Antimicrobial Stewardship Dashboard Basics

A visible antimicrobial stewardship dashboard helps prescribers change habits and keeps patients safer. Start with the data you already collect, build proportionate visuals that guide targeted action, and show CQC how your practice monitors antibiotic prescribing quality.

Why antimicrobial stewardship dashboards matter now

• CQC expect practices to demonstrate active monitoring of antibiotic prescribing, not just policy existence.
• The UK Health Security Agency reports that antimicrobial resistance causes thousands of deaths each year, making stewardship a patient safety priority.
• Integrated care boards review prescribing data at PCN and practice level, comparing broad spectrum use and total antibiotic items per patient.
• Patients increasingly question antibiotic prescriptions, and visible data helps prescribers explain decisions with confidence.

Select metrics that drive behaviour change

Focus on indicators that reveal prescribing patterns and support clinical conversations.

Core metrics for every practice:

• Total antibiotic items per 1,000 registered patients per month, compared with ICB and national averages.
• Proportion of broad spectrum antibiotics (co-amoxiclav, quinolones, cephalosporins) as a percentage of all antibiotic prescriptions.
• Repeat antibiotic prescriptions issued within 30 days of the previous course for the same indication.
• Number of delayed prescriptions issued and the proportion collected by patients.

Additional metrics for targeted improvement:

• Prescribing rates for urinary tract infections in older patients, segmented by care home and community dwelling.
• Compliance with local formulary first line choices for respiratory tract infections.
• Safety netting follow up completed within 48 hours of issuing a delayed prescription.
• Adverse drug reactions reported through the yellow card scheme or recorded in clinical systems.

Gather data from accessible sources

Most practices hold the information needed without commissioning expensive audits.

Monthly prescribing data:

• Download practice level prescribing statistics from OpenPrescribing or your ICB medicines optimisation dashboard.
• Extract antibiotic prescription counts and costs from your clinical system pharmacy module.
• Request feedback from community pharmacists about delayed prescriptions and patient queries.

Qualitative intelligence:

• Review complaints and compliments mentioning antibiotics, treatment decisions, or infection outcomes.
• Capture themes from significant event analyses involving sepsis, delayed diagnosis, or antibiotic related harm.
• Include prescriber reflections from peer review meetings and clinical supervision notes.

External benchmarks:

• Compare your data with neighbouring practices, PCN aggregates, and the national STAR-PU adjusted figures published by NHS Business Services Authority.
• Reference local microbiology service reports on resistance patterns and hospital admission trends linked to primary care prescribing.

Design a dashboard that informs at a glance

A well designed dashboard should answer three questions in under one minute: where are we now, how does this compare, and what needs attention?

Visual layout principles:

• Use simple line charts to show monthly trends over the past 12 months, with your practice data and ICB average on the same axes.
• Apply traffic light colours to flag metrics above or below agreed thresholds, but avoid relying on colour alone for accessibility.
• Add short narrative boxes (two to three sentences) to explain spikes, such as seasonal respiratory illness, locum prescribing patterns, or care home outbreaks.
• Highlight specific cohorts that need focus, such as patients with recurrent urinary tract infections or care home residents with repeat prescriptions.

Practical setup:

• Store the dashboard in a shared clinical governance folder accessible to all prescribers, with view only permissions for auditors and inspectors.
• Update data monthly on a fixed schedule, ideally within five working days of prescribing data release.
• Include the dashboard in induction materials so new prescribers understand practice expectations from day one.

Turn dashboard insight into clinical action

Data only improves care when it leads to agreed changes in practice behaviour.

Monthly prescribing meeting routine:

1. Review the dashboard as the first agenda item and allow five minutes for questions.
2. Agree two or three specific actions with named leads and review dates, such as revising repeat prescription templates or arranging microbiology input for complex cases.
3. Revisit previous actions and record outcomes so the team sees progress over time.
4. Share a one page summary with non-prescribing staff so reception and administration teams understand why certain queries need clinical triage.

Tailored patient communication:

• Prepare short scripts for reception staff when patients request repeat antibiotics before review is due.
• Develop template messages for patient records explaining delayed prescribing rationale and safety netting advice.
• Update waiting room displays and website content to reflect current prescribing guidance and resistance concerns.

Collaborative learning:

• Share anonymised dashboard findings with neighbouring practices or the PCN clinical director so support and training can be coordinated.
• Invite the ICB medicines optimisation team to interpret trends and suggest targeted interventions.
• Log every intervention, including brief education sessions, changes to clinical system templates, and individual prescriber feedback.

Assign ownership and governance

Clear accountability ensures the dashboard remains current and influences decisions.

Name an antimicrobial stewardship lead:

• Confirm which partner, pharmacist, or advanced nurse practitioner owns the dashboard and reports progress at partner meetings.
• Include antimicrobial stewardship as a standing item in clinical governance agendas.
• Allocate protected time for the lead to update data, prepare summaries, and coordinate improvement work.

Evidence for CQC and commissioners:

• Keep a folder containing dashboard iterations, action logs, and meeting minutes showing how data influenced decisions.
• Capture before and after snapshots when interventions reduce broad spectrum prescribing or improve formulary compliance.
• Store patient feedback and safety event reviews alongside prescribing data to demonstrate holistic stewardship.

Avoid common pitfalls

Several challenges emerge when practices first introduce antimicrobial dashboards.

Data overload:

• Start with four core metrics and add complexity only when the team asks for deeper analysis.
• Resist the temptation to track every antibiotic class; focus on broad spectrum agents and total volume first.

Blame culture:

• Present dashboard findings as system insights, not individual prescriber performance league tables.
• Use anonymised peer comparison when highlighting variation, and offer support rather than criticism.

Stale information:

• Automate data extraction wherever possible using clinical system reports or OpenPrescribing API feeds.
• Set calendar reminders for monthly updates and delegate the task if the lead is on leave.

Disconnect from frontline practice:

• Involve reception supervisors and nursing teams in dashboard reviews so they understand the context behind prescribing changes.
• Test any new patient communication or triage protocols on a small scale before rolling out practice wide.

Put it into practice

Choose one prescriber group (for example, the Tuesday morning clinic team) and introduce the dashboard at their next meeting. Ask three questions: does this data match your experience, which metric surprises you most, and what single change would make the biggest difference? Use the answers to refine the dashboard design and agree the first improvement action before the meeting ends. When the pilot group reports positive change, extend the dashboard to the wider practice and consider where premium audit templates, patient leaflets, and structured meeting agendas will accelerate progress.

Disclaimer

This guidance is for general information. It is not a substitute for legal, clinical, or specialist advice. Always seek professional support tailored to your practice.