Outpatient and home parenteral antibiotic therapy (OHPAT) in the UK: A consensus statement by a working party

Abstract

Technology, procedures, devices and drugs account for 50-75% of the increase in healthcare costs. The UK National Health Service (NHS) executive is keen to promote the provision of high-technology care at home as part of its commitment to providing high-quality care in the community. The provision of parenteral antimicrobial therapy in the community lends itself to this philosophy. Despite this, and though outpatient and home parenteral antibiotic therapy (OHPAT) is an accepted 'standard of care' for managing many infections in North America, Europe has been slow to respond to this innovation in healthcare delivery. At present, a few enthusiasts are responding to this challenge but most infections requiring parenteral therapy are treated in the inpatient hospital setting. Currently, OHPAT in the UK has low government priority and existing activity is poorly coordinated and under-resourced. However, emergency medical admissions have risen by 50% since 1984 and now account for almost half of all NHS admissions. This in turn has necessitated an emergency cash boost for the NHS, and led to calls for approaches that reduce delays in discharging patients and lessen the need for people to be admitted to hospital in the first place. These aims are ably met by OHPAT strategies. This consensus statement aims to advise those healthcare workers and managers on how best to develop, fund, implement and evaluate a new or existing OHPAT program.