Scottish Management of Antimicrobial Resistance Action Plan 2014-18 (ScotMARAP2)

Background

The scale of the threat of antimicrobial resistance (AMR) and the case for action was set out in the Annual Report of the Chief Medical Officer 2011 published in March 2013 and the UK Five Year Antimicrobial Resistance Strategy 2013-18 sets out actions to address the key challenges to AMR. The overarching goal of the Strategy is to slow the development and spread of AMR and focuses on activities around 3 strategic aims:

• improve the knowledge and understanding of AMR,
• conserve and steward the effectiveness of existing treatments,
• stimulate the development of new antibiotics, diagnostics and novel therapies.

The UK AMR Strategy identifies 7 key areas for action to support the 3 strategic aims:

1 Improving infection prevention and control practices in human and animal health.

2 Optimising prescribing practice through implementation of antimicrobial stewardship programmes.

3 Improving professional education, training and public engagement to improve clinical practice and promote wider understanding of the need for more sustainable use of antibiotics.

4 Developing new drugs, treatments and diagnostics through better collaboration between research councils, academia, industry and others.

5 Better access to and use of surveillance data in human and animal sectors.

6 Better identification and prioritisation of AMR research needs to focus activity and inform our understanding of AMR.

7 Strengthened international collaboration working with and through a wide range of governmental and non-governmental organisations, international regulatory bodies and others.

In Scotland, the Scottish Management of Antimicrobial Resistance Action Plan 2008, made recommendations for improving the use of antimicrobials across all healthcare settings as part of the broader Healthcare Associated Infection (HAI) Task Force Delivery Plan. ScotMARAP has largely been delivered by establishment of the Scottish Antimicrobial Prescribing Group (SAPG) and collaborative working between national stakeholders and NHS boards.

ScotMARAP has been refreshed to address key areas 2, 3 and 5 (human sector) of the UK AMR Strategy and ScotMARAP 2 provides an update to the original ScotMARAP document including revised roles and deliverables for SAPG and other stakeholders.

The remaining areas of the UK AMR strategy will be implemented in Scotland via an overarching Controlling Antimicrobial Resistance in Scotland (CARS) group and actions from ScotMARAP 2 will feed into this group.

ScotMARAP 2 will inform the operational delivery plans of SAPG for 2014 - 18 as well as the annual work plans of national and local stakeholders, and will be integrated into the current HAI Task Force Delivery Plan. ScotMARAP 2 will build upon the successes of ScotMARAP 2008 to maintain and further develop the current national stewardship programme using a quality improvement approach informed by the evolving national informatics capability.

A summary of the key aims of ScotMARAP 2 are shown in the following Antimicrobial stewardship driver diagram:

Based on the CDC/IHI Antimicrobial stewardship Driver Diagram http://www.cdc.gov/getsmart/healthcare/pdfs/Antibiotic_Stewardship_Driver_Diagram_10_30_12.pdf