Getting the most from the TARGET toolkit

To get maximum effect regarding antibiotic use, all or as many as possible of the resources should be used with action planning by those involved in antimicrobial stewardship activities such as those from clinical commissioning groups (CCGs) and primary care networks (PCN), prescribers working in primary care, and those involved in training prescribers around infection management. Collectively, the TARGET resources will support practices in planning, implementing and reviewing activity in delivering quality improvement programmes relating to antimicrobial stewardship. A recent rigorous RCT evaluation in routine general practice showed that a one hour TARGET workshop given by local GPs, microbiologists or medicine managers, combined with demonstrating the resources, significantly reduced antibiotic use.

It is essential to plan and monitor implementation of the TARGET Antibiotics Toolkit appropriately and this is best achieved by developing a local antibiotic action plan, either for your CCG or your practice. It is important that this plan is developed using a whole team approach so that everyone who is involved in communication and prescribing around antibiotics has had the opportunity to contribute.

Each CCG, PCN and Practice has different prescribing pressures and priorities. It is therefore also important that prescribers take ownership of the planning process as well as the adaptation and implementation of resources at a local level. Before beginning the planning process we recommend you appoint a local antibiotic champion from within the CCG or the practice. This could be a prescribing lead, GP with a specialist interest in infection management, nurse practitioner, clinical pharmacist, or any other person who can be responsible for antimicrobial stewardship in your practice, your PCN or CCG. This is someone who has responsibility for leading on all issues relating to antibiotics and leads the development and implementation of the antibiotic action plan.

In order to maximise effectiveness of the TARGET resources, users should plan, monitor and review the implementation as part of a cyclical process as follows:

TARGET Toolkit implementation cycle

Abbreviations: CCG = Clinical Commissioning Group; PCN = Primary Care Network