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AMR National Action Plan – IMC Alignment

By September 8, 2023No Comments

DHSC is working with a variety of key stakeholders to develop the 2024-2029 AMR National Action Plan for 2024 publication.

The draft proposal contains outcomes and commitment which underpin the high-level objectives which are then intended to be supported by deliverables and actions in more granular detail.

Any comments from stakeholders are being incorporated where appropriate to get expert input to inform the deliverability for sign off at the end of the year. It will be an interactive process with a wide range of different views.

Comments can be made by members of the IMC in writing until 22 September 2023.

The National Action Plan contains some of the IMC’s recommendations, including the holistic approach which is advocated, particularly stewardship, control, and waste management.

At this stage of the process, the plan doesn’t contain any prioritisation but, in partnership with CSOs and other stakeholders, there will be criteria to introduce prioritisation.

They recognise that the commitments in their current form are high level and not in the required level of detail and there are also a number of dependencies that need to be assessed. The intention is that there will be continuous activity over the years that the plan covers and beyond.

The National Action Plan will amplify the narrative internationally with the UN and international stage with other global leaders.

BIVDA and others emphasised the importance of linking therapeutics and diagnostics as they are still siloed.

Regarding approval of innovations and existing products, the group stated that timely approval processes, personalised medicine, and test/drug combinations were assessed with appropriate criteria in a similar manner to the way breast cancer has previously been addressed.

It is also important to distinguish the difference between the use of diagnostics in primary, secondary and tertiary settings, to ensure that there is not a diagnostic gap and that the opportunities are more focused and targeted.

In the IMC white paper, it refers to the MedTech Funding Mandate being prohibitive for diagnostics to qualify and doesn’t contain any microbial technologies.

It was also noted that outside of the National Action Plan, the Long Term Workforce Plan doesn’t mention AMR, with DHSC hoping to link the plan with other national strategies across the board which will have time to have an effect on medical training. The UK has a lot of resources available for e-learning and health development. It was commented that training should be a civic responsibility, like cancer and sepsis. Training should be delivered in combination with educating the public.

Leads in ICSs are not clearly defined and there is a concern that the structure and funding may not be robust and the time for reflection may not be adequate to report. ICSs are going to be reporting stewardship into Trusts and Boards.

HealthTech appraisals need to generate more evidence of the value of AMR and diagnostics on the overall burden, public efficiency, and social benefit towards the de-linkage model and value-based healthcare.

Understanding the enablement value of infection management is critical and needs to be embedded across diagnostics, therapeutics, technology, and training.

Understanding the baseline of old microbials is required to identify the value of new ones.

There is no standardised dataset across the system and there is real value in understanding mortality rates and infection journeys. AMR needs a Covid-type dashboard for person-centred care and transparency through the pathway.

This isn’t just relevant to AMR, and DHSC have wider areas to look at too.

Patient objectives are expected to be captured through patient advocacy groups, and their engagement for the implementation of the plan is important.

Accountability is needed for each element of the plan and, whilst it requires collaboration in the most part, individuals should also be accountable in order to join up the pieces of who is doing what, and to ensure a legacy beyond party politics.

Alignment is health cost benefits from the treasury and other quality of life guidance is needed as the algorithm is different for AMR.

Equality and Equity aspects also need to be included as there are different infection areas and differing outcomes of blood stream infection, for example. Reference to the Paediatric community is also required as there is different guidance and approach.

The next steps are to continue the stakeholder consultation until 22 September and look towards the development of the deliverables, which will be ad-hoc rather than a full review.

Ben Kemp