The information requested is not held or routinely published.

The UK Health Security Agency’s (UKHSA) English Surveillance Programme for Antimicrobial Utilisation and Resistance (ESPAUR) publishes surveillance data on antibiotic-resistant infections, including estimates of 30-day all-cause mortality following resistant bloodstream infections. However, these figures are not a measure of deaths attributable to antimicrobial resistance and should not be interpreted as deaths caused by antibiotic-resistant infections. This surveillance data is available on the GOV.UK website.

The UKHSA publishes case-fatality statistics for healthcare-associated infections, which are available on the GOV.UK website, including methicillin-resistant staphylococcus aureus. However, these cannot be used to determine deaths attributable to antibiotic resistance because they do not distinguish the effect of resistance from other factors such as underlying illness, age, comorbidities, or the infection itself.

There is no breakdown of the statistics by National Health Service estate.

The ESPAUR’s 2024 to 2025 report included a breakdown by hospital- and community-onset infection but did not include place of death and cannot determine the proportion of deaths occurring in hospital.

The UKHSA is now developing the capability to produce annual estimates of deaths attributable to antibiotic-resistant bloodstream infections as part of the United Kingdom’s 2024 to 2029 national action plan for antimicrobial resistance, which is available on the GOV.UK website.

The United Kingdom’s 2024 to 2029 antimicrobial resistance (AMR) national action plan (NAP), published in May 2024, recognises that AMR impacts people differently. People with cystic fibrosis are an increased risk of infection, including resistant infections, and therefore action to tackle the threat of AMR is even more important for this group. In particular, the use of accurate diagnostic testing to guide effective antibiotic use, a priority commitment in the NAP, is critical for people with cystic fibrosis.

The Department, through the National Institute for Health and Care Research (NIHR), has invested over £88 million in AMR programme funding over the last five years. This includes research to develop and evaluate diagnostics and point‑of‑care testing to improve infection detection and optimise antibiotic use. The NIHR also supports the development of health technologies, including diagnostics, through its wider research infrastructure.

The UK will continue to invest in tackling AMR where it is most impactful, helping to ensure that our actions to address AMR reduce the burden for the people who are more affected.

The Veterinary Medicines Directorate (VMD) regularly speaks to veterinary prescribers through antibiotic stewardship groups. These bring together government, veterinary profession and livestock sector representatives to support responsible use and reduce antimicrobial resistance (AMR). These include:

· The Cattle Antibiotic Guardian Group

· Pig Health and Welfare Council Antimicrobial Usage (AMU) Subgroup

· British Poultry Council Stewardship Group

· Responsible Use of Medicines Alliance (RUMA) Companion Animal and Equine Group

· RUMA Targets Taskforce meetings

· Ruminant Antibiotic Stewardship Roadmap Steering Group

· Medicine Hub Industry Liaison Group

· The electronic Medicine Book (eMB) Pigs Steering Group

These discussions aim to:

· Share research, AMU, AMR, and disease surveillance data

· Promote responsible antibiotic prescribing, storage and disposal

· Encourage creation and uptake of training and guidance, including for vets and animal keepers

· Improve health and disease prevention through herd/flock health planning

· Advise on metrics for monitoring AMU

· Improve accuracy, availability, and coverage of AMU data in livestock, companion animals, and horses

· Encourage antibiotic use data for auditing and benchmarking

· Discuss environmental transmission pathways with veterinary prescribers, and the impact of these on their prescribing

By focusing on stewardship and responsible use of antibiotics in animals, the risk of AMR in animals, and potential subsequent onwards transmission through the environment is reduced.

The Department for Environment, Food and Rural Affairs monitors antimicrobial resistance (AMR) in zoonotic and commensal bacteria from food samples taken from Third Country Imports to the European Union of fresh meat at Northern Ireland’s Points of Entry. This AMR testing is carried out on beef and/or pork and chicken and/or turkey on alternating years. These inspections are carried out in line with and under European Commission Implementing Decision (EU) 2020/1729 on the monitoring and reporting of AMR in zoonotic and commensal bacteria, which applies in Northern Ireland under the Windsor Framework.

For the rest of the United Kingdom, port health authorities (PHAs) have a statutory obligation to prioritise sampling under official controls which are intended to mitigate known food safety risks. PHAs have their own local sampling plans which will be informed by the UK’s National Monitoring Plan and other intelligence. Currently, it is more practical to sample for AMR screening inland.

The Food Standards Agency (FSA) is currently funding two AMR surveys at retail which includes testing foods imported into the United Kingdom. This includes the raw frozen chicken meat survey and the eggshell membrane food supplements survey, which includes supplements imported into the UK.

The Government takes a ‘One-Health’ approach to controlling AMR through the UK’s 2024 to 2029 National Action Plan. The FSA leads on AMR in food and promoting good hygienic practices across the food chain. Surveillance improves our understanding of AMR by measuring, predicting, and understanding how resistant microorganisms spread from animals and agriculture to humans via the food chain. This allows decisions to be based on robust surveillance, scientific research, and datasets. We monitor AMR bacteria found in foods to understand trends over several years and detect emerging new threats to protect the public and future effectiveness of antibiotics both in healthcare and animal welfare.

In 2022 the Veterinary Medicines Directorate (VMD) initiated a collaboration with the Centre for Environment Fisheries and Aquaculture science (Cefas) with the support of the British Trout Association (BTA), to establish AMR surveillance in bacteria responsible for disease in UK farmed trout. Results from this pilot scheme have been reported in the UK Veterinary Antibiotic Resistance and Sales Surveillance Reports (2023 & 2024). Building on this work the development of a national surveillance programme for AMR in healthy aquatic animals – including finfish and shellfish – is currently under consideration.

The Veterinary Medicines Directorate has also established the Private Laboratories Initiative (PLI) to strengthen national AMR surveillance by capturing clinical data from private veterinary diagnostic laboratories, which are not currently included in government surveillance programmes. Addressing this surveillance gap will improve our ability to understand of AMR trends and detect emerging threats. This work includes aquaculture, with work underway led by Cefas. Further details can be found in the UK‑VARSS 2024 report (p.169).

The United Kingdom’s 2024 to 2029 National Action Plan (NAP) to confront antimicrobial resistance (AMR) sets out a range of commitments and targets to mitigate the AMR risk, including to reduce antibiotic use in humans. Aligned to the NAP, NHS England is taking a range of steps to embed antimicrobial stewardship (AMS) within professional responsibilities across the National Health Service workforce.

This includes establishing professional accountability and leadership through regional AMS networks, embedding AMS into continuous professional development training programmes, and providing digital decision-support tools and national reporting on antibiotic prescribing targets.

As set out in the Chief Medical Officer’s annual report 2025, the formation of regional infection groups (RIGs) was recently proposed by the NHS England Infectious Disease Clinical Reference Group to embed AMS at a local level. NHS England is committed to introducing RIGs, which would collaborate with the UK Health Security Agency (UKHSA) to deliver local, data-driven AMS interventions that span community and secondary care settings.

It is envisaged that RIGs would be comprised of senior leaders across NHS Regional Teams, UKHSA, Regional Pathology Networks, Infection, Prevention and Control teams, and NHS Emergency Preparedness, Resilience & Response, organised according to regions or integrated care board (ICB) clusters. RIG initiatives would be shaped and informed by local, regional or ICB cluster priorities.

Through these measures, AMS is embedded in education, clinical practice, and regional governance, ensuring responsible prescribing, and safeguarding the effectiveness of antimicrobials for the future.

The United Kingdom’s 2024 to 2029 National Action Plan (NAP) to confront antimicrobial resistance (AMR) sets out a range of commitments and targets to mitigate the AMR risk, including to reduce antibiotic use in humans. Aligned to the NAP, NHS England is taking a range of steps to embed antimicrobial stewardship (AMS) within professional responsibilities across the National Health Service workforce.

This includes establishing professional accountability and leadership through regional AMS networks, embedding AMS into continuous professional development training programmes, and providing digital decision-support tools and national reporting on antibiotic prescribing targets.

As set out in the Chief Medical Officer’s annual report 2025, the formation of regional infection groups (RIGs) was recently proposed by the NHS England Infectious Disease Clinical Reference Group to embed AMS at a local level. NHS England is committed to introducing RIGs, which would collaborate with the UK Health Security Agency (UKHSA) to deliver local, data-driven AMS interventions that span community and secondary care settings.

It is envisaged that RIGs would be comprised of senior leaders across NHS Regional Teams, UKHSA, Regional Pathology Networks, Infection, Prevention and Control teams, and NHS Emergency Preparedness, Resilience & Response, organised according to regions or integrated care board (ICB) clusters. RIG initiatives would be shaped and informed by local, regional or ICB cluster priorities.

Through these measures, AMS is embedded in education, clinical practice, and regional governance, ensuring responsible prescribing, and safeguarding the effectiveness of antimicrobials for the future.

The 2024 to 2029 United Kingdom antimicrobial resistance (AMR) national action plan (NAP) includes research to improve understanding of AMR spread across humans, animals, agriculture, and the environment, to strengthen future AMR surveillance strategies.

The Environment Agency is conducting research into environmental transmission of AMR including monitoring novel forms of resistance, such as antifungal resistance and bioaerosols. The UK Health Security Agency’s modular ward will generate evidence on how the hospital environment contributes to the spread of AMR infection, with a focus on how risks associated with water and wastewater can be mitigated.

The Health Protection Research Unit on Healthcare Associated Infections and AMR led research on wastewater infrastructure in hospitals on AMR gene dissemination in humans and is exploring the impact of hospital wastewater in terms of perpetuating AMR.

The Unified Infection Dataset (UID) supports early detection of antimicrobial resistance (AMR) through epidemiological outputs, infectious disease surveillance, outbreak response, and allied research with rich linked data. The UK Health Security Agency (UKHSA) has developed innovative analytical tools for large datasets via the UID and the Enterprise Data Analytics Platform (EDAP). AMR-related data continues to be ingested into the EDAP, including:

• national laboratory surveillance data from the UKHSA’s Second Generation Surveillance System;
• healthcare associated infections (HCAI) data from the UKHSA’s data capture system; and
• health equity data.

The EDAP aims to deliver a strategic platform for data enrichment, data analytics, and data science for AMR and HCAI and will support streamlined and timely surveillance outputs to tackle AMR and improve public health.

The UKHSA’s Porton AMR network leads on the discovery and development of novel antimicrobials, optimising antibiotic combinations, vaccines, and non-traditional therapies. The UKHSA is also working on advancing AMR typing and whole genome sequencing reference laboratory services and providing clinical advice to support NHS England front line services dealing with AMR associated infections.

NHS England is streamlining diagnostic innovation through the cross-sector ‘Moving Forwards Infection Diagnostics’ events series. Engagement will inform an ‘infection diagnostics framework’ by 2027 and identify target product profiles for diagnostics needed in the National Health Service. A rapid review pipeline to identify optimal tests within the market and assess how existing diagnostics can be optimised is also being produced. These winter ‘Point of Care Testing’ pilots have been funded to further build the evidence base.

Actions taken to tackle higher rates of resistant infections in more deprived communities include a health inequalities outcome within the latest United Kingdom antimicrobial resistance (AMR) national action plan, which is available at the following link:

https://www.gov.uk/government/publications/uk-5-year-action-plan-for-antimicrobial-resistance-2024-to-2029/confronting-antimicrobial-resistance-2024-to-2029

Commitments under this outcome aim to improve data reporting on health inequalities in AMR and antibiotic use, publish a toolkit of resources that supports organisations to develop interventions, and implement and evaluate interventions to address inequalities in AMR.

NHS England encourages regions and integrated care boards to focus on building trust to increase the uptake of vaccinations. They work with community and faith leaders particularly in areas of high deprivation, using a make every contact count approach.

The United Kingdom is looking forward to participating actively in the fifth Ministerial High-Level Conference on antimicrobial resistance (AMR) which will be held in Nigeria in 2026. The Government is considering how best to celebrate the 2028 centenary of the UK's discovery of penicillin. We will internally consider whether this will include bidding to host the sixth Ministerial High-Level Conference on AMR, which will take place in 2028.

The United Kingdom’s 2024 to 2029 antimicrobial resistance (AMR) national action plan (NAP) highlights the importance of accurate diagnostic testing to guide effective antibiotic use.

Outcome six of the NAP commits to cross-sector working to develop diagnostics as a tool to tackle AMR. The Department, through the National Institute for Health and Care Research (NIHR), has invested over £16 million into programme funding for AMR diagnostics research. The Department also funds the NIHR HealthTech Research Centres, which accelerate development of healthcare technologies, including diagnostics.