What is the challenge your project is going to address and how does it connect to your chosen theme?

Antimicrobial resistance (AMR) is a global problem. Key ways of tackling AMR described in the UK’s five-year national action plan are reducing need for, and unintentional exposure to, antimicrobials, and optimising use of antimicrobials.

One recommended course of action is to test and implement national and local behaviour change interventions to nudge improved antibiotic prescribing and consumption using behavioural science. The TARGET  (Treat Antibiotics Responsibly, Guidance, Education, Tools) toolkit has been designed to assist health professionals and patients deliver quality improvement programmes to increase responsible antibiotic prescribing. It is based on the Theory of Planned Behaviour (a widely used psychological models to explain human behaviour).

However this resource is poorly implemented and utilised in primary care eg general practitioners, community pharmacies, minor injury units,  and in secondary care in the setting of the emergency department

What does your project aim to achieve?

Though these resources have been available for a decade, and despite regular awareness raising in the primary care setting,  feedback from GPs is that there are substantial barriers to their use resulting in patchy uptake. Examples of barriers relate to perceived value of the resource, access to the materials, uncertainty when to use these materials.

The TARGET toolkit supports NICE guidance on adopting a self care approach and prudent prescribing of antibiotics for upper respiratory tract conditions and urinary tract conditions (about two-thirds of GP prescribing) .

The ambition is to seek out the views of staff and patients on how the   toolkit can best be utilised to  help influence prescribers’ and patients’ personal attitudes, social norms and perceived barriers to optimal antibiotic prescribing.

Improvements in how these resources are used will improve antibiotic stewardship, outcomes for patients and benefit the wider population.

How will the project be delivered?

We would convene a project team consisting of in house  (including governance managers and service managers) and external experts (health psychologist) and Q members, and staff from the target areas (ED, MIUs, CCG, GP) across primary and secondary care to work on the project. We will identify, through qualitative approaches,  the barriers and enablers to implementation of the toolkit resources. We will collaborate with a health psychologist to identify an appropriate behaviour change theory model (e.g. Theoretical Domains Framework) and use that to inform the qualitative study interview protocol to ensure all domains likely to impact on behaviour change are explored.

The output of the qualitative interviews / focus groups will inform the strategy for implementation of the TARGET resources across primary and secondary care in Cornwall.

What and how is your project going to share learning throughout?

Our outputs will be distributed not just in the south west but also nationally and shared with NICE. As we progress our project, learning will be widely applicable and can be shared via the Q community and in wider forums, e.g. AMS groups. We can share learning via twitter as well.