Antimicrobial resistance (AMR) is a major challenge to the UK’s health security, and is already responsible for a significant burden of death, disability and prolonged illness globally. The growing resistance of bacteria, viruses and fungi to the drugs commonly used to treat them threatens modern medicine, and our ability to carry out standard medical procedures. This report draws on the expert input of a roundtable held by public service think tank Reform in October 2022, to assess progress made against proposals published by Reform in 2020.
The report recommends the following actions to address the threat of AMR:
- NHS England, in collaboration with NICE, should urgently commission a national assessment of the clinical and cost-effectiveness of using rapid diagnostic tools. As part of this assessment, differences in the effectiveness of using diagnostics to support prescribing in primary and secondary care should be considered.
- NHS England should centrally purchase diagnostic tools, to more rapidly increase the percentage of prescriptions that are supported by a diagnostic test, drawing on evidence collected from the national assessment and Wales’ use of a central budget for diagnosing respiratory tract infections.
- Public health departments should work with charities and patient organisations to develop AMR awareness campaigns in the vein of those delivered during the COVID-19 pandemic, which highlight the experience of individuals living with drug-resistant infection and their families. As far as possible, these campaigns should be led by local Directors of Public Health, to increase the trust that local communities have in AMR messaging.
- A high-level AMR committee should be formed of permanent secretaries from the Department of Health and Social Care, the Department of Food, Environment and Rural Affairs, the Head of AMR at NHS England, and Chief Executives of the UK Health Security Agency and the Veterinary Medicines Directorate. This group should meet at an appropriate frequency to track progress against the Government’s twenty-year vision for AMR, promote cross-government coordination, and assess present and future social and economic impacts posed by AMR.
- To drive AMR preparedness and health security coordination at Cabinet Level, the Government should create a subcommittee of the National Security Council dedicated to assessing progress against the five-year action plan and twenty-year vision for AMR, and discuss future risks to health security. A named minister for health security should convene the subcommittee.