Source · Select Committees · Public Accounts Committee
Recommendation 4
4
Accepted
Mandate health bodies to demonstrate progress in using diagnostic tools for AMR over two years.
Recommendation
DHSC has made slow progress in implementing diagnostic tools that could help reduce AMR. Inappropriate prescribing of antibiotics in primary care is estimated to be around 20% of antibiotic prescriptions, which is too high and could drive AMR. ‘Inappropriate’ includes prescribing antibiotics or other antimicrobials when they are unnecessary (for example, using antibiotics to treat a viral infection), prescribing the wrong one (for example, not the most suitable antibiotic), or using them for longer than necessary. Diagnostic tools can be used to diagnose what infection a patient has, reducing inappropriate prescribing by enabling clinicians to determine with accuracy whether a patient needs antimicrobial treatment and, if so, which one. However, the 2019–24 NAP target to report on the percentage of antibiotic prescriptions supported by the use of diagnostic tools was not achieved and has not been included in the 2024–29 NAP, and there has been only limited progress in making better use of diagnostic tests. 4 recommendation DHSC, NHS England and UKHSA should set out how they intend to make demonstrable progress in the use of diagnostic tools, including under the Pharmacy First Scheme, over the next two years.
Government Response Summary
The government commits to several actions, including an infection diagnostics framework by 2027, producing a rapid review pipeline, and scoping pilot schemes for point-of-care tests under Pharmacy First to launch in Q3 2025-26 and report in 2026-27. It also highlights ongoing research funding and partnerships in AMR diagnostics.
Government Response
Accepted
HM Government
Accepted
The government agrees with the Committee’s recommendation. sector working to develop diagnostics as a tool to tackle AMR. DHSC, through National Institute for Health and Care Research (NIHR), has invested over £18 million into research AMR diagnostics research. DHSC also funds the NIHR HealthTech Research Centres, which accelerate development of healthcare technologies, including diagnostics. NHSE is streamlining diagnostic innovation through hosting the cross-sector ‘Moving Forwards Infection Diagnostics’ events series. Engagement will inform an ‘infection diagnostics framework’ by 2027, and the identification of target product profiles for diagnostics needed in the NHS. A rapid review pipeline to identify optimal tests within the market and assess how existing diagnostics can be optimised is also being produced. NHSE has developed clinical pathways for Pharmacy First, which support pharmacists in treatment decisions, guiding appropriate antibiotic use or antibiotic-sparing. Pathways function as diagnostic tools, encompassing clinical decision-support tools and risk- stratification, and are already in daily use. Pilot schemes to gather evidence on clinical impact of point-of-care tests are being scoped for several primary care patient pathways, including community pharmacy, launching in Q3 2025-2026 and reporting in 2026-2027. UKHSA will explore the application of rapid laboratory tests, used to assess whether a pathogen is killed by existing or novel antimicrobials, to enable identification of novel therapeutic approaches and support translation into clinical evaluation. UKHSA and VMD are partners in the UKRI-funded Accurate, Rapid, Robust and Economical One Health DiagnoSTics for antimicrobial resistance Network, which aims to support new AMR diagnostics and detection methods progress into use in real life settings.