I’m delighted to have been appointed to lead the Antimicrobial Prescribing Optimisation Workstream of NHS England and NHS Improvement’s Antimicrobial Resistance (AMR) Programme, and to be able to share details of my new team of seven regional antimicrobial stewardship (AMS) leads.
The regional AMS leads have been recruited from a cohort of highly experienced specialist AMS pharmacists working in NHS primary and secondary care. Between us, we bring to the workstream more than 100 years of subject matter expertise in infection management and antimicrobial therapeutics. Each regional AMS lead will be supported by a part-time project support officer and recruitment to the post of translational research lead for the workstream is also underway.
The vision for the workstream, and for all of us, is that conservation of antimicrobials will be recognised as everyone’s responsibility and health and social care professionals, patients and citizens, supported by committed leadership, will be empowered to use antimicrobials wisely, diminishing the threat of antimicrobial resistance and setting an example of sustainability to the global community.
Role of regional AMS leads
The regional AMS leads are here to collaborate with key regional NHS England and NHS Improvement (NHSE&I) stakeholders and partner organisations, including infection prevention and control, patient safety, diagnostics and sepsis teams, the Department of Health and Social Care, the UK Health Security Agency, Health Education England and the Care Quality Commission, to contribute to multi-professional endeavours to mitigate the threat of AMR.
They will work with the above partners to support delivery of the Human Health elements of the UK’s National AMR Action Plan.
They will act as a source of subject matter expertise to support you and your teams, other clinical colleagues and healthcare leaders throughout their regions, as well as contributing their expertise to the national delivery of the AMR programme.
Conservation of antimicrobials will be recognised as everyone’s responsibility
They will take full advantage of their unique position, evaluating prescribing and clinical outcome data to identify high-performing provider organisations and systems within their regions, and elucidating the underlying reasons for their success, as well as working with the emerging integrated care systems to help them understand the role they can play in addressing AMR.
The workstream will monitor the latest evidence and guidance published in the scientific literature, interpreting research findings and sharing key messages with the AMS community. The team will investigate unexplained variation in practice and potential health inequalities, develop a suite of resources to support challenged provider organisations through peer review and identify where investment is needed to strengthen workforce capacity and capability to improve performance.
Research evidence and best practice case studies will be applied to inform and shape policy to facilitate and incentivise quality improvement and innovation across integrated care systems. The regional leads will play an essential role in governance of the judicious use of finite antimicrobial resources, through oversight and scrutiny of relevant metrics, providing expert interpretation of data on behalf of senior decision-makers, communicating performance and highlighting risk through appropriate regional and local forums.
The workstream will facilitate the design and implementation of digital systems to enable and promote high-quality prescribing, through decision-support and informed shared decision-making between clinicians and patients.
Meet the Antimicrobial Prescribing Optimisation Team
Dr Kieran Hand,
AMR National Pharmacy & Prescribing Clinical Lead
Kieran worked as a specialist microbiology pharmacist in NHS hospitals for 17 years and as the chief pharmacist of an acute hospital trust for two years. He led the team in University Hospital Southampton that developed the MicroGuide app, used for prescribing guidance in over 100 NHS trusts. Kieran has previously served on the Council of BSAC, the NICE Managing Common Infections guideline committee and the APRHAI scientific advisory committee. Kieran is an honorary associate professor at the University of Southampton with a research interest in decision-support for antimicrobial prescribing.
Elizabeth Beech MBE,
Regional Antimicrobial Stewardship Lead for the South West Region
Elizabeth has worked as a pharmacist within the NHS for over 30 years in a wide variety of organisations and roles, including education and research. She joined the NHS England Patient Safety Team in 2014 as a National Project Lead for Antimicrobial Resistance leading NHS implementation the UK Antimicrobial Resistance Strategy 2013-2018 and the current UK National Action Plan. In this role she led a sustained 7-year reduction in antibiotic prescribing in primary care. In August 2020 Elizabeth joined the South West Region as Regional Antimicrobial Stewardship Lead where she is establishing the South West Regional improvement collaborative to reduce population harm associated with healthcare acquired infections. Elizabeth is an active member of the Health Foundation Q community, a member of the Royal Pharmaceutical Society’s Antimicrobial Expert Advisory Group and continues to collaborate with AMR research.
Regional Antimicrobial Stewardship Lead for the North West Region
Gillian has been a hospital pharmacist for over 20 years, most recently as Principal Pharmacist at Stockport NHS Foundation Trust. Much of this time has been in a specialist antibiotic pharmacist role and Gillian was a founding member and co-chair of the North West Antibiotic Pharmacist Group. She has worked in other pharmacy sectors alongside acute trusts, including as a teacher practitioner and, until taking up this appointment, was a member of the Greater Manchester Antimicrobial Resistance Board.
Dr Naomi Fleming,
Regional Antimicrobial Stewardship Lead for the East of England Region
Naomi has worked in many different pharmacy settings, most recently as an independent prescriber and senior clinical PCN pharmacist. Naomi’s previous experience includes working as the lead antimicrobial pharmacist for Kettering General Hospital, specialising in diabetic foot infection. Naomi is currently a member of the British Society for Antimicrobial Chemotherapy’s Council and Education and Training subcommittee. She also serves on the UK Clinical Pharmacy Association’s Infection committee, supporting education. She is a visiting lecturer at De Montfort University Leicester and at the University of Northampton, contributing to their independent prescribing courses.
Prof Philip Howard OBE,
Regional Antimicrobial Stewardship Lead for the North East & Yorkshire Region
Philip has worked as a consultant antimicrobial pharmacist at the Leeds Teaching Hospitals since 2008. He was seconded to the NHS England Patient Safety Team in 2014-19 as a National Project Lead for Antimicrobial Resistance. Philip is a member of a number of NICE guideline committees and the APRHAI scientific advisory committee. He is Vice President & previous President of the British Society for Antimicrobial Chemotherapy. Philip is currently a member of the Royal Pharmaceutical Society’s Antimicrobial Expert Advisory Group and the International Federation of Pharmacy AMR Commission. He has previously served on the Infection Committee of the UK Clinical Pharmacy Association.
Dr Conor Jamieson,
Regional Antimicrobial Stewardship Lead for the Midlands Region
Conor has worked as an antibiotic pharmacist in the NHS in the West Midlands since 2002 and most recently was Pharmacy Team Leader for Antimicrobial Therapy at Sandwell and West Birmingham NHS Trust. He is the current chair of the British Society of Antimicrobial Chemotherapy’s Drug Stability Testing working group, investigating the stability of key antimicrobials for Outpatient Parenteral Antimicrobial Therapy services and Senior Editor for Education at JAC-Antimicrobial Resistance, an open access journal focusing on research and education on antimicrobial resistance.
Preety (Emlata) Ramdut,
Regional Antimicrobial Stewardship Lead for the South East Region
Preety has over 20 years’ experience in clinical pharmacy and independent prescribing, spanning across all healthcare interfaces and the criminal justice system. She worked for the Kent and Medway CCG as the Lead Medicines Optimisation Pharmacist, the Head of Quality for Primary and Local Care, and recently as the interim Deputy SRO for the COVID-19 Vaccination Programme. Preety led successful quality improvement workstreams such as the Antibiotic Guardian Award-winning AMS Campaign in Diagnostic Stewardship and the Medicines Optimisation Medication Review Programme.
Regional Antimicrobial Stewardship Lead for the London Region
Laura is moving from her role as the Senior Lead Infectious Diseases Pharmacist at Imperial College Hospitals, having previously been a Consultant Antimicrobial Pharmacist at St George’s University Hospitals. She is currently a member of the Royal Pharmaceutical Society’s Antimicrobial Expert Advisory Group, has served on the Infection Committee of the UK Clinical Pharmacy Association for 10 years, and has previously worked with NHS England to develop the national antifungal stewardship programme.
The opinions expressed in this article are those of the author. They do not purport to reflect the opinions or views of the UKCPA or its members. We encourage readers to follow links and references to primary research papers and guidance.
Competing interest statement:
The author declares: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.