NHSE: Infection tests may be ‘introduced’ to Pharmacy First to tackle AMR

“Rapid infections diagnostics” in primary care have a “huge potential” to be the “first step in antimicrobial stewardship”, NHSE’s national clinical lead for AMR diagnostics Dr Jane Freeman said yesterday (January 24).

Speaking at a Westminster Health Forum conference about tackling AMR, Dr Freeman described how the diagnostics are “not specifically for detecting AMR, but a tool that can be used in the battle” as “whenever [prescribers] are dealing with an infection” they have the potential to affect AMR.

The diagnostic tests can “enable rapid targeted treatments” by identifying pathogens and “antimicrobial sensitivity” and indicating whether or not there is a bacterial infection present, she said.

And she stressed the importance of understanding “how best to introduce diagnostics in complex clinical settings and evolving pathways, like the Pharmacy First scheme”.

Currently, the new Pharmacy First common conditions service is set to start on February 1 and will allow pharmacies to treat seven common conditions without the need for a GP appointment or prescription.

Dr Freeman said that “rapid point of care tests” for COVID-19 have already demonstrated “how effective point of care tests for infection could be”.

“Bringing infection tests close to the point of need” could result in “better [and] faster appropriate prescribing”, she added.

But she said that before such tests could be introduced into clinical pathways like Pharmacy First, “improving infection diagnostics” so that they “generate rapid, accurate, targeted high quality data” is “the real overarching task”.

Fake drugs contributing to AMR

Meanwhile, UK special envoy on AMR and former chief medical officer (CMO) and chief scientific adviser for the Department of Health and Social Care (DH) Professor Dame Sally Davies warned that fake drugs and inappropriate online prescribing pose a risk to AMR.

Responding to a question about tackling “the bad actors in AMR”, Dame Sally said that “the Medicines and Healthcare products Regulatory Agency (MHRA) fights very hard to clamp down on inappropriate prescribing across the internet”.

“I'm very concerned about counterfeit and falsified medicines” she added, explaining that of those tested, “over 50%...have a small amount of antibiotic, which means they will be driving resistance”.

“We just have to give [the MHRA] as much support as we can” she said, adding that “reviewing sales points and prescribing practices” is also important.

Pharmacy First “not an antibiotic service”

In November, contractors told C+D that they “can’t see a risk” of the new Pharmacy First service increasing AMR amid the news that this will be “closely monitored”.

The previous month, NHSE director for pharmacy Ali Sparke revealed that NHSE had agreed it would “commission a piece of evaluation to look at the implications” of Pharmacy First for AMR.

“We need to be able to demonstrate that community pharmacy is as adept as other parts of the NHS in managing antimicrobial stewardship,” he said, adding that Pharmacy First is “not an antibiotic service”.

Last year, the service came under attack from a group of scientists who claimed that enabling community pharmacists to treat seven minor illnesses could lead to antibiotic resistance.

Pharmacists hit back at the claims, branding them “disingenuous”.