Reducing Antibiotic Prescribing (RAP) Project

The Reducing Antibiotic Prescribing (RAP) Project aims to influence a reduction in the levels of antibiotic prescribing and to test whether patients, who do not need to see a GP can be safely channel-shifted to a more effective pathway, which in turn would reduce workload and increase time-capacity for General Practices, overall creating a better patient experience.

The RAP Project has been funded by the Academic Health Science Network for the North East and North Cumbria (AHSN NENC), and its innovative approach through a ‘C Reactive Protein (CRP) Point-of-Care’ test, delivered in private consultation with a Pharmacist, seeks to address Antimicrobial Resistance (AMR), which could result in an estimated 10 million deaths worldwide every year by 2050.

Led by Mike Maguire, Chair of NHS England Local Professional Network for North East and North Cumbria, the RAP Project has been tested through two GP surgeries and three Pharmacies in Middlesbrough.

Patients with a chesty cough, who phone the GP for an appointment and potentially antibiotics, are referred to the Pharmacy, where a three-minute CRP finger-prick blood test shows levels of inflammation through markers and determines whether antibiotics are appropriate.

The patient will then be managed by the Pharmacist, who may liaise with the GP to take the necessary course of action.

Of the 105 patients referred through the Project, only three have needed antibiotics. A further five have required shared decision-making between Pharmacist and GP, while the remaining 97 patients have all been successfully managed in a community Pharmacy.

This patient pathway has received excellent patient feedback, and although the sample size is too small to draw a valid conclusion, the Project indicates the potential for reducing antibiotic prescribing while increasing capacity for GPs.

Mike Maguire said: “I’ve been delighted that the hard work of the General Practice Teams and the Community Pharmacists involved in this service has led to such great patient feedback. The results of this Project speak for themselves and there is potential for this service to become a game-changer in terms of Antibiotic Prescribing and ensuring patients receive the most appropriate treatment for their condition.”

A proposal bid has now been submitted to expand the RAP Project to four Primary Care Network areas across the region, in response to the Antimicrobial Resistance Call from NHS England, launched through the AHSN NENC.

The outcome of this bid will be notified by the end of March 2020.