Implementation of a National Antimicrobial Stewardship Training Programme for General Practice: A Case Study.

Background: Approximately 71% of antibiotics in England are prescribed in general practice settings. Whilst there are various impactful training resources available to support clinicians in antimicrobial stewardship (AMS) activities, implementation, reach, and uptake affect how successful they are nationally. This case study explores the feasibility, acceptability, and usefulness of embedding the TARGET (Treat Antibiotics Responsibly, Guidance, Education and Tools) AMS training into a local incentive scheme.

Method: Black Country Integrated Care Board (ICB) invited a representative from all associated general practises to a TARGET AMS training event; attendance was linked to a local incentive scheme. Data were collected via a pre- and post-workshop survey capturing TARGET toolkit knowledge, AMS attitudes and behaviours, training feedback, and intention to implement AMS behaviours. Descriptive analyses were conducted.

Results: 157 and 101 attendees completed the pre- and post-session surveys, respectively. In total, 89% agreed that attending the session was a good use of their time. The proportions of attendees stating an intention to use the TARGET toolkit and implement a range of AMS strategies following the session were high (TARGET Toolkit: >82%, AMS strategies: >90%). Most attendees planned to implement these actions within 3 months (47%) or within 3-6 months (30%).

Conclusion: Results suggest that embedding the training into a local incentive scheme is a viable implementation approach in extending training reach. Although the impact on prescribing rates is not yet available, the high engagement and intention to implement AMS strategies observed should inspire confidence in this approach to training implementation.