The AMS Lead or champion is the key staff member but other members of the AMS team (if one is established) plus leads for Infection Prevention and Microbiology services will also be required to contribute. A multi-professional approach is encouraged to support engagement of all staff groups involved in AMS.

When an organisation is accepted as a client some initial documentation will be completed to formalise an agreement with BSAC and ensure the client organisation has the capacity to commit to the actions required for the GAMSAS process.

An External Assessor and a Local AMS expert (based within the same country/region) will be assigned to work with the client organisation.

The initial self-assessment process involves completion by the client organisation of three online questionnaires about systems and practice within the organisation for AMS, IPC and laboratory services and one questionnaire about the national AMS landscape in the country where the organisation is based. Following completion of these questionnaires the GAMSAS team may request additional documents to be submitted electronically.

The process involves a cumulative cycle of supported and self-assessment activities over a 2-3 year period comprising the following:

• Information gathering via self-assessment questionnaires with support from GAMSAS team (BSAC staff, an External assessor and Local expert).
• Review of information and preparation of a report and recommendations by GAMSAS team in collaboration with client organisation.
• Consideration by Accreditation panel and Accreditation level awarded.
• Recommendations and actions for improvement agreed to facilitate higher level of accreditation (if applicable/feasible).

Local experts will be identified in the country or locality of a client organisation under assessment. They will work with the External assessor and liaise with the client to provide a desk-top assessment of the capacity of the locality and organisation.

External assessors are appointed for their expertise and experience following self-nomination or nomination by a national body/organisation. They will work with the local expert and liaise with the client to provide a desk-top assessment of the capacity of the locality and organisation.

Following completion and review of the questionnaires the external assessor will lead a virtual Q&A session with the client and local expert and a draft report will be presented and discussed, The Final report and recommendations for action will then be presented to the client by the external assessor prior to consideration by the Accreditation Panel.

The Accreditation Panel will comprise members from across differing health economies, a minimum of 5 people who will be called to meet and assess applications. The mix of panel members will be determined by the applications received. The panel will discuss each application report with the External assessor for each client and agree on the accreditation level achieved as well as suggested improvement actions.

These roles are renumerated with standard fees payable for each client episode and for each accreditation panel meeting. Fees take the form of an honorarium with recipients having responsibility to manage and recognise any relevant personal tax and national insurance requirements due within their country.

Dependent on level of work required, fees will be up to but not exceeding £1000 for undertaking a Local Expert role, up to but not exceeding £2000 for External Assessor role and fixed rate of £500 for an accreditation panel meeting (half-day). Fees will be paid in GB pounds, Euros or US Dollars and can, if required, be made in local currency equivalent where necessary.

GAMSAS accreditation is an iterative process so that hospitals can initially achieve one of 5 levels then work towards achieving a higher level if feasible.
The table below illustrates the levels within GAMSAS:

Accreditation will require to be renewed every 3 years but it is expected that clients will build upon AMS activities to address areas for improvement identified by the Accreditation panel. This will include utilisation of recommended education resources along with any bespoke education support agreed.

An interim visit or virtual meeting will be convened at around 18 months to discuss maintenance and further development of AMS.

Being accredited as a Centre of Excellence acknowledges that the organisation is a leader in the field of AMS through having a robust and measurable AMS programme, contributing to national and global surveillance of antimicrobial use and resistance and shared learning to mentor other organisations in their locality/region.

The establishment of Centres of Excellence for AMS will allow organisations to enhance their reputation as a high quality care provider and facilitate shared learning with others in their region/country. The reputational benefit will attract clinical staff wishing to work there and provide reassurance to patients on provision of high quality care.