GPs could be incentivised not to prescribe antibiotics, says NICE

NICE has suggested that GPs could be incentivised through the QOF to limit antibiotic prescribing after it released guidance that calls for stricter monitoring and peer reviews of GP prescribing.

Antibiotics: NICE considering QOF target (Photo: iStock)
Antibiotics: NICE considering QOF target (Photo: iStock)

NICE draft guidance released on Wednesday calls for all local areas to establish antimicrobial stewardship teams to ‘monitor and evaluate’ GP antimicrobial prescribing to help combat the looming threat of resistance.

The teams should also ‘investigate’ in cases where GPs are prescribing very low or very high volumes of antimicrobials.

Local systems should be developed to allow for peer review of prescribing in an area, the guidance says. This should ‘encourage an open and transparent culture that allows questioning of antimicrobial prescribing practices’.

GP incentives

NICE’s director for clinical practice, Professor Mark Baker told the Daily Mail that NICE is considering adding incentives for GPs to not prescribe antibiotics into the QOF.

He was reported as saying: ‘Clearly there should be some structural incentive to turn that trend around and start using them less.’

A spokeswoman for NICE told GP that there were currently no concrete plans to introduce antibiotic prescribing incentives into the QOF, but confirmed that the institute saw this area as a 'potential candidate' for a new QOF target at some point in the future.

GP guidance

The guidance reiterates that GPs should not prescribe antibiotics to patients who are likely to have a self-limiting condition.

It also suggests implementing IT support systems to help GPs decide whether they should prescribe a patient an antimicrobial.

RCGP chairwoman Dr Maureen Baker said: ‘GPs can come under enormous pressure from patients to prescribe antibiotics so we welcome a team approach to ensuring that this is done appropriately and that they are used responsibly.

‘However, this must be done in an open and supportive way.

‘It is essential that GPs, their practice teams and pharmacists discuss the alternatives with patients who ask for antibiotics to treat minor illnesses, most of which will get better on their own over time.’

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