UK farming's robust response to the antimicrobial resistance (AMR) crisis has halved antibiotic use and produced some of the lowest sales in Europe. The e-Medicine Book for Pigs, launched by the Agriculture and Horticulture Development Board (AHDB) in 2016, and now capturing antibiotic use for 95% of UK pig production, has been a success story demonstrating the pig industry's contribution to this (AHDB, n.d.).
In the hope this success can be emulated in the larger and more diverse sectors of dairy, beef and sheep, the Medicine Hub — also developed by AHDB — has been ‘open for data’ since early 2021.
The importance of being able to collate national-level data cannot be overstated. Dairy, beef and sheep are the only sectors currently unable to report national usage in the Veterinary Medicine Directorate's annual Veterinary Antimicrobial Resistance and Sales Surveillance (VARSS) report (Veterinary Medicines Directorate, 2021). While the challenge is understandable given the scale, producer numbers and complexity in these sectors, failure to act risks reputation and trade — especially as pending EU regulations will require national-level anti-biotic data by species in coming years.
This is why data collation is a target for dairy, beef and sheep within the 2020 Task Force report from Responsible Use of Medicines in Agriculture (RUMA) Alliance (RUMA, 2021, n.d.); what cannot be measured cannot be managed, and our sectors need to be able to demonstrate the good job they do as well as continue to improve.
Hence, 2024 Task Force targets are to centrally capture data from 95% of dairy herds, 50% of calf rearing units, 8000 beef farms and 8000 sheep farms, using industry-agreed metrics. So how do we get started?
Using the Hub
The Medicine Hub can be found at: www.medicinehub.org.uk. It accepts usage or sales data, inputted by farmer, veterinary practice or thirdparty data holder, such as software company, processor, retailer or milk recording organisation.
All data entry routes have limitations, but on balance, sales data are considered to be more reliable and accessible than farmer medicine usage records, and are likely to form the bulk of submissions to the Medicine Hub (Figure 1).
It is therefore likely that veterinary practices will be seen as the main mechanism for uploading medicine data, especially for beef and sheep, and will need to engage with the Medicine Hub now to work out how to go about it, the resources needed, and whether it should be a chargeable service.
Whatever the route, data sharing permission is needed from the farmer; this can most easily be achieved by asking all clients to register on the Medicine Hub and cattle farmers to set up links to Cattle Tracing System (CTS) at the same time to validate livestock numbers (Figure 2). Data will only be used for reporting and bench-marking within the Medicine Hub, and will not be shared with any other entities.
Action across the UK
The Medicine Hub is developing interfaces to transfer in data collected by the Welsh Lamb & Beef Producers antimicrobial use calculator app (WLBP, 2022) (which can be used for dairy herd data too), and the strategic antimicrobial use in dairy, beef and lamb production (STAMP) antimicrobial usage benchmarking tool in Northern Ireland (STAMP, N.D.). This means data contributing to these platforms contributes to national data for the UK.
In addition to this, Quality Meat Scotland's commitment to promoting good antibiotic stewardship includes mandatory collation of antibiotic data to contribute to national recording.
Synergy Farm Health
Synergy Farm Health is a farm-only independent practice in southwest England that has been monitoring antibiotic use among its client base for several years. However, both veterinary surgeons and clients recognise the need to collate information at a national level, and there is a strong desire from some farmers to see how they compare across the whole industry.
The practice data manager, Yvonne Mowlam, currently records and calculates antibiotic sales metrics using a spreadsheet, although the practice also has access to VetIMPRESS via the practice management system. Furthermore, many of the dairy clients submit medicine data to a variety of processors and retailers who will be uploading medicine data to the Medicine Hub direct. Summaries of the different data entry options and the current data upload status are available in Figure 3 and Box 1 respectively.
Box 1.Populating the Medicine HubFarmers already recording medicine use electronically, or providing it to third parties, will not want to duplicate effort; and yet software interfaces have been slow to develop. It is hoped that investment from software companies will shortly resolve this — indeed, Vet Impress from Farm Vet Systems has already incorporated data upload to the Medicine Hub into its products, and others will need to follow suit to future-proof their operations.Several processors and retailers with existing databases are also liaising with Agriculture and Horticulture Development Board (AHDB) to work out how to upload these without duplication of effort for the farmer. Likewise, National Milk Laboratories (NML), which runs the FarmAssist program, will facilitate direct upload of medicine data once farmer permissions have been obtained.Other farmers are reliant on paper records and are not used to sharing their medicine usage with third parties other than their veterinary surgeon. In this situation they can use the Medicine Hub as an electronic Medicine Book to record their usage, enter their medicine purchases direct or else grant third-party permission for their veterinary practice to do so.
According to Yvonne: ‘At this stage we are working out which route of data entry to take for our 230 dairy clients so that we can get relevant permissions in place. For the majority of our beef and sheep clients, they simply need to register on the Medicine Hub and set up third party permissions (and in the case of cattle holdings, CTS links as well) to allow us to access their account and upload data on their behalf.’
The sooner the farmers can register on the Medicine Hub, the better, as metrics can only be generated automatically from the date the CTS link is set up.
Another important aspect to preparing for the Medicine Hub is ensuring that medicines sold are allocated to the correct enterprise. At Synergy Farm Health this has required training of all staff involved in dispensing and has involved a change in mindset for some farmers.
Rose Willis, independent veterinary surgeon and adviser
Rose Willis, who works with the Tern Veterinary Group, says the group has taken client engagement one step further, holding farmer meetings on medicine topics including practicalities, legalities, responsible antibiotic use and the Medicine Hub (Figure 4).
All attending farmers have been keen to sign up to Medicine Hub and several have done so at the end of the meeting — setting up their accounts and third-party permissions. According to Rose: ‘We found this a really effective way of generating engagement with the Medicine Hub and are likely to include this in all our future medicine training courses. Tern's first dairy farm is also now signed up and the team is having discussions to make the upload of data at point of sale as seamless as possible.’
The Fold Farm Vets
Lee-Anne Oliver, director at The Fold Farm Vets in Northumberland and joint founder of the Suckler Beef Producers Association (Figure 5) wants to use the Medicine Hub to demonstrate low antibiotic use in not just the suckler beef sector, but also among their sheep clients.
Lee-Anne said: ‘We are confident usage levels are low but through the Medicine Hub, we will be able to show this. We are also very excited about the capability it will give us to benchmark our clients' antibiotic usage against each other — anonymously and with their permission, obviously! Previously there was no standardised way of measuring antibiotic use in beef herds and we often found that we were not comparing like with like.’
The next step at the Fold Farm Vets is to encourage all their cattle and sheep clients to register their enterprises on the Medicine Hub, set up CTS link (for cattle holdings) and grant third-party permissions to the practice. This is an ongoing process, which will take time, while they work out the preferred way of uploading veterinary sales data to the Hub.
The practice uses VetIMPRESS which they hope will link up to the practice management system and allow the transfer to occur seamlessly. According to Lee-Anne: ‘The biggest piece of work is to get our clients registered, and the rest should follow. We definitely need to be demonstrating our progress nationally and the Medicine Hub is the only way we can do that.’
Next steps
A Quick Start Guide to Medicine Hub for veterinary surgeons and farmers can be found at www.ahdb.org.uk/medicine-hub, alongside a range of support materials and the helpline number. Detailed instructions on the different ways that veterinary practices and others can upload medicines data to the Medicine Hub will be available early in 2022.