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Practices to be scrutinised over harder antibiotic prescribing targets

New antibiotic prescribing targets have been released by NHS England, with cash incentives attached, and local health leaders will be encouraged to “directly monitor progress” of practices.

Clinical commissioning groups are being asked to reduce the number of antibiotics prescribed in primary care by 4%, or to the average performance levels of 2013/14.

They are also being urged to ensure that the amount of 'broad-spectrum' antibiotics (co-amoxiclav, cephalosporins and quinolones) are slashed, so that it makes up 10% or less of the total antibiotics prescribed, or to reduce it by 20% from each CCG's 2014/15 value.

Information will be available for the local leaders “to review on a dedicated website, and will allow them to directly monitor progress,” NHS England stated.

This will be incentivised with payments through the Quality Premium (QP) scheme, which is paid per patient to the clinical commissioning groups that successfully deliver the proposed measures, and the new programme goes live in April 2016.

There are further incentives available for fast cancer detection rates, e-referrals, and a good experience of making an appointment.

For cancer, primary care will need to demonstrate a four percentage point improvement in the proportion of cancers diagnosed at stages 1 and 2 in the 2016 calendar compared to 2015, or diagnose more than 60% of all cancers at stages 1 and 2 in 2016.

In terms of e-referrals, CCGs will need to either have 80% e-referrals by March 2017 and demonstrate a year-on-year increase in the percentage of referrals made electronically (or achieve 100% e-referrals), or a 20% increase in digital referrals from March 2016 to 2017. 

To get the incentives, 85% of respondents in the GP Patient Survey need to say they had a good experience of making an appointment, or there must be a 3% increase on the percentage of respondents who said they had a good experience of making an appointment since the July 2016 survey.

Meeting the requirements for cancer is worth 20% of the Quality Premium, electronic referrals are worth 20%, the experience of appointments is worth 20%, and improving antibiotic prescribing is worth 10% of the total, with three unspecified local measures making up the remaining 30%.

The maximum QP payment will be £5 per head of the population.

Paradoxically, each CCG must plan how to spend the money before they know the level of their QP award in quarter three of the 2017/18 financial year, “in order to maximise its ability to make the most effective use of the payment within 2017/18”. Each CCG is required to publish an explanation of how it has spent a QP payment.

See the full guidance here