Nice have published their draft guidance on antimicrobial stewardship, which includes a plan to release personalised prescribing data to GPs.
Resistance to antimicrobials is increasing, and alongside global-scale prescribing to animals in the farming and veterinary industry, and over-the-counter prescribing in other countries far more populous than the UK, GPs are being seen as a potential way to reduce this problem.
But just how useful will these reports be? Could they in fact do harm? It doesn't look like Nice quite appreciate the issues. In the draft guidance, on the subject of how locum prescribing could skew data:
"Currently GP prescriber codes are linked to the BSA individual cost centre rather than that of individual prescribers (for example, locums, who are not working permanently in a location, often use a ‘general’ prescriber code in 1 practice for all of their prescribing). Prescribing data do not therefore always just represent the GP name assigned to that code or cost centre."
Nice antimicrobial stewardship: draft guideline 7.6 Evidence to recommendations page 81
Some points for Nice
- NASGP estimate that there could be anything up to 17,000 GP locums prescribing in the UK.
- We know of no situations where a locum GP has her own prescribing number that can be transported to any other practice.
- In general, we GP locums always prescribe using another GPs prescribing number.
- It's unusual for a GP locum to be given their own unique username and password when signing in to the patient record.
So, should GPs be given personalised antibiotic prescribing data? Yes, absolutely. But create a level playing field first by enabling our locum GP colleagues to have the same access to those NHS structures and processes that have patient and public safety at heart.
Richard has worked as a freelance GP locum since 1995 in around 100 different practices, living and working in West Sussex and Hampshire. He founded NASGP in 1997, he is NASGP’s chairman and started the UK’s first locum chambers in 2004.
He enjoys walking, is a keen potter, reads too many books on behavioural economics and has an unhealthy obsession with his sourdough starter.