https://www.ahsn-nenc.org.uk/reducing-antibiotic-prescribing-rap-project/
This short article tells you all but in essence of 137 tests for patients contacting their GP with possible chest infections, only 8 went on to see their GP and only 3 needed antibiotics. All were referred directly to the local pharmacists used in the pilot who undertook a three-minute CRP finger-prick blood test to show levels of inflammation through markers ( using an Alere/Abbott CRP https://www.alere.com/en/home/product-details/afinion-crp.htmltesting machine) and determined whether antibiotics were appropriate.
Obviously this pilot was with a relatively small sample but the process clearly saved a large proportion of GP appointments.
NESCHA members took the lead part in the design of the patient information leaflet ( given to each patient on going to the pharmacy); helped to design the feedback process and undertook the follow up telephone interviews ( in a few cases using electronic means instead) and the view from the patients was overwhelmingly positive.
They received a quick ‘answer’ as to whether they needed antibiotics and when they did the GP appointments and antibiotics followed quickly – in one case within 15 minutes.
They were reassured at having a measured result ( in a few cases there were retests too) and volunteered that the process was effective and that they felt they were saving valuable GP time whilst being reassured.
Furthermore NESCHA also added some suggestions about making the process even more cost effective ( note that pharmacists time and the testing equipment is much cheaper than GPs’ time) by training pharmacy assistants to undertake the testing but always ensuring that the pharmacists take full responsibility for the results and informing the GP, or advising the patient on using a linctus for example.
In the light of the coronavirus the testing could not continue due to the potential for passing on the virus . However there may be a possibility that with appropriate safety precautions , that the process could potentially help identify infections early but more needs to be done first.
In short the whole process of the pilot, supported by an AHSN grant, was a great collaboration, led by Mike MaguireChair of NHS England Local Professional Network for North East and North Cumbria, working with two GP surgeries and three pharmacies, supported by NESCHA with Wade Tovey, Projects lead.
The process was not only very cost effective in terms of GP time and the saving of antibiotics ( not simply the money but also that overuse will make people more vulnerable) , but chiefly as it achieved a great deal in terms of patient satisfaction and their time too.
Interviewed by Matt Bailey at 7.10am on 29th July about NESCHA views on imminent Andy Burnham announcement later that morning. I was greatly encouraged by his feedback ( he said it was interesting and ran over time!) and wrote the paper attached.
I never dreamt that one day I would be living the system!.
Sadly Robert my co-author , died when I was in hospital some years ago but my wife visited daily and then she lived with a diagnosois mixed dementia for over four years, was admitted to hospital last October and, following a rapid discharge to a care home, died peacefully in December .
Despite a professional background in social work and years spent working on improving health and care systems, nothing fully prepares you for living that experience. It brought into sharp focus both the compassion of frontline staff and the frustrations families can face when services are not as joined-up or consistent as they should be.
NHS de-frazzle new book and brilliant review