Data shows 148 severe antibiotic- resistant infections a day in 2021
Data published by the UK Health Security Agency (UKHSA, 2022) has shown that there were 148 severe antibiotic-resistant infections a day in 2021.
Not a distant problem
Antibiotic resistance is a concern for experts. Recent estimates suggest that antimicrobial resistance causes 1.27 million deaths globally each year and 7600 deaths in the UK each year. Without working antibiotics, routine surgery will become too dangerous to perform, cancer chemotherapy will become too high risk and certain infections will require long and complex treatment or will no longer be treatable (Department of Health and Social Care, 2022).
The Department of Health and Social Care has launched a consultation to help inform a new 5-year national action plan to protect patients and capture learnings from the COVID-19 pandemic. The consultation will seek views to make sure that the next 5-year plan - continuing up until 2029 - is informed by the most up-to-date evidence.
Professor Dame Jenny Harries, Chief Executive of UKHSA, said: ‘Antibiotic resistance is not a distant problem that we can ignore - infections caused by antibiotic resistant bacteria are killing thousands of people every year in this country and globally, as well as having a huge economic impact. As we emerge from the COVID-19 pandemic, this is a pivotal moment to maintain focus on the ‘silent pandemic’ of antibiotic resistance through our extensive surveillance and antibiotic stewardship activities.’
Highlighting the problem, UKHSA (2022) found that over two-fifths of E. coli bloodstream infections are resistant to co-amoxiclav, a key antibiotic used in the treatment of serious infections in hospital.
Reducing unnecessary use
Antibiotic resistance occurs naturally, but inappropriate use and overuse of antibiotics can accelerate this. Antibiotic- resistant bacteria are less likely to respond to treatment, causing serious complications, including bloodstream infections, sepsis and hospitalisation.
Professor Susan Hopkins, Chief Medical Advisor at UKHSA, said: ‘We are already seeing resistance emerge to our very newest antibiotics - innovation to find new treatments will only succeed if we use what we have responsibly. Overuse of antibiotics will mean they stop working against life threatening conditions such as sepsis.’
In England, total antibiotic use fell by 15.1% between 2017 to 2021, from 18.8 daily defined doses per 1000 inhabitants per day to 15.9. This means that England has exceeded the government's National Action Plan goal to reduce prescribing by 15% by 2024 from a 2014 baseline. However, work is needed to ensure antibiotics are used appropriately going forwards.
Areas for action
Dr Colin Brown, Deputy Director of Antimicrobial Resistance and Healthcare Associated Infections at UKHSA, said: ‘Our extensive data and surveillance programmes have identified the immense scale of the issue in this country. It has pinpointed areas for action, with targets to improve prescribing and limit antimicrobial-resistant and healthcare- associated infections over the last 5 years. We will continue to work with partners to respond to current threats and prepare for future challenges.’
GP teams given direct access to tests to speed up cancer diagnosis
Every GP team will be able to directly order CT scans, ultrasounds or brain MRIs for patients with concerning symptoms, under plans to cut waiting times and speed up cancer diagnosis, NHS England has announced.
Reducing the backlog
NHS England say hundreds of thousands of hospital appointments could also be freed up by reducing the need for a specialist consultation first, helping to cut down wait times to as little as four weeks. There are hopes that this will boost efforts to address the backlog in secondary care.
Richard Evans, CEO of the Society of Radiographers, said: ‘Everyone working in health care knows that earlier diagnosis is key to improving outcomes for patients with cancer and many other conditions. The opportunity for primary care clinicians to refer cases that have concerning features directly for imaging could help to achieve an earlier diagnosis for many people and this has to be a good thing.’
Improving survival rates
It is estimated that around 67 000 people who are usually diagnosed with cancer through non-urgent testing will now be eligible for fast-tracking. Around one in five cancer cases are detected after routine testing following referral to a hospital specialist. It is hoped this will allow patients to be diagnosed at an earlier stage, when survival rates are better.
Louise Ansari, National Director of Healthwatch England, said: ‘People tell us that when they experience unnerving symptoms they need quicker and easier access to diagnostic tests to either give them reassurance that nothing is wrong or spot problems early so they can have a treatment plan put in place.’
Professor Martin Marshall, Chair of the Royal College of GPs, said: ‘GPs are already doing a good job of appropriately referring patients with suspected cancers. Despite the workload and workforce pressures they are facing, referrals by GPs into the rapid suspected cancer pathways are 20% above pre-pandemic levels. However, there will be patients who might not meet the criteria for rapid referral and have vague symptoms that could be cancer but are more likely to be less serious common conditions. In these situations, direct access to diagnostic services can be helpful.’
Additional training required
General practice will continue to follow National Institute for Health and Care guidelines for referring patients to urgent cancer pathways. But the new scheme will help people who have vague symptoms be offered quicker checks.
Professor Martin Marshall went on to add: ‘It will be vital that alongside direct access to diagnostics, GPs receive appropriate support and additional training to interpret the test results and that relevant IT systems used for booking tests are integrated into those that GPs already use. We also need assurances that diagnostic hubs are appropriately staffed to cope with increased demand for testing - and that safeguards are put in place to prevent this new system inadvertently adding to the workload of already overstretched GP teams.’