could include digital systems that capture AMS metrics and performance, as well as decision support tools and potentially artificial intelligence.

This comes as 20% of clinicians surveyed by NHS England said they spent more than five hours undertaking AMS activities that could be automated.

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In its 'Digital vision for antimicrobial stewardship in England', published alongside the framework this week, NHS England said: 'While a multi-faceted approach is required to tackle AMR, understanding the role of IT in healthcare professional-patient interactions where antimicrobials are prescribed – and how IT systems can support good practice – is critical to success.'

It set out that 'clinical digital systems should support clinicians with antimicrobial prescribing by offering appropriate treatment choices and durations and making it easy to record prescribing decisions'.

And they should 'support clinicians to review and revise antimicrobial prescriptions' at key timelines.

They should also support interoperable and standardised coding.

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This was based on feedback from primary and secondary care clinicians who said there were:

• Variation in systems used within integrated care systems
• Challenges with interoperability
• Lack of standardised coding

The guidance says that organisations should ensure that systems used by staff 'are intuitive, easy to use and display all the key clinical information they need to optimise patient care, avoiding the need to refer to multiple digital systems to access information'.

Digital systems should also:

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• Include embedded tools and support to guide prescribing decisions and identify risk of deterioration
• Integrate diagnostics (sampling and results) into clinical workflows
• Improve interoperability between care providers
• Enable 'data driven improvement by prioritising automated data collection, simplifying data extraction processes, and making data widely available and easy to use, for example, through dashboards that provide context and insight'
• 'Consider the development and integration of artificial intelligence, predictive analytics and risk or severity score calculators to support antimicrobial stewardship'

And patients should be enabled to 'access and contribute to their healthcare information, taking an active role in their health and wellbeing', the guidance added.

Clinical pharmacists working in general practice and primary care networks (PCNs) under the Additional Roles Reimbursement Scheme (ARRS) have a responsibility to 'ensure prescribers in the practice conserve antibiotics in line with local antimicrobial stewardship guidance', the PCN DES sets out.