Interested in Participating?

Recruitment to ARK is now closed. Thank you for your interest.

ARK Online Tool Risk Assessment for GDPR ARK Online Tool Risk Assessment for GDPR_V2.0_05Dec2018

GDPR Information Document ARK_GDPRNotice_v1.0_07Sep2018       

ARK Hospital Protocol  ARK_Hospital_Protocol_V5.0_05Nov2018

You can see a short presentation about ARK made at the Society for Acute Medicine September 2017 meeting here: ARK-Hospital SAM talk 07_09_17.

You can see our ARK CQUIN survey which was presented at FIS here: ARK CQUIN Survey FIS

You can read a summary of what participating in ARK involves here: ARK-Introduction-and-Overview

ARK-Hospital is an NIHR-funded applied research programme which aims to substantially reduce antibiotic overuse through better “review & revise” decisions. It is led by a network of NHS clinicians and investigators from the Universities of Oxford, Southampton and Sussex.

Department of Health guidance in place since 2011 promotes an initiative called ‘Start Smart then Focus’ to encourage prudent use of antibiotics in hospitals. This recommends early effective antibiotics followed by active ‘review and revise’ 24-72 hours later, with a decision to either stop antibiotics, switch from intravenous to oral administration, continue and review again, change (if possible to antibiotics with narrower spectrum of activity), or move to outpatient intravenous antibiotic therapy.

For many reasons, ‘review and revise’ is not very effective at controlling unnecessary antibiotic use. When doctors review prescriptions antibiotics are mostly continued even though detailed studies suggest they could be stopped in many cases. It is estimated that 30% of antibiotic courses could be stopped at review and revise. The UK Government has committed to a 50% reduction in inappropriate use of antibiotics in hospitals by 2020. A CQUIN for reducing antibiotic use was introduced in 2016 and this will remain a CQUIN until 2019 at least. The CQUIN data indicate that currently >90% of courses are continued at review and revise.

The main question addressed by ARK-Hospital is whether a package of interventions, designed carefully following theories of health psychology and behaviour change, can increase healthcare worker uptake of the ‘review and revise’ strategy, and whether a similarly designed leaflet for patients can increase patient acceptability of shorter antibiotic therapy durations driven by ‘review and revise’.

ARK started in March 2016. The intervention – which includes educational material, a decision tool, a patient leaflet and tools to support audit and feedback – has been developed in iterative and close engagement with patients and healthcare workers.

NHS REC approval is now in place and in April 2017 we began a feasibility assessment in one NHS acute hospital (Royal Sussex County Hospital, Brighton). Additional pilot sites will follow in autumn 2017 before roll-out nationally to a step-wedge trial in 2018-19, for a total of 36 sites.

If you would like to find out more about participating in ARK, please Contact Us

If you are admitted to an acute or general medicine ward in a hospital testing ARK, and prescribed antibiotics during your hospital stay, you will automatically be helping us with the ARK study! We will only be using anonymised data collected during your stay, so nothing that could be used to identify you such as name, address, hospital number, NHS number or date of birth. So you don’t need to do anything.

If you are a patient or carer for someone admitted to hospital would like to talk to anyone about our study and the data used in it, please Contact Us 

As part of the larger ARK programme, we are also analysing anonymised routinely collected electronic health record data from patients admitted to an acute or general medicine ward in NHS hospitals across the UK. This project has been approved by NHS Digital who have provided the anonymised data. See our ARK-observational analysis privacy note