Quality Prescribing: Scottish Reduction in Antimicrobial Prescribing (ScRAP) Programme V2

Anne Thomson, Jacqueline Sneddon, Gill Walker, Graeme Bryson, Edward James, John MacKay, Anthony McDavitt, Jill Nowell, Hazel Steele, Fiona Stewart, Debbie Waddell

Research output: Book/ReportCommissioned report


The Scottish Antimicrobial Prescribing Group (SAPG) was established in 2008 to lead the national antimicrobial stewardship agenda to address the growing threat of antimicrobial resistance. Through working with local Antimicrobial Management Teams and clinicians across primary and secondary care SAPG has greatly improved prescribing of antibiotics and contributed to the current reduced rates of Healthcare Associated Infections (HAI).

During the past eight years primary care prescribers have significantly changed their practice to reduce use of broad spectrum antibiotics and use recommended narrow spectrum antibiotics to manage common infections. In addition over the past three years there has been success across all health boards with the National Therapeutic Indicator (NTI) for Total Use of Antibiotics and the latest national data shows a 9.5% reduction in total use of antibiotics in primary care between 2012 and 2015. Utilisation of the original Scottish Reduction of Antibiotic Prescribing (ScRAP) Programme launched in 2013 has provided educational support for this NTI and encouraged reflection on local practice when prescribing antibiotics.

We are pleased to present this updated resource, ScRAP 2, which provides educational materials for Antimicrobial Management, Medicines Management Teams and GP Clusters to support facilitated quality improvement sessions for primary care prescribers to further reduce unnecessary use
of antibiotics for respiratory tract infections (RTI) and to optimise management of urinary tract infections (UTI).

SAPG has undertaken a qualitative evaluation of ScRAP to review feedback from education session facilitators and participants and make improvements to the original content. A quantitative evaluation has demonstrated the benefits of ScRAP on prescribing rates and this will be published in due course.

ScRAP 2 builds on the behaviour change methods utilised in the original ScRAP and uses a quality improvement approach to enable all practice staff to reflect and effect improvement together whilst also providing individual participants with a valuable Continuing Professional Development opportunity. The new resources focusing on UTI will provide an additional topic area for those who have already made good progress in managing RTI.

We commend the updated ScRAP programme to you and encourage GP Practices to engage with these education sessions to facilitate optimisation of antibiotic prescribing within your Board.
Original languageEnglish
Place of PublicationEdinburgh
PublisherNHS Education for Scotland
Commissioning bodyNHS Education for Scotland (NES)
Number of pages44
Publication statusPublished - Feb 2017


  • Antimicrobial resistance
  • Urinary tract infections
  • Recurrent infection
  • Professional development
  • Quality Improvement


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