Chief Medical Officer letters to high antibiotic prescribers (England)
On 29 September 2014 England's Chief Medical Officer, Dame Sally Davies, wrote to every GP in practices whose antibiotic prescribing was in the top 20% of their NHS area, saying the practice prescribed more than 80% of practices nearby, with a patient leaflet on antibiotics. Designed with the Behavioural Insights Team and run as a national randomized trial.
- Years
- 2014–2015
- Country
- United Kingdom
- Topic
- Infectious disease
- Asks people to
- Stop
- Strategy
- Social normsTrusted messenger
- Channel
- Direct mail
- Audience
- Clinicians3,227 GPs in 791 general practices in the top fifth for antibiotic prescribing within their NHS Local Area Team.
Evidence
PreregisteredPositive
Pragmatic national RCT, 1,581 high-prescribing practices (Hallsworth 2016, ISRCTN32349954): Oct 2014-Mar 2015 antibiotic items per 1,000 population were 126.98 in letter practices vs 131.25 in controls, a 3.3% relative drop and an estimated 73,406 fewer items. A second, patient-focused mailing in December 2014 had no effect.
Sponsor (who paid)
- Department of Health (England), Chief Medical Officer Foreign government, sender
- Public Health England Foreign government, funder and evaluation
Credits (who made it)
- Behavioural Insights Team Strategy, 2014-2016 source
Related campaigns
Sources
- Hallsworth M, Chadborn T, Sallis A et al. Provision of social norm feedback to high prescribers of antibiotics in general practice: a pragmatic national randomised controlled trial. Lancet 387(10029):1743-52 evaluation · 2016 · DOI 10.1016/S0140-6736(16)00215-4 · PMID 26898856
Research notes
Clinician-facing campaign. Discovered 2026-10-22 (clinician-campaigns pass). PMC4842844 fetched 2026-10-22 (authors from the Behavioural Insights Team, Public Health England and the Department of Health, including Sally C Davies). Trial registered (ISRCTN32349954) per abstract; evidence level "preregistered" assumes registration preceded the mailing, not checked. Letter content quoted from the abstract. Behavioural Insights Team is UK-based; no agency file created (non-US). Classic precedent for the opioid letter trials.
Record cases/uk-cmo-antibiotic-prescribing-letters.json, updated 2026-10-22· Link to this campaign