Equality and health inequalities assessment (EHIA): GID-IND10330: Infections: delayed antibiotic prescribing

What approaches have been used to identify potential equality and health inequalities issues during indicator development?

Equality and health inequality issues have been identified through existing EHIAs on the following NICE guideline topics:

What potential equality and health inequalities issues have been identified during indicator development?

Delayed antibiotic prescribing can help reduce unnecessary antibiotic use, but it may also raise potential equality and health inequalities issues:

How have the committee's considerations of equality and health inequalities issues identified in 1.2 been reflected in the indicator?

The committee observed inconsistencies in recording delayed prescriptions, noting that SNOMED coding is available but not universally applied. They suggested quality improvement initiatives could better promote delayed prescribing, alongside guidelines for consistency, monitoring prescribing patterns, and antimicrobial stewardship programs to ensure responsible antibiotic use.

Could any indicators potentially increase inequalities?

It is unlikely that the indicator will increase inequalities.

Based on the equality and health inequalities issues identified in 1.2 do you have representation from relevant stakeholder groups for the indicator consultation process, including groups who are known to be affected by these issues? If not, what plans are in place to ensure relevant stakeholders are represented and included?

Registered national stakeholders include Age UK, British Infection Association, British Thoracic Society, British Medical Association, Carers UK, Mind, Office for Health Improvement and Disparities, Primary Care Respiratory Society UK, Royal College of General Practitioners.

Has it been proposed to exclude any population groups from coverage by the indicator? If yes, could these exclusions further impact on people affected by any equality and health inequalities issues identified?

It is proposed that the following populations will be excluded from the indicator:

It is unlikely that exclusion of these populations will increase health inequalities.

What questions will you ask at the stakeholder consultation about the impact of the indicator on equality and health inequalities?

Are there concerns about unintended consequences, such as increased follow-up visits or complications?

What practical challenges might clinicians face in integrating this indicator into routine practice?

Do you think there is potential for differential impact (in respect of age, disability, gender and gender reassignment, pregnancy and maternity, race, religion or belief, and sexual orientation)? If so, please state whether this is adverse or positive and for which group.

If you think any of these indicators may have an adverse impact in different groups in the community, can you suggest how the indicator might be delivered differently to different groups to reduce health inequalities?