Cluster page — medicines optimisation
Antimicrobial stewardship in primary care
Context
Why primary care AMS matters at population scale
Primary care accounts for around 70% of all NHS antibiotic prescribing in England. Antimicrobial resistance is recognised in the UK 5-year action plan as one of the highest-priority population health threats, and the ICB AMS programme is the operational delivery vehicle. PCN clinical pharmacists are the workforce best positioned to deliver the audit, training and patient-facing intervention this requires.
A mature PCN AMS programme runs the RCGP TARGET annual audit cycle, embeds back-up/delayed prescribing in URTI presentations, monitors broad-spectrum prescribing against ICB benchmark, delivers UTI prescribing optimisation in the over-65 cohort, and integrates AMS messaging into every relevant SMR.
PCN AMS programme
What a PCN AMS workplan covers
- Annual RCGP TARGET self-assessment and audit cycle
- Quarterly antibiotic prescribing comparator (items per STAR-PU vs ICB)
- Broad-spectrum prescribing audit (co-amoxiclav, cephalosporins, quinolones)
- Back-up/delayed prescribing training and embedded use in URTI/RTI
- UTI prescribing optimisation in over-65s (NICE NG109)
- Penicillin allergy de-labelling pathway where commissioned
- AMS messaging integration in SMR and LTC review templates
AMS KPIs
What good AMS looks like
Frequently asked questions
AMS — FAQs
What is the TARGET antibiotics toolkit?+
A Royal College of GPs and UKHSA suite of resources supporting appropriate antibiotic prescribing in general practice — patient leaflets, training modules, audit templates, and self-assessment checklists. Forms the backbone of primary care AMS.
What is ESPAUR?+
English Surveillance Programme for Antimicrobial Utilisation and Resistance — the UKHSA annual report tracking antimicrobial use and resistance, with ICB-level prescribing benchmarks that feed into local AMS priorities.
What role does the PCN clinical pharmacist play in AMS?+
Lead on practice-level antibiotic audit (RCGP TARGET audits), embed AMS messaging in SMR and LTC reviews, deliver back-up/delayed prescribing training, and produce the quarterly PCN antibiotic prescribing comparator against ICB benchmarks.
How are AMS outcomes measured?+
Antibiotic items per STAR-PU (the case-mix adjusted prescribing rate), broad-spectrum prescribing proportion (co-amoxiclav, cephalosporins, quinolones), 30-day repeat antibiotic rate, and audit completion against the RCGP TARGET annual cycle.
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