Report: UK health workers lag in stewardship training

A new report from Health Education England has found that healthcare providers and organizations in the country need to do more to make sure their staff members are appropriately trained to combat antimicrobial resistance.

In a survey conducted by the organization, which supports the training and education of English healthcare workers, only 65% of the responding organizations—which included National Health Service (NHS) hospitals, clinical commissioning groups (CCGs), and professional medical organizations—reported that they had developed, supported, or commissioned educational training and resources for prescribers or trainee prescribers on the prudent use of antimicrobials, and only 61% could confirm that all prescribers within their facility had received induction and training in antibiotic stewardship.

While less than half of the organizations responding to the survey said they provided mandatory core training in prudent antimicrobial use to medical prescribers only, even fewer said they extended the training to pharmacists, nurses, and other allied health professionals. In addition, only 40% of the organizations could confirm that their prescribers were familiar with or provide training that covers national guidelines for appropriate antimicrobial prescribing.

Only a third of the organizations confirmed that core training in antimicrobial stewardship was repeated every 3 years, as is called for under national guidelines.

"The provision of education on prudent antibiotic use for prescribers and other staff needs to improve for CCGs and NHS trusts or organisations," the authors of the report write. "Healthcare providers have an important role in ensuring that staff have the right knowledge and skills in ensuring the appropriate use of antimicrobials in everyday practice, and any training needs are appropriately addressed."

Under the Health and Social Care Act 2008 code of practice on the prevention and control of infections, which was revised in 2015, healthcare providers in England are required to ensure that all prescribers receive induction and training in prudent antimicrobial use and are familiar with antimicrobial resistance and stewardship competencies. National recommendations also state that mandatory core training in prudent antibiotic use should be provided to pharmacists and nurses, in addition to doctors, and that training updates be provided every 3 years.

The NHS has made reducing healthcare-associated infections a national priority, with a goal of cutting healthcare-associated gram-negative infections and inappropriate antibiotic prescribing in half by 2020. That goal is one element of the UK government's response to the Review on Antimicrobial Resistance, a 2014 report by British economist Lord Jim O'Neill and the Wellcome Trust. The report estimates that if antimicrobial-resistance is not addressed, drug-resistant pathogens could cause 10 million deaths a year by 2050.

"System wide engagement and action will be needed to reduce the threat posed by antimicrobial resistance, and the workforce needs to be adequately equipped to help tackle this threat," the report states.

In response to the survey, Public Health England issued a number of recommendations for healthcare providers, including the following:

  • Healthcare providers should ensure that all prescribers receive induction and training in prudent antimicrobial use and updates every 3 years, and should consider providing mandatory core training in prudent antimicrobial use for doctors, pharmacists, and nurses as an introductory session on induction.

  • Healthcare providers should ensure the inclusion of antimicrobial resistance awareness as part of mandatory infection prevention and control training for all staff.

  • Healthcare providers should consider locally mandated and implemented staff training on antimicrobial resistance in areas that show increasing resistance patterns and antimicrobial consumption and poor compliance with local antimicrobial policy and national guidelines.

"We ask employers to take note of this report and take forward actions to place more training to ensure their staff are well-trained in how to combat antimicrobial resistance," Ged Byrne, director of education and quality at Health Education England, said in a press release.

The organization also acknowledges it needs to do a better job, and calls on itself to develop a guide to learning materials for antimicrobial resistance and infection and improve information sharing around antimicrobial resistance training.

See also:

Apr 19 Health Education England report

Apr 19 Health Education England press release

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