Call for evidence outcome

Antimicrobial resistance national action plan: call for evidence

Updated 16 August 2023

Introduction

Antimicrobial resistance (AMR) arises when the organisms that cause infection evolve ways to survive antimicrobial treatment. Once standard treatments are ineffective, it is easier for infections to arise, persist and spread. These resistant organisms can be found in people, animals, food and the environment.

The impacts of unchecked antimicrobial resistance are wide-ranging and extremely costly, not only in financial terms, but also in terms of public health, food security, environmental wellbeing and socio-economic development. Coordinated, cross-sectoral action is required to tackle AMR, including in all 4 pathogenic domains (bacteria, fungi, viruses, parasites).

In January 2019, the UK government published its vision for AMR to be contained and controlled by 2040. The vision recognises that a global problem as significant and complex as AMR requires a long-term course of action that progressively strengthens our understanding of AMR and what works to contain and control it.

Background to this call for evidence

In support of the vision, the government also committed to develop a series of 5-year national action plans that will each prioritise actions and direct resources based on the latest information about what the biggest risks are, and which interventions are most effective in addressing them.

The UK’s first national action plan in support of the 20-year vision was published in 2019 and will run until 2024. An addendum to the national action plan was published in 2022 to reflect lessons learnt from the COVID-19 pandemic and progress made in the first 2 years of delivery.

This call for evidence has been launched to inform the development of the next 5-year national action plan, which will run from 2024 until 2029. Rather than a formal consultation on specific proposals, it’s a request for ideas and evidence on which we can build. In addition to this call for evidence, the government is consulting with a wide range of stakeholders across and beyond government to inform the national action plan’s development.

We encourage input from technical experts (including on human health, animal and plant health, food and AMR in the environment) on this call for evidence.

How to respond

You can respond as an individual, or on behalf of an organisation by completing the online survey.

Submissions of evidence from all interested parties are invited as part of the government’s process to inform the development of the next AMR national action plan. You should note that any positions expressed do not necessarily represent current or future UK policy.

The deadline for responses to the call for evidence is 20 January 2023.

Next steps

The evidence gathered through this exercise will inform the 2024 to 2029 AMR national action plan. This is the first stage in a broad consultation process; the findings from this call for evidence will inform further, in-depth engagement with stakeholders.

Consultation questions

The threat of AMR

The threat of AMR and our ability to respond to it is affected by several factors. These include: population size and demographics; trade patterns; and major global events, for example the coronavirus ‘COVID-19’ pandemic and the war in Ukraine.

The first 2 questions are about the scale and nature of the threat of AMR. The other questions are about our efforts to respond to AMR.

Question

From your experience, how has the scale of the threat of AMR changed since the national action plan was published in 2019?

a) the threat of AMR has increased since 2019 b) the threat of AMR has stayed the same since 2019 c) the threat of AMR has reduced since 2019 d) don’t know

There are several drivers of AMR, which may differ between sectors. The national action plan for 2019 to 2024 states that the 3 biggest drivers of AMR for infections in humans in the UK are:

1. a rise in the incidence of infections, particularly Gram-negative bloodstream infections (including E. coli)
2. the import of resistant infections through international travel
3. antimicrobial use

Question

In your opinion, what are the top 3 drivers of AMR?

Please give 3 short answers.

Priority interventions for tackling AMR

The current national action plan focuses on 3 key ways of tackling AMR:

• reducing the need for, and unintentional exposure to, antimicrobials (including preventing and controlling the occurrence of infections, vaccination and limiting exposure to antimicrobials through food and the environment)
• optimising the use of antimicrobials (including ensuring that the right drug, time, dose, duration, patient/animal and route are taken)
• investing in innovation, supply and access (including supporting the development, supply, and access to old and new antimicrobials, vaccines and diagnostics)

We would like your view on which of these areas requires the most focus over the next 5 years. Through ongoing stakeholder engagement in 2023, we will further prioritise the specific actions that fall within each of these areas.

Question

Which of these areas would you most like to see prioritised over the next 5 years?

1. reducing the need for, and unintentional exposure to, antimicrobials
2. optimising the use of antimicrobials
3. investing in innovation, supply and access

Question

Are there any actions you think are required to tackle AMR that do not fall within one of these categories?

• yes (please specify)
• no
• don’t know

Learning from previous action to tackle AMR

We would like to learn from current and previous government action on AMR. Since the publication of the national action plan, the UK has made significant progress in tackling AMR. For example, the UK has:

• reduced the use of antibiotics in food-producing animals
• piloted novel and innovative ways of evaluating and paying for antibiotics on the NHS
• published the national infection prevention and control manuals in England and Wales
• advocated for more action on AMR on the global stage, including through the UK’s G7 presidency

Question

Within the UK, what are the key successes we should look to maintain or build on in responding to AMR?

Please include up to 3 examples in no more than 250 words.

Despite the substantial progress made on AMR in the past decade, we know there is much more to do. There are some areas where we have struggled to make the progress we envisaged. This includes failing to reduce the incidence of some specific drug-resistant infections in people. It also includes other areas where we think we could focus more government action, such as understanding and minimising the transmission of AMR in the environment. Given financial pressures and limited resources both within and outside of government, we are seeking views on the most important, realistic and tangible actions we can take to have the most impact on AMR.

Question

Within the UK, what are the areas that require more focus or development to address AMR?

Please include up to 3 examples using no more than 250 words in total.

The national action plan includes several commitments to improve the professional capacity and capability for tackling AMR. We would like to understand whether we have the required workforce and skillsets to best tackle AMR.

Question

Within your sector, do you think the UK has sufficient capacity and capability to tackle AMR?

• yes
• yes, in some areas (please specify)
• no
• don’t know

Since 2019, several capabilities required to tackle AMR have changed. This includes our sequencing capability, surveillance capabilities, diagnostic lab capability, and antimicrobial stewardship activity.

Question

What additional capacity and capability is needed in your sector to effectively tackle AMR?

Please give up to 3 examples using no more than 250 words in total.

Question

In your opinion, what are the key barriers to making progress on tackling AMR in your sector?

Please give up to 3 examples using no more than 250 words in total.

International efforts to tackle AMR

AMR is a global challenge, and no one country can tackle it alone. The UK plays a leading role advocating for and taking action to tackle AMR in several multilateral arenas. As part of our leading international role, we helped secure the Political Declaration on AMR at United Nations General Assembly in 2016. We also recently secured G7 commitments on AMR on a number of ministerial tracks. We will continue to deliver our domestic commitments on AMR, as well as pushing forward international commitments. Through our global engagement, we recognise there is also much to learn from other countries’ efforts, both successes and challenges.

Question

What, if anything, do you think we can learn from other countries’ responses to AMR?

Please be specific about which countries you are referring to in your answer.

Please give up to 3 examples using a maximum of 250 words in total.

Opportunities from COVID-19

We saw an unprecedented level of cross-disciplinary working during the COVID-19 pandemic with government, industry and researchers collaborating to respond to a significant public health challenge. The toolbox we used to tackle COVID-19 will be similar for AMR. As reported by the Academy of Medical Sciences, diagnostics, surveillance, therapeutics and vaccines are crucial aspects of the AMR response and can draw on the COVID-19 experience.

Question

In your opinion, which of these tools should be prioritised for adapting to use in tackling AMR?

1. diagnostics
2. surveillance
3. therapeutics
4. vaccines

Question

In your opinion, are there any other tools that should be adapted from use during the COVID-19 pandemic for tackling AMR?

• yes (please specify)
• no
• don’t know

COVID-19 has also delayed progress in tackling AMR, putting severe strain on healthcare services and diverting resources from the ‘silent pandemic’ of AMR to the urgent COVID-19 response.

We think it has also altered the risk landscape. For example, different patterns of healthcare use during COVID-19 restrictions led to increased prescribing of antimicrobials in certain settings (such as dentistry). Also, COVID-19 potentially made patients more vulnerable to hospital acquired infections.

Question

Do you believe the changes in ways of working within your organisation due to the COVID-19 pandemic have affected efforts to respond to AMR, such as delivery of the current national action plan (NAP)?

• yes
• no
• don’t know

Question

In what way have they affected the response to AMR or delivery of the NAP?

Please give up to 3 examples using no more than 250 words in total.

Question

Are there other ways in which the COVID-19 pandemic has altered the AMR risk landscape?

Please give up to 3 examples in no more than 250 words in total.

Question

Are there other global events, such as supply chain disruption or the conflict in Ukraine, that have changed the UK’s ability to respond to AMR?

• yes
• no
• don’t know

If yes, how have other global events changed the UK’s ability to respond to AMR?

Please specify which global event you’re referring to.

Measures of success

The national action plan includes measurable ambitions and targets including to:

• reduce the number of resistant infections
• reduce antimicrobial use in humans and animals
• ensure prescriptions state whether they were supported by a diagnostic test

Question

In your opinion, what are the best measures of success in tackling AMR?

Please give up to 3 suggestions.

During the COVID-19 pandemic, public awareness of infection spread increased, along with prevention and control measures and acceptability of point of care diagnostics.

Question

Do you believe that there is sufficient public and professional awareness of AMR?

• yes
• no
• don’t know

If no, what should be done to increase awareness of AMR?

Please tell us in a maximum of 250 words.

Further information

Question

Is there any other evidence you would like to tell us as we develop the 2024 to 2029 national action plan?

Please tell us using no more than 250 words.

Question

Are you content for the DHSC AMR policy team to contact you to take part in further stakeholder engagement as we develop the 2024 to 2029 national action plan?

• yes
• no

Data protection

Over the course of October and November 2022, the Department of Health and Social Care (DHSC) will seek the views of individuals and organisations through a call for evidence, to inform the next 5-year national action plan for AMR. This notice sets out how data collected through this call for evidence will be used and respondents’ rights under Articles 13 and/or 14 of the General Data Protection Regulation (GDPR).

Data controller

The Department for Health and Social Care is the data controller.

What personal data we collect

You can respond to the call for evidence through our public survey, which can be completed online, or on paper and submitted by email.

We will collect data on:

• whether you are responding as an individual or on behalf of an organisation
• the country you live in, or where your organisation provides services in the UK
• your area of work
• (if responding online) your internet protocol (IP) address (this is for security purposes and will not be attached to your survey response)

If volunteered by you, we will also collect data on:

• your email address (if completing a paper survey and submitting it by email, or if responding on behalf of an organisation and confirming that DHSC can contact you about your response)
• any other personal data you volunteer by way of evidence or example in your response to open-ended questions in the survey

How we use your data (purposes)

Your data will be treated in the strictest of confidence.

We collect your personal data as part of the call for evidence process:

• for statistical purposes; for example, to understand how representative the results are and whether views and experiences vary across demographics
• so that DHSC can contact you for further information about your response (if you are responding on behalf of an organisation and have given your consent)

Legal basis for processing personal data

The legal basis for processing your personal data is to perform a task carried out in the public interest, that of consulting the public.

The legal basis for processing your sensitive personal data is that it is necessary for reasons of public interest in the area of public health (namely to ensure the new UK AMR national action plan takes into consideration the views and experiences of experts in the field).

Data processors and other recipients of personal data

All responses to the call for evidence will be seen by:

• professional analysts and policy leads working on the development of the new national action plan in DHSC
• DHSC’s third-party supplier (SocialOptic), who is responsible for running and hosting the online survey

DHSC may also share your responses with:

• individuals supporting this project within DHSC’s executive agencies and/or executive non-departmental public bodies, such as NHS England
• other government departments
• external researchers if additional support is required to analyse the responses received

International data transfers and storage locations

Storage of data by DHSC is provided via secure computing infrastructure on servers located in the European Economic Area (EEA). Our platforms are subject to extensive security protections and encryption measures.

Storage of data by SurveyOptic is provided via secure servers located in the United Kingdom (UK).

Retention and disposal policy

DHSC will only retain your personal data for as long as either:

• it is needed for the purposes of the call for evidence
• the law requires us to

This means that personal data will be held by DHSC for a minimum of 1 year and a maximum of 8 years.

SurveyOptic will securely erase the data held on their system 5 years after the call for evidence online survey closes, or when instructed to do so by DHSC if the data has served its intended purpose (whichever happens earlier).

Data retention will be reviewed on an annual basis. Anonymised data will be kept indefinitely.

How we keep your data secure

DHSC uses appropriate technical, organisational and administrative security measures to protect any information we hold in our records from loss, misuse, unauthorised access, disclosure, alteration and destruction. We have written procedures and policies that are regularly audited and reviewed at a senior level.

SocialOptic is Cyber Essentials certified.

Your rights as a data subject

The data we are collecting is your personal information and you have considerable say over what happens to it. As such, you have the right to:

• see what data we hold about you (this is known as a ‘right of access request’)
• ask us to stop using your data, but keep it on record
• have some or all of your data deleted
• have some of your data corrected
• lodge a complaint with the Information Commissioner’s Office (ICO) if you think we are not handling your data fairly or in accordance with the law

Comments or complaints

Anyone unhappy or wishing to complain about how personal data is used as part of this programme, should contact data_protection@dhsc.gov.uk in the first instance or write to:

Data Protection Officer
1st Floor North
39 Victoria Street
London
SW1H 0EU

Anyone who is still not satisfied can complain to the Information Commissioner’s Office. Their website address is www.ico.org.uk and their postal address is:

Information Commissioner's Office
Wycliffe House
Water Lane
Wilmslow
Cheshire
SK9 5AF