Projects focused on communications within the community

NHS Grampian

Provide a brief overview of your project?

On 26th January 2019 four members of the Antimicrobial Management Team (AMT) of NHS Grampian manned a stand at Pittodrie Stadium (Aberdeen Football Club) during a home fixture, with the theme of Antimicrobial Awareness. We harnessed the opportunity to engage with fans both pre-game and at half –time, in an area with a predicted footfall of 3,500 on the day. In the run up to the game Aberdeen FC featured a news article about the initiative on the club website and social media accounts. The article linked to the Antibiotic Guardian Website.
On the day all AMT members wore Antibiotic Guardian T-shirts and our stand was flanked by two large pull up banners advertising the campaign. The club encouraged fans to visit the stand via the tannoy system. Our prime method of engaging with fans was via the Antibiotic Guardian quiz. We ran a competition, with all completed entries eligible to win a £25 voucher for the Aberdeen FC club shop (kindly donated by the club). We received 105 completed entries (engaging with many more fans) and provided copies of the answers when entries were submitted. We discussed the Antibiotic Guardian Campaign with fans and had copies of potential pledges on clipboards, facilitating discussion and to demonstrate the simplicity of the pledges. In addition we utilised Antibiotic Guardian pens and stickers to aid our engagement with fans. Alongside the Antibiotic Guardian campaign we highlighted the Keep Antibiotics Working campaign, supplying leaflets and childrens colouring sheets.
We shared our visit via social media (Facebook and Twitter) with coverage from NHS Grampian and personal accounts. A short follow up article was included in the NHS Grampian ‘Upfront’ staff newsletter in February 2019.

Please cite 3 examples of outcomes or impacts from the project on tackling AMR.

We have tallied the quiz answers (multiple choice) received on the day and it is our intention to use this information to guide and shape future pubic engagement and information campaigns. The results can help us identify areas of education to target, to enable us to improve the knowledge of the public locally and tackle any misconceptions.
We were able to engage with a large number of people, of varying age groups and backgrounds, in a short timescale, distributing information and initiating conversations on AMR in a forum we had not previously explored. Forming links with a local football club facilitated the formation of a new avenue to highlight AMR and the large following of such an organisation, via social media and otherwise, should help spread the message to a wide number of the local population. The football club have intimated their willingness to assist us with further events in the future, so a valuable link to the local community has been established.
Our visit gained lots of social media coverage both locally and nationally with posts shared and retweeted by various groups e.g. Scottish Antimicrobial Prescribing Group (SAPG). The varying twitter handles and hashtags used should have resulted in a large audience. As a result we have been asked to give a presentation on our event to the Association of Scottish Antimicrobial Pharmacists and this may result in a similar model being followed by other areas to continue to work to highlight the reality of AMR and its consequences to the public in Scotland.

How is the project to be developed in the future?

We aim to continue our association with Aberdeen Football Club as this allows us to reach a wide and diverse audience. We will continue to explore the possibility of high profile figures within the club making public pledges to become Antibiotic Guardians, with associated coverage, to further highlight the campaign and encourage fans to follow in their footsteps.

NHS Lanarkshire

Provide a brief overview of your project?

As part of a junior pharmacist led World Antibiotic Awareness Week Event, a poster was designed based on the Antibiotic Guardian Campaign pledges. It was designed as a novel stimulating prompt, aid memoire designed to overcome poster (wall paper) fatigue and draw in variety of audiences.  Behavioural science and improvement methodology encourages novelty to generate interest. Key messages were chosen from different categories and included health professional messages and general public messages e.g. for families and pet owners and was adapted to include priority areas for antimicrobial stewardship.
With a colourful visual aid and clear messages for everyone within the local community, healthcare workers and members of the public, it was easy for everyone to find a message applicable to them.
The poster was used to start conversations around antimicrobial stewardship and how everyone has a role to play to improve the prescribing of antibiotics and help reduce antimicrobial resistance. It was used locally in the Winter Health Campaign to generate discussion and promote antibiotic guardian pledges in acute hospitals and GP surgeries in Lanarkshire. It was also distributed to wards and discussed with pharmacy teams in hospitals.
The poster was then taken to national meetings such as the Association of Scottish Antimicrobial pharmacist group (ASAP), the Scottish Quality and Safety Fellowship meeting which included a wide range of healthcare professionals, and the local Royal Pharmaceutical Society Scotland Event ‘Improving antimicrobial stewardship – join the war on bugs’ for community pharmacists and technicians.

In additional to this the poster was used to promote the Antibiotic Guardian message on social media via twitter. It played a significant part of the national twitter awareness campaign. (The poster featured in the top 10 tweets on the Antibiotic Guardian hashtag during World Antibiotic Awareness Week). It was also used as the key infographic in a national online article by Diane Ashiru- Oredope to promote the Antibiotic Guardian message.

Please cite 3 examples of outcomes or impacts from the project on tackling AMR.

We have tallied the quiz answers (multiple choice) received on the day and it is our intention to use this information to guide and shape future pubic engagement and information campaigns. The results can help us identify areas of education to target, to enable us to improve the knowledge of the public locally and tackle any misconceptions.
We were able to engage with a large number of people, of varying age groups and backgrounds, in a short timescale, distributing information and initiating conversations on AMR in a forum we had not previously explored. Forming links with a local football club facilitated the formation of a new avenue to highlight AMR and the large following of such an organisation, via social media and otherwise, should help spread the message to a wide number of the local population. The football club have intimated their willingness to assist us with further events in the future, so a valuable link to the local community has been established.
Our visit gained lots of social media coverage both locally and nationally with posts shared and retweeted by various groups e.g. Scottish Antimicrobial Prescribing Group (SAPG). The varying twitter handles and hashtags used should have resulted in a large audience. As a result we have been asked to give a presentation on our event to the Association of Scottish Antimicrobial Pharmacists and this may result in a similar model being followed by other areas to continue to work to highlight the reality of AMR and its consequences to the public in Scotland.

How is the project to be developed in the future?

The poster has great potential to be developed in future and can be easily adapted with different messages. It has the potential to be included in the Public Health England resources and also as part of the ongoing Antibiotic Guardian Campaign. It could also be adapted and incorporated into the Scottish Antimicrobial Prescribing Group resources for EAAD/WAAD for 2020.

The University of Manchester (Winner - Antibiotic Guardian Awards 2017)

Name: Roger Harrison

Provide a brief overview of your project?: Dr Harrison is Senior Lecturer in Public Health, Division Lead for Social Responsibility, University of Manchester and recently member of the Education Committee for the charity Antibiotic Research UK. Since August 2016, he has:
Established and directed a concerted, campus-based programme to raise awareness about antibiotic resistance (ABR), to the 48,000 students and 12,000 staff across the University and implemented opportunities to expand student-public engagement on this topic in the local conurbation.

Dr Harrison established support from senior staff in the Faculty of Biology, Medicine and Health Sciences to legitimize his commitment to this work. He forged a new programme of activity between University of Manchester, the Students’ Union, and Public Health England (northwest).

The starting objectives of this are to:
(1) Increase awareness and understanding amongst the 48,000 registered students on antibiotic resistance, to coincide with the pilot study on public engagement from Public Health England (Granada-region, Feb-March 2017).
(1) Increase active involvement and pledge to the Antibiotic Guardian campaign across campus and local conurbation
(2) Establish a rolling-programme of workshops on ABR and hand-hygiene to be delivered in local primary schools
(3) Develop interdisciplinary projects for students as part of their curricular and extra-curricular activities with a focus on antibiotic guardianship and public education.
(4) Establish a programme of public engagement events to educate and improve ABR-related behaviours in the community
(5) Ensure all undergraduate programmes in the Faculty of Biology, Medicine and Health Sciences include appropriate training and education on antibiotic resistance awareness and stewardship, commensurate with their degree.

List any supporting partners or organisations worked with: Public Health England (north-west)
Students’ Union for The University of Manchester
The Manchester Museum
Primary Schools in Greater Manchester

How has your project demonstrated success in highlighting antibiotic stewardship within your chosen category?: Since August 2017, Dr Harrison has:
1) Received an endorsement for the University’s involvement with the Antibiotic Guardian campaign from its’ President, Professor Dame Nancy Rothwell

2) Obtained funding with a rolling-programme providing Antibiotic Guardian workshops for primary school children in deprived parts of Greater Manchester. A student society has been formed by medical students, “Beat the Bugs” to deliver these, with a completed pilot to 150 primary school children from 6 schools. There are 35 schools on the waiting list, and recruitment and training is underway to expand more student volunteers.

3) Introduction of taught/assessed project options in undergraduate and postgraduate programmes, Faculty of Biology, Medicine and Health Sciences. This has included:
• MBChB Year 2: presenting a review of evidence “what does the public need (or want) to know about antibiotic resistance?”
• MSc in Health & Science Communication students: A novel, innovative team-based ‘treasure-hunt’ activity, utilising a new mobile application and global positioning systems, and which is tailored to specific context/groups. Launching at Hull Science Festival, 2nd April 2017
• MBChB Year 4: creating a package of patient-centred online learning resources directed to promoting healthy ABR-behaviours. Completion expected September 2017

3) Directed a university – public symposium “Antibiotics – a global ticking time bomb”, with the Global Health Society. Over 130 students, academics, health professionals and public attended the event, with a wide-perspective of seven international speakers, from life sciences, humanities, medicine and public health.

4) Directed 12 students from various undergraduate and postgraduate programmes to host a public-engagement event on antibiotic guardianship and hand-hygiene as part of the Body Experience2017, Manchester Museum. At least 800 of the 2,500 visitors (exceptional and unexpected demand!) engaged in at least one of the activities about ABR and infection control/prevention and hundreds seen to be registering on the ipads to pledge support to the Antibiotic Guardian.

5) Directed a social-media campaign in partnership with the Students’ Union (serving 48,000 students) and campus Residential Life (specific for 8,000 students). This included interviews with local academics leading work on ABR, promotion of educational materials, highlights from the student project-based activities and repurposing of Public Health England’s pilot-campaign materials. Information was distributed in hard and electronic copy to 8,000 students in University managed accommodation. Further resources made available, and a specific section has been mainstreamed on the Students’ Union webpage.

All of the above activities and achievements have been promoted across the University with various blogs, newsletter and with social media across the virtual world and several radio-interviews.

Cite 3 examples within the project which highlight promotion of the protection of antibiotics?: Dr Harrison directed a public engagement event on antibiotic awareness which was attended by over 800 visitors during a science festival, Manchester Museum (18/3/17). He was helped by 12 students he had recruited. Many photographs clearly demonstrate children and parents across all-groups actively engaged. Many parents wanted to find out more about possible visits/workshops to their local school, and completed a contact form. These will be followed-up through the ‘Beat the Bugs’ programme described above. The event identified more marginalized groups – for example, Dr Harrison agreed to host a half-day event at the University, on this and similar topics, for a network of home-schooled children in the north-west.

Dr Harrison gained commitment from The Students’ Union to fully-embrace the need to increase the 48,000 students’ awareness and primary and secondary prevention behaviours to help reduce antibiotic resistance. It is the first-time that a health/wellbeing campaign has been endorsed mid-point during an academic year, outside of the standard Executive election process. The Students’ Union have carried out interviews with senior academics across Campus who are leading various research programmes associated with antibiotic resistance and posted these across social media. They have repurposed digital resources from Public Health England’s campaign on antibiotic resistance (north-west pilot) and ensured these are widely promoted on their campus-wide digital screens, social media and via specific student email. The Students’ Union have agreed to continue to support this programme of work and have created a specific page on their main website which is to be populated with key resources, sources of help and links to the Antibiotic Guardian campaign.

Since August 2016, Dr Harrison has educated 46 undergraduate and postgraduate students in the Faculty of Biology, Medicine and Health Sciences in different ways. He has restructured one of the course units in Population Health, to use antibiotic resistance as the focus for the course units’ learning objectives (delivered across ten weeks to 29 current students); he is supervising seven students assessed projects on antibiotic resistance; he recruited a further ten students to support all of the activities described above. In addition, he is helping to train additional students to help run primary school workshops on this topic.

Key outcomes of project?: Responsible for 150 primary school-children in 6 schools, receiving n awareness-raising workshop and which has become mainstreamed as part of a formal student society programme.

Led a team of students to deliver public-engagement to over 800 members of the public during a science festival to raise awareness and educate about ABR
Increased the number of undergraduate and postgraduate students doing dedicated work on this topic from a public health perspective

Further maintained Manchester conurbation as having one of the highest number of pledges to be an antibiotic guardian, proportion to its’ population size

Directed an extensive awareness raising and educational campaign delivered to 48,000 students & 12,000 staff

How is the project to be developed in the future?: To work with the School Governors’ network in Greater Manchester and the Parents’ Teacher Association to at least double the number of primary schools in Greater Manchester’s most deprived wards to receive an awareness/education workshop on antibiotic resistance and basic hygiene

The number of university students carrying out assessed projects on aspects associated with antibiotic resistance will be increased and extended to other health/allied health teaching programmes

Carry out an audit of teaching curriculum specific to antibiotic resistance, and from the students’ perspective

To established a fully-resourced programme of work with the Students’ Union including high-profile dedicated space on the main website, with a digital hub of knowledge, information and support and activities (such as the above) they can become involved with as part of the antibiotic guardian agenda

To continue discussions with Public Health England about hosting a one-day public-professional engagement conference on antibiotic resistance

To submit a multidisciplinary grant application for Wellcome’s Public Engagement fund.

NHS Leeds West Clinical Commissioning Group

Name: Shak Rafik

Provide a brief overview of your project?: The ‘Seriously.’ campaign was created to raise awareness of the threat of antibiotics misuse to a generation of young people; but soon grew into something much bigger, reaching a wider age range through community engagement activities across Leeds.

In partnership with a creative agency, Magpie, we developed a stewardship campaign that encouraged members of the public to pledge their support to take antibiotics seriously.

The ‘Seriously.’ campaign aimed to educate people about the global threat caused by antibiotics misuse. We used a community co-creation approach to ensure the campaign was effective at reaching the initial 16-23 year old audience. This involved carrying out focus groups and audience testing to establish the tone, the messages, the media and the placement.

The youth audience did not want the serious message to be diluted in any way. They felt the global threat of superbugs, over-prescribing and incorrect use of antibiotics is an issue they couldn’t ignore. Therefore, they wanted the ‘Seriously.’ brand to be big, bold and impossible to miss.

The campaign’s messages were also developed through focus groups, in order to find the most impactful and memorable messages. They were split into ‘attention-grabbing’, e.g. SUPER GONORRHOEA’ and educational, e.g. ‘Finish what you started’.

As the campaign took shape, the audience reach grew. Although initially aimed at a younger audience, feedback suggested that the campaign resonated with wider age ranges, including families, who got involved with community engagement activities.

This then, led to a large and successful event in the city centre, which allowed the messages of antibiotics guardianship to spread even further.

List any supporting partners or organisations worked with: Magpie Creative Communications
Community Pharmacies West Yorkshire (CPWY)
Leeds Teaching Hospitals NHS Trust
Leeds Community Healthcare NHS Trust
Leeds City Council
Members of the Leeds Antimicrobial Stewardship Group
University Students’ Unions

How has your project demonstrated success in highlighting antibiotic stewardship within your chosen category?: Right from the idea generation, through to creative development and implementation, community ambassadors were involved. Young people helped create and develop the campaign, and deliver the messages to their peer groups.

A team of 10 students were recruited, aged 16-23, from five local universities and colleges. The student ambassadors ran engagement events in their place of study, as well as across the city; drummed up support from peers on social media and on-campuses; hung posters; made and shared videos, and raised awareness to wider members of the public. The ambassadors were the lifeblood of the campaign and ensured that stewardship messages were delivered from one person to another in an engaging way.

All media referred the public to our pledge website, seriouslyresistant.com, where visitors were encouraged make a pledge to become serious about antibiotics. Each of these pledges were linked to Antibiotics Guardian pledges, e.g. ‘I pledge to take antibiotics exactly as prescribed to me’. This meant the ‘Seriously.’ campaign contributed to UK-wide antibiotics stewardship.

Our ambassador team also engaged with members of the public offline, and asked them to fill in pledge cards.

A secondary key part of the antibiotic guardianship approach was to encourage ‘gifted’ public engagement support. A resource pack was created which allowed local businesses, organisations, clubs and student groups to spread the brand and its messages. A great success was seen with the student-run commercial video production arm of Leeds Trinity University, Trinity Vision’. Three student groups used the ‘Seriously.’ resources to create promotional videos aimed at their peers.

Please cite 3 examples within the project which highlight promotion of the protection of antibiotics?: ‘Finish what you started’
One of the key messages developed through community feedback was ‘Finish what you started’. It was displayed on poster drums around the city, on social media and in pharmacies themselves – we worked with pharmacists to attach a ‘finish what you started’ sticker to every antibiotics prescription dispensed, within pharmacies in key locations. This ensured that the brand and an antibiotics guardianship message was there, in the hands of the public, at a time it was most relevant.

Videos
The ambassadors developed a video which involved vox pops from peers who were told about how super gonorrhoea spread in Leeds due to the incorrect use of antibiotics. Their reactions were then filmed and stitched together to create an engaging brand teaser about what seemed, at first, like a spoof. This was, however, followed by a serious message from the ambassadors who explained how superbugs can thrive if antibiotics aren’t used correctly, and invited them to join the campaign to consign antibiotic resistant bugs to history.

Meanwhile, students at Leeds Trinity University, gifted their time to develop their own videos. One included ‘Zombie Dave’ who gave viewers a snapshot into a dismal future unless the public act now, and together.

City centre event
The pinnacle of the campaign was an event in the main shopping street in Leeds on a busy Saturday. It featured a giant 12ft pledge screen and live ‘pledge stations’; videos playing to shoppers; a photo booth where members of the public could take a quiz to test their future-resistance before dressing up as their character (e.g. future-proof Martian) before taking home a souvenir snap; a ‘seriously tough’ buzz wire, and balloons for the kids. Each of these activities created engagement opportunities. The ambassadors and colleagues from the NHS engaged with members of the public to explain how to use antibiotics correctly, and encouraged them to pledge to get serious about antibiotics, to change their own behaviour, and influence others’.

During the event we achieved 600 pledges.

This main event was supported by mini PR stunts, including one that took place on European Antibiotics Awareness Day. This involved a giant 10ft red balloon travelling around the city centre, which was filmed and broadcast through Made in Leeds TV.

Key outcomes of project?: • A successful co-created campaign that engaged with the target audiences to develop the messages; and saw the target audience engaging with peers to deliver the messages

• 2,794 pledges in total, to date

• Engagement and ‘gifted’ support from city-wide stakeholders, including Trinity Vision (Leeds Trinity University), Leeds Beckett University, Leeds City College, Leeds City Council

• Coverage in Yorkshire Evening Post and on Made in Leeds TV

• Endorsement from key national experts including Diane Ashiru-Oredope and Elizabeth Beech as well as, Dr Pixie Mckenna a well-known TV doctor

• Campaign has been shared with other local organisations including NHS Wakefield CCG, NHS North Kirklees CCG and NHS Greater Huddersfield CCG as well as the South West Yorkshire Prescribing Committee

• Campaign coverage was picked up by the Australian Antimicrobial Stewardship

• Shared with the Centers for Disease Control and Prevention (CDC) in USA, and University of Leeds Astbury Centre

• Insight-led resources developed that can be shared, free of charge, to any NHS organisation

• Unexpected outcome that a local discreet campaign targeted students in west Leeds has been seen and endorsed by a range of key partners and individuals. As a result further investment has been provided to run the campaign Leeds-wide and to work with hard to reach communities to adapt it for their needs

How is the project to be developed in the future?: After proving the campaign’s success at engaging the public, it will be extended city-wide, delivered jointly by NHS Leeds West CCG, NHS Leeds North CCG, NHS Leeds South & East CCG and Leeds City Council.

The next phase of the campaign aims to engage new communities each with their own challenges, including areas of deprivation, ethnic minority communities, international students and high prescribing affluent areas.

We are confident that using the same approach – of audience insight and community co-creation – to develop a message and engagement strategy tailored to each audience segment, will result in a successful campaign. Our ambition is for Leeds to be known as the city that makes the greatest impact on antimicrobial resistance within the UK.

British Veterinary Association

Name: Felicity Quick

Provide a brief overview of your project?: BVA is committed to promoting the responsible use of antibiotics within the veterinary profession and has been doing so for many years. BVA also believes that the best way to ensure antibiotic guardianship is through a One Health approach.

BVA decided to create a new One Health AMR awareness poster to launch for European Antibiotics Awareness Day 2016, that could be used in both veterinary and general practice waiting rooms. The poster needed to convey simple messages around responsible use of antibiotics that could be applied to both humans and animals taking a course of antibiotics.

To ensure the poster reached both veterinary and doctor waiting rooms we reached out to the British Medical Association (BMA) and Public Health England to see if they would like to support the poster and add their logo to it. We also asked the Veterinary Medicines Directorate (VMD) to support it too as the regulating body behind the veterinary medicines, including antimicrobials, in the UK. Finally, we included the Antibiotic Guardian logo. All parties agreed, bringing a truly One Health theme to the posters. The inclusion of medical organisations also enabled the poster to be shared more widely with medical professions.

BVA wrote the original copy for the first draft of the poster, but worked with the various supporters to ensure the language and poster design was relevant to both humans and animals. The poster included five “busted” myths around antibiotic prescription and use, and featured images of both humans and animals to illustrate that the messages were intended for all.

To date the poster has been distributed to over 16,000 veterinary professionals through our journal In Practice. It was also widely available at London Vet Show on both the BVA and VMD stands where it gained a lot of positive feedback. Our social media posts about the poster always gain several shares and comments. Further to this, BVA’s Senior Vice President, Sean Wensley, has recently been in discussions with Royal College of General Practitioners in Northern Ireland (RCGP NI) about the use of the poster in GP waiting rooms in Northern Ireland. His recent blog on the poster and his discussions with RCGP is available to read here: https://www.bva.co.uk/news-campaigns-and-policy/bva-community/bva-blog/poster-drop-your-doc-one-health-approach-to-tackling-amr.

The BMA recently included a link to the poster in their Local Medical Committees (LMC) newsletter and are planning further work to promote it to their members.

List any supporting partners or organisations worked with: Supporters listed on the poster:
British Medical Association (BMA)
Public Health England
Veterinary Medicines Directorate
Antibiotic Guardian Scheme

On promoting to medical organisations:
Royal College of General Practitioners in Northern Ireland (RCGP NI)
BMA

How has your project demonstrated success in highlighting antibiotic stewardship within your chosen category?: Antimicrobial resistance and good antibiotic stewardship are priority areas for BVA and we’ve worked for many years to promote responsible use of antibiotics to the veterinary profession, including running seminars, webinars and congress discussions, creating posters and “myth busting” materials, and participating in lobbying and coalition organisations such as RUMA. This poster however has demonstrated success in highlighting antibiotic stewardship because it creates the link between humans and animals, emphasising how everyone needs to play their part in combating antimicrobial resistance.

Our poster has been widely used in veterinary practices. It was also held up as an example of antibiotic stewardship and promoting a One Health message at an AMR talk from leading veterinary representatives in this area – Nigel Gibbens (CVO) and John Fitzgerald (RUMA) – at BVA Congress 2016.

Further to this, our Senior Vice President has been leading on discussions with the Royal College of General Practitioners in Northern Ireland (RCGP NI) to further promote the use of the posters to GPs in Northern Ireland.

We hope that anyone viewing the poster will not only take away the message of how important responsible use of antibiotics is, but also consider how the health and wellbeing of animals, people and the environment are linked and impact each other.

Cite 3 examples within the project which highlight promotion of the protection of antibiotics?: • The five “busted” myths on the poster which challenge the common misconceptions around antibiotic prescription and use. These all demonstrate how important it is to protect antimicrobials and use them responsibly.
• The link between human and animal antibiotic use and that resistance can happen in the same way to both groups if antibiotics are not protected.
• The inclusion of the Antibiotic Guardian logo as a supporter, which highlights the poster is all about ensuring antibiotics are protected.

Key outcomes of project?: We hope that anyone viewing the poster will not only take away the message of how important responsible use of antibiotics is, but also consider how the health and wellbeing of animals, people and the environment are linked and impact each other.

How is the project to be developed in the future?: All supporters will continue to promote the poster to their various members to ensure it reaches as many veterinary and medical waiting rooms as possible. BVA will also continue discussions with RCGP NI and work towards the posters being widely available in Northern Ireland.

For 2017 we will consider whether other organisations could be included as supporters to expand the poster’s reach even further.

Wiltshire Council

Name: Issie Tucker

Provide a brief overview of your project?: Devised a badge competition for primary schools. It consisted of three categories – antibiotics, hand washing and naughty bugs. The schools could enter individuals or teams, making 6 categories in total. Judges were myself, someone from a local art centre and someone from the school support team. Best entries won Glow and Show kits for their schools and these were demonstrated with the children at assemblies. all entries got a certificate and there is a rolling display around 10 main libraries throughout the county.

List any supporting partners or organisations worked with: Local art centre; libraries; primary schools.

How has your project demonstrated success in highlighting antibiotic stewardship within your chosen category?: Limited evaluations received to date and are positive in terms of meeting the school curriculum, sounding interesting and something the children wanted to do.
The current display has voluntary feedback sheets that are still being collated.

Cite 3 examples within the project which highlight promotion of the protection of antibiotics?: Explanation of why the competition was being run;
The badge design highlighted various elements of antibiotic resistance and how hand hygiene made a significant difference.
Comments from each entry were invited and many demonstrated how much understanding and knowledge had been imparted to the children from the teachers.

Key outcomes of project?: Increased awareness amongst school staff, pupils and parents
On-going exposure to the public in the form of a display.

How is the project to be developed in the future?: it has been shared with colleagues from other councils and PHE.
The glow and show kits are extremely popular and we are currently looking at the feasibility of using local libraries as a lending source for registered groups, such as schools, care homes and nurseries.

Capital and Coast DHB, Wellington, New Zealand (Highly Commended - Antibiotic Guardian Awards 2018)

Provide a brief overview of your project:

Although, New Zealand is one of the developed world’s highest users of antimicrobials per capita, it is only just beginning to embrace and address the concept of AMS.

In the absence of national campaigns, at Wellington Hospital we decided to take the initiative and show what could be done with a small number of enthusiastic individuals but little else in the way of resources.

We wanted to build on a highly visible WAAW 2016 social media/poster campaign and expand our influence to increasing antibiotic awareness amongst local schoolchildren via a poster competition. We utilised the fantastic resources at e-Bug and were able to set up a competition were the children received an introduction to the issues and then designed us posters to highlight either hand hygiene or the difference between bacteria and virus.

The poster designs were voted for in the hospital lobby where they were put up on display) and on social media with the four winners rewarded by a visit to Wellington Hospital for photos with a local rugby hero, followed by a lab tour that included their names in bacteria. The morning was finished off with pizza and cakes in the Medical School cafe.

A low cost but high impact prize was delivered which has now sparked off a potential national completion for 2018!  Our campaign gained support from Super Rugby champions, Olympic gold medallists, Helen Clark (ex-MZ PM and UN Ambassador) and even our newly elected PM Jacinda Ardern as she stepped off the plane from a meeting with Donald Trump!

Cite 3 examples within the project which highlight promotion of the protection of antibiotics?:

Each year, NZ is the first country in the world to see World Antibiotic Awareness Week, and sadly as it has coincided with a decent earthquake each of the last two years, we have been up at midnight, hearts racing and ready to go! Using this fact to our advantage and the UKs #KeepAntibioticsWorking hashtag we were able to make an international splash on Twitter with our own simple campaign and provided very active support of other WAAW campaigns around the globe. The campaign materials developed at Wellington, such as posters, stickers and other resources, along with weblinks to WHO, WHO Western Pacific, Antibiotic Guardian, etc were shared with other NZ hospitals to encourage greater kiwi participation in WAAW.

In addition to social media we had supporting posters which included one or two humorous or thought provoking tag lines to encourage managers, pharmacists, nurses and prescribers within the hospital. The focus was on preserving the efficacy of antibiotics not only for future generations but for new admissions. One unplanned ‘success’, was a poster targeted at junior doctors that  included the line ‘Fever is not a sign of Tazocin deficiency’ finding its way onto a popular doctors Facebook page where it gained 1000’s of likes and shares.

The campaign targeted raising awareness via education. The 2017 focus was on local Wellington school children but with the ambition, and now realisation, that this could be used to generate competition and interest for a Government supported national campaign in 2018. AMS based questions were also introduced into an NZ School of Pharmacy’s Clinical Diploma. Education offers is one of the most effective ways to tackle many of the issues that drive over consumption of antibiotics.

How is the project to be developed in the future?:

We have fed back all our WAAW 2017 successes and failures to the Ministry of Health who have since launched the first New Zealand AMR Action Plan. Members of the team are also active members of the new national group that aims to tackle AMR and increase awareness in a high impact way at a national level in 2018. One of the highlights of the 2017 campaign was the powerful and supportive links built with passionate AMS colleagues around the globe with special mentions to established Antibiotic Guardians such as Diane Ashiru-Oredope, Elizabeth Beech, Graham MacKenzie, Dai John, Phil Howard and Cliodna McNulty whose energy and support enabled our campaign to make a decent little splash and gain interest for WAAW 2018.

A personal ambition is to see an AMR story line in popular NZ hospital soap Shortland Street during WAAW 2018!

Cwm Taf University Health Board

Provide a brief overview of your project:

Cwm Taf University Health Board (CTUHB) is the highest antibiotic prescribing health board in Wales.  Anecdotal reports from local general practitioners suggest that patients expect to receive antibiotics for self-limiting infections, which often results in inappropriate antibiotic prescribing.  An antibiotic resistance education and awareness session, called ‘antibiotic myth busting’ was designed and undertaken with community groups in CTUHB.  The session aimed to reduce public antibiotic expectations with the hope of consequently decreasing inappropriate antibiotic prescribing.

An education session aimed at the general public was designed to dispel the common myths surrounding antibiotic use.  It took the form of an interactive Power Point Presentation delivered by a pharmacy technician to community groups in CTUHB from May 2017 to April 2018.  Key messages centred on not taking antibiotics for self-limiting viral infections, understanding antibiotic resistance and signposting to community pharmacy common aliments schemes. A before and after questionnaire using diads was used to assess self-reported changes in knowledge and behaviour.  The study was considered service evaluation and approved by CTUHB Research and Development department and no ethics approval was required.  The results were analysed using Microsoft Excel®.

Cite 3 examples within the project which highlight promotion of the protection of antibiotics?:

1. Antibiotic Guardian video. This is played at the end of the session to enhance the understanding of the important role antibiotics play in modern medicine. It also informs the viewers of the three steps they can take to protect antibiotics.
2. Antibiotic pledge. The audience are encouraged to sign up and make a pledge as an Antibiotic guardian and told how one simple act that they pledge can help protect antibiotics for our future and future generations.
3. During the session we talk about what antibiotic resistance is and the difference between a virus and a bacteria. The audience are informed of a scheme our LHB community pharmacies are involved in, Choose Pharmacy, and encouraged to use this service when suffering from minor ailments or viral infections for symptomatic relief and advice on getting well without the use of antibiotics.

How is the project to be developed in the future?:

Whilst the session achieved its objectives, it also demonstrated that participants knew several of the key messages before attending the session.  Based on these findings we will reflect on whether we are targeting the right participant demographic, or whether people’s knowledge doesn’t necessarily translate into the desired behaviour.

A limitation of the project was that the before and after questionnaires completed by a participant could not be correlated, and therefore shifts in individuals’ views could not be analysed.  Future work will be to update the session based on feedback received, and re-design the questionnaire on an electronic format.  The session will also be adapted to target different community groups such as mums and toddlers groups and schools.

Fixers

Provide a brief overview of your project:

The charity Fixers worked with a group of young people to design and create a pill shaped capsule stuffed with a leaflet about antibiotic resistance.

The Shropshire based group had met during an Antibiotics Guardian Summer School and felt compelled to spread the message after discovering one of their mums suffered from antibiotic resistance.

The leaflet was designed in bright, bold colours to be attractive to young people. It details what antibiotic resistance is and five simple steps people can take to prevent it from happening.

One thousand capsules were stuffed with the leaflet. These were handed out to pharmacies, doctors and the general public across Shropshire.

The leaflet was subsequently made it a Powerpoint display which doctors and pharmacies were encouraged to display in their waiting rooms.

Cite 3 examples within the project which highlight promotion of the protection of antibiotics?:

EXAMPLE 1: The leaflet found within the pill shaped capsule contained all the information, in layman terms, on the importance of the protection of antibiotics. It listed five steps people can take:

1) Only use antibiotics when prescribed by a certified health professional.

2) Always take the full prescription, even if you feel better.

3) Never use leftover antibiotics. Take any waste to the pharmacy to be disposed of.

4) Never share antibiotics with others.

5) Prevent infections by regularly washing your hands, avoiding contact with sick people and keeping your vaccinations up to date.

EXAMPLE 2: The audience event, organised by Fixers and the young people, was attended by 100 people. It ensured the capsules were distributed to a wide audience of varying age ranges. Some of the feedback received proved this project really was making a difference.

One woman said ‘Thanks for this, I will be sharing the information with my family.’

Another added ‘I didn’t realise how important it was to complete the course as I thought if I felt better then it’s fine not to.’

EXAMPLE 3: GPs and Pharmacists received a digital copy of the leaflet which they were able to display on the screens in GP practice waiting rooms and pharmacies. This meant the message about the protection of antibiotics was further reaching those that mattered.

How is the project to be developed in the future?:

As all 1,000 capsules have now been distributed, Fixers plans to fundraise to produce more capsules and leaflets. A local media campaign will be launched, detailing the story behind the project and calling on people to donate.

Once the funds have been raised, a further 1,000 capsules will be ordered and stuffed with the informative leaflet. These will be distributed to pharmacies and doctors surgeries across the country.

The young people have also been working with Shropshire Health Champions, supported by their local NHS, to raise awareness of the issue among their peers.

Indian Pharmaceutical Association (IPA)

Provide a brief overview of your project:

The 54th National Pharmacy Week (NPW) 2015: Theme: Responsible Use of Antibiotics Saves Lives

Posters/leaflets and PowerPoint presentation were developed and it was used by most IPA branches, pharmacy colleges, pharmacists and others to create public awareness. Material available on the IPA website.

New initiative taken up was a competition on the theme for practising pharmacists, students and academicians.http://www.ipapharma.org/html/NPW_2015.html

Awareness video was displayed on TV channel of the Metro railway more than 40 times a day for 10 days.

DOTS TB Pharmacist Project:

It’s a public private partnership model developed by IPA with the support of Govt TB authorities where community pharmacists are engaging in the National TB Programmes which use the strategy DOTS (Directly Observed Treatment Short course) This model ensures that patients take their prescribed treatment for full duration and do not leave it halfway. Pharmacist monitors the entire DOTS TB treatment. Default in treatment is one of the main reasons for the emergence of MDR TB. More than 5000 pharmacists in different parts of the country are trained by IPA,Govt TB Cells and other NGOs.This is one of the major contribution from organizations like IPA to prevent emergence of resistant TB.

Media:

Interviews of IPA office bearers to talk on AMR on Television Channels during Antibiotic Awareness Week 2015. Several articles written by IPA office bearers in regional languages on AMR

Continuing Professional Development (CPD) Programmes for pharmacists:

These programmes included talks on antibiotics, Schedule H1 drugs and many more areas

Activities of IPA-Bengal Branch a case-in-point:

Activities on Antimicrobial activities during 2014:

A colourful mobile tabloid was arranged with posters and promotional materials against “Antimicrobial Resistance”, to raise awareness among the public,was well covered by electronic and print media

Knowledge appreciation and perception survey:

Knowledge appreciation and perception survey was conducted at 5 big hospitals of Kolkata in collaboration with IPA Bengal Pharma and Healthcare Trust during the NPW week covering about 2300 patients and carers.

Various colourful posters and leaflets in English and Bengali were designed, displayed and distributed. Some of the catchy slogans used were, Use Antibiotics only When Prescribed, Use of Antibiotic, when not needed harms you, me and all), Show prescription to buy antibiotic. Colourful leaflets were inserted in newspapers to reach general households.

Cite 3 examples within the project which highlight promotion of the protection of antibiotics?:

Activities at retail pharmacy level:

Kolkata was selected as a model district for better and intensive coverage to sensitize the chemists/pharmacists of the district. Two pre-NPW seminars were conducted in collaboration with Bengal Chemists & Druggist Association on “Misuse of Antibiotics” that were attended by over 1000 retail pharmacists and pharmacy owners and were highly appreciated. The seminars has resulted in emphasizing that pharmacies must insist on proper prescription for dispensing antibiotics, counsel the patient for taking the full course as prescribed, follow drug regimen, and no self-medication. Most pharmacists agreed and would also display posters about the need of proper use of antibiotics. Most pharmacists attended the workshops showed adherence to these principles.Kiosks were set up at 5 medical college & hospitals to directly reach and interact with outdoor patients

DOTS TB pharmacist project has also resulted in treatment adherence and reducing chances of DR TB.

How is the project to be developed in the future?:

Intensify Public Awareness activities and sensitization of community pharmacists.

Sheep Industry group – led by SHAWG

Provide a brief overview of your project:

The UK sheep industry has traditionally been a low user of antibiotics and it was for this reason there was a concern that both farmers and vets might be complacent and unwilling to act to reduce usage levels.

Our community is made up of UK sheep farmers, together with their vets. There are approximately 40,000 UK sheep farms that are home to approximately 16 million ewes and many more lambs born each year.  Each sheep farm is served by a local veterinary practice but historically there has been low levels of active veterinary involvement on sheep farms.

Under the leadership of the Sheep Health and Welfare Group (SHAWG), a consortium of leading sheep veterinary and sheep farming organisations have come together to ensure a concerted effort to communicate simple coordinated messages.  Through good collaboration it has been possible to reach large numbers of farmers, their vets, the merchants and pharmaceutical companies that sell sheep health products as well as involve the companies that process sheep meat and the retailers that sell it.

We had to think creatively about how we reached farmers. As a result we have used mailshots, articles and letters in national farming and veterinary media as well as campaigns through social media such as Twitter and YouTube.

Aware of the low overall usage, we concentrated on the specific ‘Hot Spot’ concern areas for antibiotic usage as highlighted by the RUMA Sheep Target Task Force – namely antibiotic use in the control of neonatal lamb diseases, and in the control of lameness and in prevention of abortion.  For all these areas we have been able to suggest that farmers and vets plan ahead, prevent disease occurring, for example with good hygiene and environmental conditions and protect animals, for example through vaccination or adequate colostrum intake.

Cite 3 examples within the project which highlight promotion of the protection of antibiotics?:

1.Collaboration and joined-up messaging has been an essential strength of this project as partners have worked to encourage good relationships between sheep farmers and their vets.  The Sheep Veterinary Society (~700 members) and the National Sheep Association (~7000 members) have been in regular conversation with the Agriculture and Horticulture Development Board (AHDB;~40,000 sheep farmers) and the National Farmers Union (~49,000 members) so that timely and appropriate messages have been widely issued.  All these organisations, as well as pharmaceutical companies, have supported vets in setting up Flock Health Clubs where they have developed closer relationships and benchmarking groups for sheep farmers.  Robust evidence has been collated via collaboration with researchers at Nottingham and Liverpool universities.

2.Veterinary communications

The Sheep Veterinary Society issued Good Practice Guidelines on the Responsible Use of Antibiotics on sheep farms. Joint letters have been published in leading veterinary media to point vets to these guidelines and specifically to remind vets of their responsibilities with respect to prescribing antibiotics at lambing time.  Vets have been encouraged to conduct farmer meetings and been provided with meeting planners, presentations and resources together with plenty of enthusiasm.

3.Sheep farmer communications

Apart from targeting sheep farmers via their vets there have been many sheep-farmer facing material issued by the levy board and the membership organisations.  Lamb meat processors and retailers (eg Dunbia and J Sainsbury’s; Dalehead Foods and Waitrose) have organised series of meetings where responsible antibiotic use has been specifically targeted. Case studies have appeared in leading farming journals such as Farmers Weekly as well as in the NSA Sheep Farmer magazine.  AHDB have issued briefings that have been posted to sheep farmers as well as a series of infographics that have been widely promoted through social media.

This coordinated approach has ensured widespread messaging to sheep farmers and vets.

How is the project to be developed in the future?:

The collaborative group continues to liaise closely through teleconferences as well as at face to face meetings.  We are working through a detailed GANTT chart that coordinates all organisations to ensure continuation of messages that are both coordinated and progressive.