New development: A ‘journey of personal and professional emotions'—emergency ambulance professionals during Covid-19

IMPACTThis article explores the consequences of emotional labour on UK NHS ambulance staff and their response to the Covid-19 pandemic. It highlights the challenges faced by ambulance crews while dealing with their emotional labour within the context of organizational settings. Research findings also explain the importance of emergency responders' psychosocial wellbeing. The article has clear relevance as to how frontline staff manage their emotional labour in other emergency service settings, such as the police and fire and rescue services.Alternate :Managing emotions are essential aspect of many jobs, and frontline healthcare workers have to manage and control their emotions while caring for critically ill patients and working in an emotionally-charged dynamic environment;this was particularly the case during Covid-19. Ambulance workers are an important group in this respect but they are currently under-researched. Evidence behind this article comes from data collected from an NHS ambulance trust in England. One of the key contributions of this article is to highlight how frontline ambulance professionals manage their emotional labour while working within the stipulations of organizational constraints.

Getting it right first time: what have we learnt?

Getting It Right First Time (GIRFT) is a national programme of improvement to identify and reduce unwarranted variation and non-evidence-based practice in healthcare. It aims to improve patient care, increase productivity and reduce costs. Professor Tim Briggs, an orthopaedic surgeon, began the programme with a pilot review visiting every orthopaedic surgery department in England. He used publicly available data to illuminate variation, and worked with the clinicians and management to develop improvements. The impressive initial report in 2015 led to NHS Improvement investing £60m to expand the programme to 40 medical and surgical specialties. The follow-up Orthopaedic report detailed savings of £696m to the NHS. GIRFT is now sharing its data with the CQC and leading the charge with elective recovery following COVID-19. GIRFT differs from previous programmes of improvement through its peer led, supportive approach to promoting change with early engagement of both clinicians and management. Common themes run through the almost 40 specialty reports published to date: variation in procurement and litigation costs, huge variations in patient treatment options (often with a lack of evidence base) and poor data quality. Successfully applied in orthopaedic surgery, it has been taken on enthusiastically by other specialties. Whether it can deliver its objective of £1.4bn savings whilst improving patient outcomes is yet to be seen, but its approach is changing the culture of the NHS.

The Emerging Challenges and Strengths of the National Health Services: A Physician Perspective.

The National Health Services (NHS) is a British national treasure and has been highly valued by the British public since its establishment in 1948. Like other healthcare organizations worldwide, the NHS has faced challenges over the last few decades and has survived most of these challenges. The main challenges faced by NHS historically have been staffing retention, bureaucracy, lack of digital technology, and obstacles to sharing data for patient healthcare. These have changed significantly as the major challenges faced by NHS currently are the aging population, the need for digitalization of services, lack of resources or funding, increasing number of patients with complicated health needs, staff retention, and primary healthcare issues, issues with staff morale, communication break down, backlog in-clinic appointments and procedures worsened by COVID 19 pandemic. A key concept of NHS is equal and free healthcare at the point of need to everyone and anyone who needs it during an emergency. The NHS has looked after its patients with long-term illnesses better than most other healthcare organizations worldwide and has a very diversified workforce. COVID-19 also allowed NHS to adopt newer technology, resulting in adapting telecommunication and remote clinic. On the other hand, COVID-19 has pushed the NHS into a serious staffing crisis, backlog, and delay in patient care. This has been made worse by serious underfunding the coronavirus disease-19coronavirus disease-19 over the past decade or more. This is made worse by the current inflation and stagnation of salaries resulting in the migration of a lot of junior and senior staff overseas, and all this has badly hammered staff morale. The NHS has survived various challenges in the past; however, it remains to be seen if it can overcome the current challenges.

A reflection on the NHS, health security, and refugees

In 2021 a sudden influx of refugees arrived in the UK from Afghanistan, at a time when the British public were being encouraged to access healthcare services to obtain COVID-19 vaccinations. This report examines the successes and failures of care provision in the NHS across the country, in particular Wolverhampton, whereby refugees accessed healthcare provision in a local Primary Care Network. The report considers the author's personal experiences while working within the local Primary Care Network, in addition to published research, in the context of health security. Furthermore, it highlights recommended improvements within the NHS to provide aid to the vulnerable, while preserving the system set out to create health security.

Looking back to look forward: Surviving COVID-19 and the future of the NHS.

The COVID-19 pandemic affected healthcare systems worldwide, including the National Health Service (NHS). It drastically changed the practice and delivery of healthcare and laid bare longstanding structural flaws. It also brought a time of innovation and digitalisation and renewed appreciation of the role of public health. This paper offers a thematic summary of a debate held in December 2021 by the University of Edinburgh School of Medicine. It featured a multi-specialty panel of doctors and patient representative discussing the likely impact of the pandemic on the future of NHS. It serves as a reflection point on the pressures the NHS has faced since and their likely genesis at a time when the impact of the pandemic on staff risks being forgotten.

Critical Reflections on the COVID-19 Pandemic from the NHS Frontline

The COVID-19 pandemic fundamentally changed the way we live, work, and interact with each other. Nowhere was the pandemic more profoundly experienced than on the frontline of healthcare. From overwhelmed Intensive Care Units to shortages of Personal Protective Equipment (PPE) and clap for carers, the UK's National Health Service (NHS) became the focal point for the pandemic response. Utilising data from online survey responses (N = 16) complemented by four online interviews and one face-to-face interview (N = 5) with NHS workers primarily during the height of the pandemic, this article offers a preliminary analysis on the challenges the UK's healthcare workers faced through working in conditions of crisis management. The article particularly addresses NHS workers' amplification of fear, anxiety, and exhaustion;the absence of widespread solidarity;and implications of the absence of coherent governmental messaging upon the workforce. We situate this discussion within a critical account of neoliberal political economy, the theoretical framework of social harm, and the absence to explicate the harmful conditions of the pandemic's frontline. While the data are confined to the UK's NHS workers, its findings are relevant to other countries across the world that enacted similar responses to deal with COVID-19.

Comparative effectiveness of two- and three-dose COVID-19 vaccination schedules involving AZD1222 and BNT162b2 in people with kidney disease: a linked OpenSAFELY and UK Renal Registry cohort study.

Background: Kidney disease is a key risk factor for COVID-19-related mortality and suboptimal vaccine response. Optimising vaccination strategies is essential to reduce the disease burden in this vulnerable population. We therefore compared the effectiveness of two- and three-dose schedules involving AZD1222 (AZ; ChAdOx1-S) and BNT162b2 (BNT) among people with kidney disease in England. Methods: With the approval of NHS England, we performed a retrospective cohort study among people with moderate-to-severe kidney disease. Using linked primary care and UK Renal Registry records in the OpenSAFELY-TPP platform, we identified adults with stage 3-5 chronic kidney disease, dialysis recipients, and kidney transplant recipients. We used Cox proportional hazards models to compare COVID-19-related outcomes and non-COVID-19 death after two-dose (AZ-AZ vs BNT-BNT) and three-dose (AZ-AZ-BNT vs BNT-BNT-BNT) schedules. Findings: After two doses, incidence during the Delta wave was higher in AZ-AZ (n = 257,580) than BNT-BNT recipients (n = 169,205; adjusted hazard ratios [95% CIs] 1.43 [1.37-1.50], 1.59 [1.43-1.77], 1.44 [1.12-1.85], and 1.09 [1.02-1.17] for SARS-CoV-2 infection, COVID-19-related hospitalisation, COVID-19-related death, and non-COVID-19 death, respectively). Findings were consistent across disease subgroups, including dialysis and transplant recipients. After three doses, there was little evidence of differences between AZ-AZ-BNT (n = 220,330) and BNT-BNT-BNT recipients (n = 157,065) for any outcome during a period of Omicron dominance. Interpretation: Among individuals with moderate-to-severe kidney disease, two doses of BNT conferred stronger protection than AZ against SARS-CoV-2 infection and severe disease. A subsequent BNT dose levelled the playing field, emphasising the value of heterologous RNA doses in vulnerable populations. Funding: National Core Studies, Wellcome Trust, MRC, and Health Data Research UK.

Relationships, Rights, and Responsibilities: (Re)viewing the NHS Constitution for the post-pandemic 'new normal'.

Action needs to be taken to map out the fairest way to meet the needs of all NHS stakeholders in the post-pandemic 'new normal'. In this article, we review the NHS Constitution, looking at it from a relational perspective and suggesting that it offers a useful starting point for such a project, but that new ways of thinking are required to accommodate the significant changes the pandemic has made to the fabric of the NHS. These new ways of thinking should encompass concepts of solidarity, care, and (reciprocal) responsibility, grounded in an acceptance of the importance of relationships in society. To this end, we explore and emphasise the importance of our interconnections as NHS stakeholders and 're-view' the NHS Constitution from a relational perspective, concentrating on the rights and responsibilities it describes for patients and the public as NHS stakeholders. We argue that the NHS Constitution, of which most stakeholders are probably unaware, can be used as a tool to engage us, and to catalyse conversation about how our responsibilities as NHS stakeholders should change in the post-pandemic 'new normal'.

Successful prioritisation of inguinal herniotomies in children during the COVID-19 pandemic to minimise emergency presentations.

Background: The coronavirus disease 2019 (COVID-19) disrupted the delivery of elective surgery in children. We introduced guidance to mitigate this impact. By reviewing the outcomes for inguinal herniotomies, we aimed to determine if this guidance has enabled us to prevent an increase in the elective surgery wait time and therefore the need for emergency surgery for incarcerated hernias. This report aims to share our learnt lessons about responding to a crisis limiting accessibility to elective surgery. Results: We performed a retrospective review of all elective and emergency herniotomies performed between April 1 and September 30, 2019 (pre-COVID-19) and the same period in 2020 (post-COVID-19). We compared the data on wait time from referral to clinic review/elective surgery and incarceration rates. During the study period in 2019, 76 elective herniotomies were performed compared to 46 in 2020. We did not observe a simultaneous increase in emergency herniotomies in 2020 (27 [2020] vs 25 [2019], OR [95% CI] = 1.53 [0.79-2.9]; p = 0.2). The median time from referral to elective surgery in 2019 compared to 2020 did not differ (56 vs 59 days, respectively; p = 0.61). In 2020, 72% of children that required emergency surgery had not been previously referred to our service and the median age (interquartile range) at which they presented with an incarcerated hernia was 2.8 months (2.1-13.7 months). Conclusion: By adhering to local guidelines for resumption of elective activity, the pandemic did not result in children waiting longer to be seen by a surgeon for a suspected inguinal hernia. As a result, we did not perform more emergency herniotomies. Urgent prioritisation of hernias in infants, from birth up to 3 months old, was a beneficial strategy. Public health education on childhood hernias will improve outcomes. Supplementary Information: The online version contains supplementary material available at 10.1186/s43159-023-00243-1.

Very rapid insight generation to support UK health and care systems: An AHSN approach.

Introduction: COVID-19 challenges are well documented. Academic Health Science Networks (AHSNs) are a key partner to NHS and care organizations. In response to managing COVID-19 challenges, Wessex AHSN offered rapid insight generation and rapid evaluation to local NHS and care systems to capture learning during this period. This novel "Rapid Insight" approach involved one-off online deliberative events with stakeholders to generate insights linked to specific, priority areas of interest, followed by rapid analysis and dissemination of the findings. Context: Key objectives were to enable system leaders to build their adaptive leadership capability and learn from the experience of COVID-19 to inform recovery planning and system support. Rapid Insight (RI) gathered together health and care professionals into a tightly managed, virtual forum to share system intelligence. Approach: Focused questions asked about the systems' response to the pandemic, what changes to continue and sustain, or discontinue. Participants responded simultaneously to each question using the virtual chat function. Immediate thematic analysis of the chat conducted in 48-72 h by paired analysts for each question strengthened analytical integrity. Mind maps, the key output, provided easily assimilated information and showed linkages between themes. Telephone or virtual interviews of key informants (health and care professionals and patients) and routinely collected data were synthesized into short reports alongside several RI events. However, insufficient time limited the opportunities to engage diverse participants (e.g., mental health users). Data from RI can scope the problem and immediate system needs, to stimulate questions for future evaluative work. Impact: RI facilitated a shared endeavor to discover "clues in the system" by including diverse opinions and experience across NHS and care organizations. Although these rapid virtual events saved on travel time, digital exclusion might constrain participation for some stakeholders which needs other ways to ensure inclusion. Successful rapid engagement required Wessex AHSN's existing system relationships to champion RI and facilitate participant recruitment. RI events "opened the door" to conversations between up to 150 multi-professional clinicians to share their collective response to COVID-19. This paper focuses on the RI approach with a case example and its further development.

(How) is COVID-19 reframing interaction between the NHS and private healthcare?

In March 2020, a 'major deal' was struck between the National Health Service (NHS) and private healthcare sector to facilitate 'crisis' and 'continuity' responses to COVID-19. A further deal was struck in January 2022 to support the NHS in tackling the Omicron variant, suggesting that the pandemic was evolving, rather than definitively over. The legal basis for these deals was a Public Policy Exclusion Order, a temporary relaxation mechanism in UK competition law defined by a 'disruption period'. In a global pandemic, the 'healthcare disruption period' might be considered to be of a different scope and nature to short-term disturbances experienced in other sectors, such as groceries. This article examines the Public Policy Exclusion Orders issued in respect of health services in England and Wales, and the Collective Agreements notified under these between March 2020 and March 2021, and again in March 2022. Amid ongoing tensions surrounding 'NHS privatisation', this enables a timely analysis of whether the underlying relationship between the NHS and private healthcare may be changing in response to COVID-19, and how considerations of ethical frameworks are also relevant to this aspect of the pandemic response.Copyright © The Author(s) 2023.

Between donation and exchange. The plasma supply chain in the Italian transfusion system

The Italian transfusion system is based on the public property of blood and its derivatives: any commodification is refused and the USA model is avoided, as Richard Titmuss recommended. Nevertheless, the for profit sector comes into play with regard to plasma manufacturing. This "plasma supply chain” relies on a complex collaboration among the Italian NHS' top institutions (Ministry of Health and Regions), four Third Sector Organizations which gather voluntary donors, and four for profit firms which produce Plasma-Derived Medicinal Products. Through a qualitative methodological approach, this article aims to explore such a mechanism, investigating its strengths and weaknesses, comparing it to other systems worldwide and analysing its reaction to the Covid-19 pandemic. The final aim is considering and evaluating it in light of both Titmuss' position and Achille Ardigò's viewpoint about the usefulness of a "triple pole model”. Copyright © FrancoAngeli.

Tra dono e scambio. La "filiera” del plasma nel sistema trasfusionale italiano

The Italian transfusion system is based on the public property of blood and its derivatives: any commodification is refused and the USA model is avoided, as Richard Titmuss recommended. Nevertheless, the for profit sector comes into play with regard to plasma manufacturing. This "plasma supply chain” relies on a complex collaboration among the Italian NHS' top institutions (Ministry of Health and Regions), four Third Sector Organizations which gather voluntary donors, and four for profit firms which produce Plasma-Derived Medicinal Products. Through a qualitative methodological approach, this article aims to explore such a mechanism, investigating its strengths and weaknesses, comparing it to other systems worldwide and analysing its reaction to the Covid-19 pandemic. The final aim is considering and evaluating it in light of both Titmuss' position and Achille Ardigò's viewpoint about the usefulness of a "triple pole model”. Copyright © FrancoAngeli.

‘The Biggest Charity You've Never Heard of': Institutional Logics of Charity and the State in Public Fundraising in Scotland's NHS

The boundaries between state and charitable activities within the NHS are set out in regulations but are also enacted, blurred, and contested through local practices. This article reports research on NHS Charities– charitable funds set up within NHS organizations to enhance statutory provision – in Scotland. We analysed financial accounts and conducted qualitative interviews with staff in 12 of the 14 NHS Charities in Scotland, where they are generally known as endowments. Our findings suggest that Scotland's endowments are relatively wealthy in charitable terms, but that this wealth is unevenly distributed when population size and socio-economic deprivation are considered. We also identify two diverging organisational approaches to decisions, including those about appropriate and inappropriate fundraising. We argue that these approaches cohere with contrasting ‘state' and ‘charitable' institutional logics, which in turn imply different attitudes to potential inequalities, and to relationships with local publics.

Work-related experiences of mental health professionals during COVID-19 pandemic: a qualitative study

The imposition of nation-wide lockdowns and sporadic transition to remote work produced unforeseen psychological challenges likely to impact the medium of care and workload of mental health professionals. The present study explored the lived occupational experiences of clinical psychologists, counsellors, and psychotherapists working in the National Health Service (NHS) and private practice in the UK during COVID-19 pandemic. Nineteen professionals (11 employed in the NHS and 8 working in independent settings) were interviewed about their professional experiences during first and second waves of the pandemic. Data were analysed using interpretative phenomenological analysis. Three main themes emerged from the analysis: (i) transition from face to face to online therapy;(ii) novel changes and wellbeing;and (iii) uncertain professional support in uncertain times. The findings suggest that lack of experience in providing online or telephonic psychotherapeutic services from home negatively impacted professionals' physical and psychological health and wellbeing. Thus, to cope with it, they availed psychological and structural support from colleagues, co-workers, clinical supervisors, managers, organisations, and professional bodies. This study adds to the existing body of research on the impact of the pandemic on UK-based mental health professionals and from an applied perspective, it highlights the need for skill-upgradation of professionals. © 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Sleepiness and safety at work among night shift NHS nurses.

BACKGROUND: Sleepiness associated with night shift working (NSW) is known to adversely affect workers' health and well-being. It has been associated with adverse safety outcomes and is a recognized workplace hazard among healthcare workers. AIMS: This study was aimed to assess the prevalence of self-reported sleepiness in NSW nurses and midwives. This study also explored the consequences of sleepiness on safety at work and driving. METHODS: A cross-sectional study of NSW nurses and midwives was conducted at an National Health Service (NHS) hospital trust from 16 March 2020 to 1 June 2020. Data were collected by online questionnaire and included information on demographics, shift work and safety aspects. Sleepiness was assessed with the Epworth Sleepiness Scale (ESS). RESULTS: Data collection coincided with the first coronavirus pandemic peak in England. Out of 1985 eligible NSW nurses and midwives, 229 participated in the study, with a response rate of 12%. The prevalence of sleepiness was 28%. Following a night shift, 49% of nurses reported nodding off at the wheel and 44% reported a near-miss car accident in past 12 months. An abnormal ESS score was significantly associated with near-miss car accidents (odds ratio [OR] 2.75, 95% confidence interval [CI] 1.31-5.77) and with low confidence in undertaking complex tasks at night (OR 2.64, 95% CI 1.20-5.84). CONCLUSIONS: More than a quarter of NSW nurses and midwives reported excessive daytime sleepiness although, due to the low response rate, this may not be representative. Adverse driving events were common. Elevated ESS scores correlated well with safety issues relating to work and driving.

Development of thermosensitive hydrogel of Amphotericin-B and Lactoferrin combination-loaded PLGA-PEG-PEI nanoparticles for potential eradication of ocular fungal infections: In-vitro, ex-vivo and in-vivo studies.

The most prevalent conditions among ocular surgery and COVID-19 patients are fungal eye infections, which may cause inflammation and dry eye, and may cause ocular morbidity. Amphotericin-B eye drops are commonly used in the treatment of ocular fungal infections. Lactoferrin is an iron-binding glycoprotein with broad-spectrum antimicrobial activity and is used for the treatment of dry eye, conjunctivitis, and ocular inflammation. However, poor aqueous stability and excessive nasolacrimal duct draining impede these agens' efficiency. The aim of this study was to examine the effect of Amphotericin-B, as an antifungal against Candida albicans, Fusarium, and Aspergillus flavus, and Lactoferrin, as an anti-inflammatory and anti-dry eye, when co-loaded in triblock polymers PLGA-PEG-PEI nanoparticles embedded in P188-P407 ophthalmic thermosensitive gel. The nanoparticles were prepared by a double emulsion solvent evaporation method. The optimized formula showed particle size (177.0 ± 0.3 nm), poly-dispersity index (0.011 ± 0.01), zeta-potential (31.9 ± 0.3 mV), and entrapment% (90.9 ± 0.5) with improved ex-vivo pharmacokinetic parameters and ex-vivo trans-corneal penetrability, compared with drug solution. Confocal laser scanning revealed valuable penetration of fluoro-labeled nanoparticles. Irritation tests (Draize Test), Atomic force microscopy, cell culture and animal tests including histopathological analysis revealed superiority of the nanoparticles in reducing signs of inflammation and eradication of fungal infection in rabbits, without causing any damage to rabbit eyeballs. The nanoparticles exhibited favorable pharmacodynamic features with sustained release profile, and is neither cytotoxic nor irritating in-vitro or in-vivo. The developed formulation might provide a new and safe nanotechnology for treating eye problems, like inflammation and fungal infections.

Voluntary private health insurance demand by Portuguese seniors before the COVID-19 pandemic.

AIMS: The Portuguese health system is mainly described as a National Health Service (NHS), but it also has some Bismarckian features. On top of these two layers of health insurance coverage, there is a market for voluntary private health insurance (VPHI). Usually, seniors are not eligible for this type of health insurance and this may serve as a complement or supplement to the NHS. The purpose of this work is to identify the main factors associated with holding a VPHI policy among seniors before the COVID-19 pandemic. MATERIAL AND METHODS: We use data collected by the National Health Survey of 2019/20 and estimate a multivariate logistic regression. RESULTS: The main findings show that VPHI may be bought by seniors as a facilitator to access health care, either specialised or dental care. While oral health is not covered by the NHS, specialist care is only available after referral by a gatekeeper and requires a long waiting time to be scheduled. Results show that people who had an appointment with a dentist or a specialist in the last 12 months are more likely to have a VPHI policy. Additionally, it was found that people benefiting from occupation-based insurance schemes are less likely to buy private health insurance. CONCLUSION: The current Portuguese health system organization based on different layers of health protection raises some issues concerning equity to health care access by seniors.

Batteryless wireless magnetostrictive Fe30Co70/Ni clad plate for human coronavirus 229E detection.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been garnered increasing for its rapid worldwide spread. Each country had implemented city-wide lockdowns and immigration regulations to prevent the spread of the infection, resulting in severe economic consequences. Materials and technologies that monitor environmental conditions and wirelessly communicate such information to people are thus gaining considerable attention as a countermeasure. This study investigated the dynamic characteristics of batteryless magnetostrictive alloys for energy harvesting to detect human coronavirus 229E (HCoV-229E). Light and thin magnetostrictive Fe-Co/Ni clad plate with rectification, direct current (DC) voltage storage capacitor, and wireless information transmission circuits were developed for this purpose. The power consumption was reduced by improving the energy storage circuit, and the magnetostrictive clad plate under bending vibration stored a DC voltage of 1.9 V and wirelessly transmitted a signal to a personal computer once every 5 min and 10 s under bias magnetic fields of 0 and 10 mT, respectively. Then, on the clad plate surface, a novel CD13 biorecognition layer was immobilized using a self-assembled monolayer of -COOH groups, thus forming an amide bond with -NH2 groups for the detection of HCoV-229E. A bending vibration test demonstrated the resonance frequency changes because of HCoV-229E binding. The fluorescence signal demonstrated that HCoV-229E could be successfully detected. Thus, because HCoV-229E changed the dynamic characteristics of this plate, the CD13-modified magnetostrictive clad plate could detect HCoV-229E from the interval of wireless communication time. Therefore, a monitoring system that transmits/detects the presence of human coronavirus without batteries will be realized soon.

Antimicrobial stewardship in solid organ transplant-Opportunities in the National Health Service.

BACKGROUND: Antimicrobial stewardship (AMS) is an intervention, which ensures the appropriateness of antimicrobial use to avoid in part the rising problem of antimicrobial resistance and negative effects of inappropriate antimicrobial use. In the solid organ transplant (SOT) population, which is prone to a particularly high risk of infection resulting from immunosuppression and anatomical issues with each type of SOT, the need for good stewardship has never been more important. This article looks at current AMS practice in SOT units in the United Kingdom and how things could be improved in the future. METHODS: The current practice of AMS alongside national antimicrobial resistance rates were reviewed using national mandatory reporting data. The background to the current practice and policies in place in the National Health Service (NHS) were also reviewed and possibilities for future approaches explored. RESULTS: AMS is a requirement within all NHS hospitals in the United Kingdom as per government policy. Mandatory reporting of specific bloodstream infections (BSIs) and antimicrobial consumption alongside financial incentives has been the approach nationwide. Gram-negative resistance rates in BSIs have been increasing prior to the COVID-19 pandemic. Little SOT-specific data on antimicrobial resistance exists, and the general approach to AMS in SOT units has generally modeled the national approach. CONCLUSION: Although there is a good, standardized approach to AMS in the NHS, there is a need for SOT-specific AMS approaches to be developed in the United Kingdom. More data is required on antimicrobial resistance rates, and studies are needed to investigate optimal antimicrobial prophylaxis regimens for each solid organ group. Tools to aid AMS efforts and novel treatment options for complex multiresistant infection must also be explored amongst transplant centers.