Seriously Resistant is a local approach to a global healthcare crisis. Using creative tactics to deliver simple, consistent messaging, the campaign, now in its 5th year, engages target audiences and is helping reduce antibiotic use.

Seriously was originally developed in 2016 as an insight-led campaign targeting students. Using prescribing data and insight from healthcare professionals, we have developed the campaign each year, tailoring it for key target audiences and working with Magpie, a local agency specialising in behaviour change campaigns. During our last big public campaign in 2019, we targeted the highest users of antibiotics: young children via their parents / carers and schools and the over 65s.

Highlights included:

  • A social media competition to name the giant superbug mascot (Doug the Bug)                                 

  • Taking Doug, Seriously bugs & ladders and information packs to family friendly events across the city during the summer holidays

  • Developing a Seriously-branded lesson plan and superbug activity for 47 primary schools, as part of Leeds City Council’s healthy schools programme

  • Creating a Seriously-themed newspaper, word searches and bingo for older people’s lunch clubs. Doug also attended an over-60s dance class

  • Using Doug and a ‘pledge hedge’ to initiate conversations and collect action pledges during Antibiotic Awareness Week.

  • Engaging NHS staff via a “guess who’s in the superbug costume” and “spot the superbug” competitions on our internal channels

  • Creating Seriously resources for partner organisations, including content for internal channels and social media plans

  • Out of home advertising on billboards, on buses and in bus stations.

The campaign engages with the public to educate them about how to keep antibiotics working and to encourage them to make a pledge to be an antibiotic guardian of the future. This allows us to have meaningful conversations to help people change their behaviour and protect antibiotics for themselves, their families and their community.  Our plain English pledges have been approved by NHS England and tested with each audience group. By the end of our 2019 campaign, there were nearly 24,000 pledges to help keep antibiotics working. In addition, campaign recognition averaged 90-100% and recall of key messages averaged around 60%.

The campaign’s success so far has secured the support of the city’s multiagency Antimicrobial Stewardship Group. This has enabled us to work with colleagues across the health and care system to deliver clear and consistent AMR messages, e.g. the city’s Healthy Schools team have used branded resources in lessons about handwashing. These have been backed up by materials for parents in take-home packs. When a family is then on social media or out in Leeds and spot a Seriously-branded bus or see Doug the Bug at a Breeze event, the AMR message is reinforced with each encounter. Similarly, the acute trust pharmacy team use Seriously-branded patient materials and community pharmacists have taken part in events and media interviews about the campaign.  Engagement with GP practices has seen primary care prescribing rates steadily decrease.

We had learned from our previous campaigns that language barriers and cultural attitudes towards illness and medicine usage could be a challenge to engaging with AMR messages. With that in mind, our plan for 2020 was to focus on reaching non-English speaking communities via third sector organisations and community ambassadors. We had also planned to work more closely with health care professionals to ensure that they had the materials they needed to manage patient expectations and facilitate conversations. Unfortunately, COVID-19 has delayed those plans. In addition, we understand from anecdotal feedback that the pandemic has impacted prescribing of antibiotics. But just as AMR hasn’t gone away, neither has Seriously, and we’re working with our pharmacy and public health colleagues to better understand the current situation and to re-think our campaign objectives and tactics so that we can launch a new campaign for 2021-22.

Before the COVID-19 pandemic, we had been visiting schools across Leeds to teach children about the importance of antibiotics and why if we don’t act now, they could stop working in the future. Lesson plans included information about the importance of health and hygiene in order to prevent infection and the correct use of medicines. Pupil’s examined proper handwashing techniques and made pledges to wash their hands; they then got creative making postcards to take home and share their learning with families. The sessions received positive feedback from teachers and pupils.

Partnership work has always played a crucial role in the campaign. COVID-19 makes this even more important at a time when communications and engagement resources are stretched and health messages confusing. We will continue to share resources and learning with other organisations to help ensure the campaign’s legacy and continued development, as we work together to achieve our antimicrobial stewardship group’s ambition for Leeds to be known as the city that makes the greatest impact on antimicrobial resistance within the UK.

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