Arwain DGC: helping farmers, equine owners and vets enhance their antimicrobial stewardship efforts across the large animal sectors in Wales
Arwain DGC builds on the pioneering work of an earlier project – Arwain Vet Cymru – which focused on improving antibiotic prescribing in cattle and sheep through a Wales-wide network of Veterinary Prescribing Champions (VPCs).
Arwain DGC extends this success to a broader schedule of activities, bringing together experienced collaborators to deliver a wide-ranging programme addressing AMR in animals and the environment.
The key players are leading Welsh agricultural stakeholders (Menter a Busnes, Welsh Lamb and Beef Producers Ltd), academic institutions (University of Bristol and Aberystwyth University) and veterinary delivery partners (Iechyd Da and Milfeddygon Gogledd Cymru).
The programme includes:
Leading antimicrobial stewardship (AMS) across the Welsh large animal sector:
Arwain DGC, an interdisciplinary collaboration between vets, industry associations and academics, develops cross-cutting AMS initiatives across the Welsh large animal sector. Since 2019, we have supported the following communities:
Established data-driven animal disease and AMU monitoring:
The interdisciplinary Arwain DGC team has established preventative and surveillance initiatives, developing AMS within the large animal sector:
Challenged and changed community AMU mindsets:
Encouraging AMS norms and values across the Wales large animal community is key to societal change. Arwain DGC has delivered effective public engagement activities, delivered across varied platforms:
The RUMA Targets Task Force and its contribution to combat AMR in the farmed livestock sector
RUMA was established to promote the highest standards of food safety, animal health and animal welfare in the British livestock industry. It has a current focus to deliver on the Government objective of identifying sector-specific targets for the reduction, refinement or replacement of antibiotics in animal agriculture. The story of the Targets Task Force began in 2016, when in response to the Lord O’Neil report, RUMA showed industry leadership by establishing the RUMA Targets Task Force. It set about ensuring that the AMR issue and the responsible use of antibiotics was on the agenda for each of the livestock producing sectors. It worked with sector representatives, both vets and farmers, to create and roll out sector specific antibiotic use targets. The first targets were published in Nov 2017 and ran until 2020. This first phase recognised that each of the sectors was in a different place in terms of the AMR journey, but they helped engage the various industry stakeholders and ensured a positive commitment to ensuring that where antibiotics are used it is done responsibly and with consideration to the principle of as little as possible but as much as necessary. The response across agriculture has been entirely voluntary and without the need for legislation, but where industry initiatives could be harnessed to encourage compliance, for instance farm assurance schemes, these have been used where appropriate. The RUMA targets have helped focus stakeholder support and activity across the UK livestock sectors to achieve a 52% reduction in antibiotic between 2014 and 2020. The use of Highest Priority Critically Important Antibiotics (HP-CIA) in UK food producing animals has also fallen by 75% since 2014, and sales of colistin are virtually nil.
– The RUMA targets have helped focus stakeholder support and activity across the UK livestock sectors to achieve a 52% reduction in antibiotic between 2014 and 2020
– The use of Highest Priority Critically Important Antibiotics (HP-CIA) in UK food producing animals has also fallen by 75% since 2014, and sales of colistin are virtually nil
– Just a quarter of the UK’s antibiotics are now used to treat disease in food producing animals, despite over a billion farm animals being reared and managed in the UK every year – – Levels of antibiotic resistance found through Government monitoring and surveillance are also stabilising and falling in response to these reductions in use
All of this activity has been realised principally through voluntary multi-sector collaboration, cross sector initiatives, codes of practice, industry body support and requirements within farm assurance schemes. The UK’s multi sector voluntary approach led by RUMA is quite unique when compared with other country’s efforts to combat AMR.
In 2019 work began on the next phase of targets by the Targets Task Force 2 (TTF2) building on the lessons learned from phase 1. The first three years of the TTF saw technical developments, the capture of data and microbiological research which has changed the understanding of antibiotic use and resistance. These findings informed new targets launched in November 2020 and which run from 2021 to 2024. This second phase looks to further enhance and strengthen the response of Agriculture to antibiotic use and demonstrates the continued commitment across agriculture to tackle the AMR challenge.
Electronic recording of antibiotic use in livestock – eMB and Medicine Hub
AHDB have developed eMB, the electronic medicine book for pigs, and the Medicine Hub for ruminants. These are tools to collect antibiotic usage data at farm level for UK farms. Details of each antibiotic used on farm, alongside the number of animals in the herd/ flock are collected and allow farmers to track their use over time and compare against similar farms. The systems also allow farmers to share their data with their vet, facilitating discussions around herd health and treatment plans and supply evidence of responsible antibiotic use to their supply chain.
eMB now contains antibiotic use data for over 95% of UK-reared pigs and enables farmers to track and benchmark their antibiotic use.
The recently published national antibiotic use figure for pigs, based on 2021 data collected in eMB, shows an overall reduction in antibiotic use of 69% from the baseline set using data from 2015 and a 95% reduction in use of highest priority critically important antibiotics.
AHDB analyse the data from eMB to identify trends in antibiotic use and areas requiring industry input. Use is reported against industry set targets and eMB is used to track the impact of industry initiatives aimed at reducing and refining use.
We continue to refine eMB to ensure it remains a key tool for antibiotic stewardship for the pig sector. A recent addition has been a rolling 12-month benchmark, with farms with use in the top 5% being encouraged to complete, and regularly review, an antibiotic reduction plan with their vet.
We have also developed a similar system for the ruminant sector – Medicine Hub. This was launched towards the end of 2021 and our focus currently is on encouraging uptake and engagement from the dairy, beef and sheep sectors.
Farm Vet Champions supports veterinary teams to improve antimicrobial stewardship in farm practice through free CPD and SMART goal setting.
Farm Vet Champions (FVC) is a collaborative project to unite and empower UK farm animal veterinary practitioners to establish and embed responsible antimicrobial stewardship. FVCs supports the veterinary profession to continue to improve animal health and welfare standards and provide positive inspiration and leadership towards One Health efforts. The project is funded by the Veterinary Medicines Directorate (VMD) and supported by numerous veterinary sector organisations.
The online learning platform is accessible for free for all veterinary practice team members and offers bitesize learning with users able to select the format (webinars, podcasts, articles) and topics that are most relevant to them. The FVC mantra is to Plan, Prevent and Protect our herds and flocks by predicting disease threats and reviewing animal husbandry and environmental influences in herd or flock health. FVC also provides users with a SMART (Specific, Measurable, Attainable, Realistic and Time-bound) goals tool which supports the sustained translation of learning into practice and can be set at an individual or team level.
FVC is hosted by RCVS Knowledge (the charity partner of the Royal College of Veterinary Surgeons), an impartial organisation that provides the perfect environment to collaborate with veterinary stakeholders to provide evidence-based educational materials and promote Quality Improvement in veterinary practice. FVC drives behaviour change in responsible antimicrobial use through our online learning platform and the SMART goals tool. Setting SMART goals has demonstrated accountability and improved success in achieving goals.
Within the FVC community, we have established a FVC Ambassador group of inspirational farm animal veterinary surgeons committed to championing responsible antimicrobial use and sharing ideas and knowledge. Through both education and the SMART goals tool, FVC highlights the importance of teamwork in the success of this mission. This teamwork is cultivated both within the practice setting and out in the field with farmer clients.
We have attracted over 730 users to the FVC platform, with more than 450 meeting a detailed criteria, including being an RCVS registered veterinary professional driving antimicrobial stewardship forward in practice and on farms.
With an estimated 3,315 registered farm vets in the UK we have reached 14% of our target audience.
Uniting the profession
FVC has brought many veterinary organisations together, collaborating to drive the core message, ‘Plan Prevent Protect’. An example of support FVC has received across the industry is being feature in the RUMA ‘Sector in Focus campaign: Sheep’ which highlights the progress that has been made with antibiotic stewardship through case studies and industry commentary. To have a spotlight in this campaign demonstrates the achievements and growing potential scope of the FVC project.
FVC inspired Alex Royden, to provide a case example demonstrating the effective implementation of ‘Plan Prevent Protect’. A poultry farm client was experiencing a daily mortality rate of 1% due to multi-drug resistant E. coli associated egg peritonitis. An on farm investigation revealed a series of health, welfare, and management issues to address.
Working with the farm, a plan was made to improve flock health which incorporated the use of vaccinations, vaccination auditing, improved farm biosecurity and water hygiene, parasite monitoring and control, and environmental management and enrichment. In the next flock cycle, the farm saw an >50% increase in net profit compared to the previous flock. The flock’s egg production and other production parameters remained above target for the entirety of the flock’s production cycle, demonstrating the improvement in health and welfare that had been achieved through the interventions.
Through planning and consideration around prevention techniques, the flock was protected. This is just one example of how the project can influence the industry and reduce the use of antibiotics.
Our ambition is to make a difference in every veterinary practice, at the point of every vet-farmer conversation. Since July 2022, we have been developing a FVC Ambassador group of forward-thinking individuals to widen the reach within the veterinary community. We aim to establish an inclusive and sustainable FVC communities on local, regional, and virtual levels. These groups will share ideas, set and track SMART goals to monitor progress, and showcase best practice implementation.
We will continue to produce our “in conversation with…” podcasts which allow topical focus on more specific subjects (such as the challenges faced this lambing season with restricted oral antibiotics or the ‘Plan Prevent Protect’ application to backyard hens) to support the industry. We will continue to promote and recruit new Farm Vet Champions with a focus around students and recently qualified vets to help and support them to feel confident and empowered to make informed decisions.