The correct prescription of antibiotics for in-patients is paramount to patient safety. Trust policy states that all in-patients on antibiotics must have a start date, duration, and indication for antibiotics documented on the drug-card. On a single day all drug-cards were reviewed assessing whether documentation was in line with policy. In the initial audit, 28 antibiotic courses were prescribed; of these courses only 15 (53.5%) had an indication documented and 15 (53.5%) had a review/stop date documented.

A monthly league table, coined ‘The Champions League’, was created. This named individuals who had correctly or incorrectly prescribed antibiotics, following identification in the monthly audit. It was published monthly and displayed in the doctors' office, on wards and circulated to all Consultants. After two published league tables, 19 antibiotic courses were prescribed. Indication was documented in 18 (94.7%) and 16 (84.2%) had the review date documented. This improvement has continued to the present day.

Prescribing standards appear to have improved with the use of this novel motivational tool. The competitive nature of surgical trainees has led to the Champions League becoming a talking point. Top placed doctors are rewarded with Premiership rugby tickets and those who consistently underperform are sensitively offered remedial instruction.