Brinnington Health Centre in Stockport, Greater Manchester, has reduced overall antibiotic prescribing by 15% after adopting a near real-time prescribing dashboard designed to support safer, more consistent antimicrobial prescribing across primary care.

Using BRIT2, a dashboard developed through a collaboration between The University of Manchester and Graphnet Health, the practice has improved visibility of prescribing patterns, identified variation between clinicians, enhanced compliance with NICE guidance and strengthened antimicrobial stewardship activity across the practice team. 

The practice has also achieved:

• A 10% reduction in broad-spectrum antibiotic prescribing
• A 20% improvement in coding indications for broad-spectrum antibiotics

Primary care accounts for around 81% of antibiotic prescribing in England, making general practice central to efforts to tackle antimicrobial resistance (AMR). 

The challenge

Like many GP practices, Brinnington Health Centre wanted better visibility of prescribing activity and variation across the practice, particularly around broad-spectrum antibiotic use, prolonged prescribing courses, repeat prescribing patterns and compliance with local and national antimicrobial guidance.

Traditional prescribing audits often relied on historical data that was several months old, limiting the ability to identify trends quickly or intervene early. Existing searches and audits could also be time-consuming and provided limited patient-level insight.

As a training practice with multiple clinicians and trainees working across the surgery, the team wanted a more dynamic and practical way to support antimicrobial stewardship, identify learning opportunities and improve prescribing consistency.

The solution

Brinnington Health Centre became a pilot site for BRIT2 in 2023.

The dashboard analyses two years of patient-level prescribing data and enables practices to review prescribing by indication, antibiotic type, course length, repeat prescribing patterns and deferred prescribing activity. 

The system integrates with GP records and provides near real-time insight into prescribing activity, allowing clinicians to review trends and drill down into individual patient records where appropriate.

The practice used the dashboard to review prescribing across conditions including urinary tract infections, sinusitis, otitis media and lower respiratory tract infections.

Clinicians were able to review:

• Prescribing trends by indication
• Broad-spectrum antibiotic use

The practice also used the system to support training and quality improvement activity across the multidisciplinary team.

Dr James Higgins, GP Partner at Brinnington Health Centre and Clinical Director at Tame Valley Primary Care Network, said:

What BRIT2 allows us to do is look at prescribing behaviour almost in real time and understand what is happening at both practice and patient level.
 
It helps us identify variation between clinicians, review prescribing decisions and support more evidence-based conversations across the team.

Improving prescribing consistency and stewardship

Using BRIT2, the practice identified variation in the management of sinusitis and otitis media, with some clinicians prescribing antibiotics more readily than others. This enabled the team to revisit NICE guidance collectively and improve consistency across the practice.

The dashboard also highlighted higher-than-expected use of cefalexin for urinary tract infections. By drilling down into patient-level data, clinicians found much of this prescribing related to care home residents unable to swallow tablets or capsules, where cefalexin represented the most practical option within local antimicrobial guidance.

The practice was also able to review antibiotic course lengths in more detail.

One review identified longer doxycycline courses being prescribed for some respiratory infections, allowing targeted feedback and improved alignment with prescribing guidance.

The dashboard further enabled the practice to identify patients repeatedly receiving antibiotics throughout the year. In some cases, these were patients on long-term prophylactic antibiotics, while in others the data highlighted opportunities for earlier intervention or alternative treatment approaches.

The practice also began using the system to support conversations around recurrent antibiotic use in children and more appropriate use of delayed prescribing where clinically suitable.

Positive outcomes for patients and clinicians

The move to near real-time prescribing insight has helped the practice improve prescribing quality while supporting safer, more personalised patient care.

The dashboard has enabled the team to:

• Reduce unnecessary antibiotic prescribing
• Improve consistency between clinicians

Dr Higgins said:

One of the biggest advantages is being able to identify recurring patterns that we might otherwise miss.

It allows us to have better conversations around delayed prescribing, recurrent infections and the appropriate use of antibiotics in children, helping us move towards a more proactive and personalised approach.

Supporting wider antimicrobial stewardship goals

The project aligns with the UK’s 2024–2029 National Action Plan on antimicrobial resistance, which highlights the importance of improving antimicrobial stewardship, reducing unnecessary prescribing and making better use of healthcare data. 

The wider BRIT2 programme builds on research led by The University of Manchester using national primary care datasets including OpenSAFELY and CPRD, alongside a Knowledge Support System developed to support clinicians during consultations. 

Ian Nicholson, Population Health Consultant at Graphnet Health, said:

This is about helping clinicians make informed decisions quickly, consistently and safely while improving patient care.

Future plans

Brinnington Health Centre is now exploring further opportunities to improve coding of deferred prescriptions, review recurrent antibiotic use in children and identify patients who may benefit from earlier referral or alternative treatment pathways.

The practice also plans to continue using the dashboard to support audit activity, training and ongoing quality improvement across the wider multidisciplinary team.