Decision support tools can help GPs reduce antibiotic prescriptions for respiratory conditions

Electronically delivered interventions, integrated into practice workflow, result in moderate reductions of antibiotic prescribing for respiratory tract infections in adults, which are likely to be of importance for public health. | BMJ | via National Institute for Health Research


A 12% reduction in GP antibiotic prescriptions for respiratory conditions was achieved through the use of electronic decision and training tools. This reduction did not increase the risk of serious infections compared to usual care.

The low-cost intervention in this large NIHR-funded trial included a short training webinar for GPs and feedback on their practice’s prescribing rates. The decision support tool gave prompt access to NICE prescribing guidelines and printable patient information leaflets when a respiratory tract infection code was inserted into a patient’s medical record. However, the reduction in prescriptions was only seen in those aged 15-84; no difference was observed in older adults and younger children.

Overall the decision support was used in a minority of respiratory consultations. This was a carefully designed study which showed positive but relatively modest effects. It highlights the need for multiple approaches in the continuing efforts to tackle the complex problem of rising rates of antimicrobial resistance.

Gulliford MC, Prevost AT, Charlton J et al. | Effectiveness and safety of electronically delivered prescribing feedback and decision support on antibiotic use for respiratory illness in primary care: REDUCE cluster randomised trial | BMJ | 2019 | 364:I236.

Further detail at NIHR

FREE NHS WiFi at Crystal Peaks Medical Centre

NHS England | November 2018 | NHS WiFi at Crystal Peaks Medical Centre

Crystal Peaks Medical Centre is a  GP practice in a busy retail park in Sheffield; it installed NHS WiFi in July 2018,  NHS England have now produced a case study about this innovation and  video interview with Dr Kirsty Gillgrass, a GP Partner at the practice. There are approximately 7,000 patients registered with the practice. It is a training practice with 5 GP partners and a large multi disciplinary primary care team. 

The practice, along with other practices in the neighbourhood, is applying for digital inclusion funding to encourage digitally excluded patients to take charge of their health and wellbeing and make use of patient online services.

Practice staff will encourage patients to sign-up for patient online services while in the waiting room, and staff will be able to use mobile devices to demonstrate to patients how to book appointments online and order repeat prescriptions.

Having access to free WiFi can also reduce anxiety for patients before their appointment. Being able to make good use of their time by accessing emails, checking social media or even downloading an ebook to calm their nerves can improve the patient experience (Source: NHS England).

Extra support pledged for GPs this winter

NHS England has announced it will provide £10 million to GPs to support delivery of additional extended hours, out of hours and unscheduled care sessions over winter.


The Winter Indemnity Scheme will be used to cover the costs of professional indemnity for the extra services provided by GPs, giving them the freedom to work extra sessions securely and without extra costs. This is the fourth year that NHS England has funded the successful winter indemnity scheme, having first introduced it in 2015-16.

Having committed £10 million to support the initiative, NHS England will be monitoring uptake across GP practices, out of hours services, NHS 111 and urgent care service providers, to evaluate the scheme’s impact.

Full story at NHS England