Development of a capability framework for antimicrobial stewardship specialist health professionals working in the NHS in England: utilizing Delphi methodology

Abstract

Background Antimicrobial stewardship (AMS) programmes are led by multi-professional teams and are central to optimizing antimicrobial use and minimizing inappropriate use. Although frameworks exist that describe the knowledge and skills relating to antimicrobial resistance (AMR) and AMS for generalist healthcare professionals, there is a need to provide a framework for AMS specialists working in the NHS that supports the development of flexible capabilities rather than granular competencies. Objectives To develop a multi-professional capability framework to recognize and develop the specialist knowledge and skills of AMS staff across all sectors of healthcare, including adult and paediatric services, at all levels of post-foundation specialist practice. Methods A modified Delphi approach was adopted. Initial capability statements were derived from a literature review. An expert panel of UK-based AMS professionals participated in two Delphi survey rounds to assess the importance of each capability statement and map level of delivery against level of practice. Descriptors of practice and professional development resources were identified through follow-up workshops and consultation. Results From 922 source statements, 45 capability statements were agreed and structured into four domains: AMS Professional Practice, Leadership and Management, Education, and Research and Quality Improvement. Consensus was reached across all statements following two Delphi rounds. Descriptors of practice and development resources were identified to support benchmarking and professional development across all levels of specialist practice. Conclusions This multi-professional capability framework defines AMS specialist practice relevant to all NHS sectors, supporting professional development, career progression, and strategic workforce planning across all professional groups.