NHS England has issued recommendations alongside a “what good looks like” framework for antimicrobial resistance (AMR), pointing to the use of clinical digital systems for prescribing, integrating the coding process and decision support tools into clinical workflows, displaying timely and relevant clinical information, and more.
On prescribing, the recommendations outline that clinical digital systems should support clinicians by offering “appropriate” treatment choices and durations, and making it easy to record prescribing decisions. In secondary care, they should support the use of start smart then focus principles, whilst in primary care and outpatient settings, they should facilitate the use of delayed or back up prescribing strategies. The role of clinical digital systems in reviewing and revising prescriptions by offering access to key information and decision support tools, supporting electronic referral of patients to AMS teams or infection specialists where required, and flagging key clinical advice on treatment plans, are also considered.
The framework adds that these systems may also play a role in tackling inconsistency in the coding process, according to the recommendations, which point to the need for workflows in primary care to be structured so that diagnosis coding occurs prior to a prescription being generated. It adds, for systems to require documentation of diagnosis linked to the prescription in secondary care with the potential for this to be reviewed, and for all prescriptions to be linked to a coded diagnosis to facilitate audit.
Diagnostic tests, clinical decision support tools and treatment guidelines should be integrated into digital systems and be visible at key stages of the clinical workflow, the recommendations state, whilst relevant and timely information on things like recent microbiology culture and sensitivity results should be easy to view. NHSE also notes the importance of systems supporting the increased uptake of patient-facing tools by improving functionality and ease of use; interoperability between care settings; support for surveillance and reporting on key metrics; alert prioritisation; agility and adaptability to support innovation.
The accompanying digital framework for antimicrobial stewardship offers best practices for the use of IT systems, across seven success measures: well led, smart foundations, safe practice, support people, empower patients, improve care, and health populations. This looks at how organisations can ensure that their stewardship teams are supported to drive digital transformation, including through building digital and data expertise in this area, creating clear accountability and governance processes, and building partnerships with suppliers. Smart foundations also covers IT infrastructure and data, looking to workforce capacity, technical expertise, and the reliability and secureness of hardware.
Across the remaining measures, NHSE highlights steps that organisations should be taking to support the real-time use of data, optimising alerts and decision support to improve care and minimise disruptions to workflows, promoting digital literacy amongst the workforce, placing patients at the centre of service design, embedding digital and data to transform care pathways, and using data to inform care planning.
More on the use of digital from NHSE
NHS England’s board met last month to discuss operational, performance, delivery, and digital, data and technology updates. The digital, data and technology transformation update noted the Frontline Digitisation programme is on track for 96 percent of trusts to have implemented an EPR by March 2026. As of March 2025, 19 trusts are listed as having no EPR, but are in the process of procuring, or implementing one. The update highlighted that 70 percent of trusts are on track to meet the core level of digitisation maturity by March 2026, aligning with the What Good Looks Like framework.
The latest progress report from NHSE on its Rare Disease Action Plan highlights progress against its four priorities of faster diagnosis, increased awareness, better co-ordination of care, and improved access, as well as introducing three new actions, and outlining digital and data work streams. In its final year, the plan introduces three new actions, to establish a new model for clinics for multi-system disorders, improve rare disease clinical research, and support for “individualised therapies, specifically designed to a unique disease-causing variation in an individual’s DNA, addressing the root cause of the condition”.
NHSE also recently published eight principles for the “appropriate use” of digital technologies in mental health settings, aiming to provide a guide for procurement, implementation, data protection, policy, staff training and recording in patient care and treatment plans. Designed to help clinicians decide whether using digital technology is the “most appropriate, effective and least restrictive” way of treating patients in mental health settings, the principles focus on: a human rights approach, consent and capacity, equity of access, co-production, therapeutic and personalised care, safety planning, evidence base, and treatment outcomes.
