Source · Select Committees · Public Accounts Committee
Recommendation 26
26
Accepted
English pharmacists twice as likely to prescribe antibiotics for sore throats than Welsh counterparts.
Conclusion
Under the Pharmacy First scheme introduced in early 2024, patients can now consult pharmacists directly for several minor illnesses and conditions that previously required a GP visit and the pharmacist can prescribe medicines if necessary. NHS England commented that early evidence from Pharmacy First was that GPs were following the relevant protocols, and it had not seen any increase in the use of antibiotics. However, we have also seen a report of a March 2025 study claiming that patients with a sore throat are twice as likely to be given antibiotics by a pharmacist in England than they are in Wales. An author of the research study said that one possible reason for the difference might be the use of diagnostic tests for patients in Wales.66 64 AR0004, AR0005, AR0008, AR0009, AR0010, AR0014, AR0015, AR0017, AR0024 65 Q 40 66 Q 40; Pharmacies in England may be twice as likely to supply antibiotics for sore throat than in Wales, 12 March 2025 16 2 Reducing the threat of AMR in the future Getting the basics right
Government Response Summary
The government agrees with the conclusion, setting a target implementation date of Spring 2027 for related diagnostic initiatives. They are developing an infection diagnostics framework by 2027, launching point-of-care test pilots in Q3 2025-2026, and exploring rapid laboratory tests to enhance diagnosis and appropriate antimicrobial use.
Government Response
Accepted
HM Government
Accepted
4.1 The government agrees with the Committee’s recommendation. Target implementation date: Spring 2027 4.2 The government is working to fulfil Outcome 6 of the NAP, which commits to cross-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. 4.3 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. 4.4 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. 4.5 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. 4.6 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.