Freedom of Information Request: 0793

University Hospitals Birmingham NHS Foundation Trust (UHB) completed a merger by acquisition of Heart of England NHS Foundation Trust (HEFT) on 1^st April 2018.  Due to historical differences in data collection/reporting across UHB and the former Heart of England NHS Foundation Trust some responses have been provided by hospital site.

1. What point of care facilities does your trust have for the diagnosis of:
2. Group A streptococcal bacteria
3. Influenza virus
4. Clostridium difficile
5. Staphylococcus aureus

We have POCT for Influenza A.

2. Does your trust require diagnostic tests before prescribing:
3. Penicillins
4. Aminoglycosides
5. Tetracyclines
6. Macrolides
7. Co-amoxiclav
8. Cephalosporins
9. Carbapenems
10. Quinolones

Queen Elizabeth Hospital

The antimicrobial prescribing guidelines for Queen Elizabeth hospital site make it clear that before starting antibiotic therapy we should ideally take appropriate cultures and swabs of the patient. Our electronic prescribing system will not assess if diagnostic tests have been taken before allowing a prescription, but our education and training on antimicrobial prescribing given to staff covers diagnostic testing and the importance of checking results to de-escalate therapy.

Heartlands, Good Hope, and Solihull Hospitals

Yes. In-line with the national AMR/sepsis CQUIN 2018/19, some of the above mentioned antibiotics are recommended for empirical treatment, however diagnostic tests relevant to the presumed source of infection are required and can be found in the Trust’s antimicrobial guidelines or are recommended by the AMS teams. Furthermore the national start SMART then FOCUS national guideline recommendations are used to encourage diagnostic led AMS overall e.g. De-escalation, STOP, or OPAT.

3. What plans do your trust have to procure new diagnostic equipment using the additional funding for additional diagnostic equipment and staff capacity?

No decisions about new diagnostics can be made until the laboratory functions have been fully consolidated for UHB as a whole.