The Pharmaceutical Journal
Vol 270 No 7253 p813
14 June 2003

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Chief Pharmacist letter (PDF 15K)
SACAR: Specialist Advisory Committee on Antimicrobial Resistance (more)

Hospital pharmacists to get £12m for enhanced role in control of infections

Hospital pharmacists in England are to receive £12m over the next three years so that they can expand their roles in reducing hospital-associated infections and to ensure safe and effective use of antimicrobials. This is the first national scheme with earmarked funds to promote a role for hospital pharmacists in a specific therapeutic area.

Funds will be allocated to primary care trusts based on the number of beds in local hospitals. Hospital trusts will have to submit bids for funding. Strategic health authorities will be asked to monitor the use of the funds. The initiative will be overseen by the specialist advisory committee on antimicrobial resistance (SACAR).

Dr Jonathan Cooke, chief pharmacist at South Manchester University Hospitals NHS Trust is the only pharmacist on SACAR. With SACAR chairman Professor Richard Wise, he will co-chair a prescribing subgroup looking at appropriate use of antimicrobials.

Dr Cooke told The Journal that there will be two elements to the new work. There is to be a national data collection exercise looking at the prescribing of antimicrobials in hospitals. "Unlike primary care, there is no central database for hospital prescribing," Dr Cooke explained. Once collected, the prescribing data will be linked to surveillance reports of resistance to antimicrobials already compiled by SACAR.

The other element will be the work carried out by clinical pharmacists. Dr Cooke said that some hospitals have already appointed specialist pharmacists in infection control or antimicrobial use. Now he hopes that all hospitals will be able to appoint pharmacists or provide other clinical pharmacy support to infection control specialists.

"I hope that this work will lead to an overall reduction in the use of antimicrobials and more appropriate use of them. For example, they could promote appropriate use of narrow-spectrum agents and educate prescribers about switching from intravenous to oral administration."

Dr Cooke noted that antimicrobial prescribing in primary care in England has declined in recent years, the only place in Europe where this is happening. Initially, SACAR's work will focus on prescribing in hospitals, but it could be extended to primary care in the future.

In a letter to hospital chief pharmacists, chief pharmaceutical officer Dr Jim Smith and chief medical officer Sir Liam Donaldson say that key areas for clinical pharmacists to focus on include antibiotic use in surgical prophylaxis, antibiotic use in children and infection control. Hospital antibiotic policies should be brought in line with best practice, working through drug and therapeutic committees.

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