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Chief Medical Officer Letters to High Antibiotic Prescribers

Improving antibiotic stewardship is a priority for Public Health England due to the continuing threat of antimicrobial resistance. The Chief Medical Officer for England is sending her annual feedback letter on antibiotic prescribing rates to GPs in April 2017.

The feedback letters are being sent to over 6,300 individual GPs in over 1,400 different GP practices with high antibiotic prescribing rates. Practices were selected based on their level of prescribing per STAR-PU and in comparison with the England average used by the Quality Premium. The letters are tailored according to GP practice prescribing rate, change in prescribing over time, and whether they were previously sent feedback. While many GPs are already reducing their usage of antibiotics, the letters are intended to support GPs to reduce their prescribing further by providing feedback on practice prescribing rates, offering encouragement and suggesting practical actions in a clear and succinct manner. Public Health England’s Behavioural Insights Team is managing the process

Public Health England ran a randomised controlled trial in 2014/15 to test the effect of sending feedback to GPs about their antibiotic usage (LANCET Vol 387, No. 10029, p1743). The trial found that practices that were sent a supportive feedback letter prescribed 3.3% fewer antibiotics than practices that did not receive a letter. GPs in practices with antibiotic prescribing rates in the top 20% for each NHS Area Team were involved in this study.

In Jan 2016 similar letters were sent to all GPs in practices whose prescribing rate, calculated as above, was in the top 20% nationally.