The Environment Agency (EA) monitors the River Great Ouse for a range of ecological and chemical parameters, including biological and physico-chemical elements, specific pollutants and priority substances.

There are currently no designated bathing waters on the River Great Ouse. It is therefore not routinely monitored for E. coli or intestinal enterococci as part of the statutory bathing water monitoring programme. At designated bathing waters, the EA monitors these bacteria as indicators of faecal contamination and potential risks to human health. Anyone can apply to designate a bathing water and the current application window is open until 15 October 2026.

The Government recognises the potential of bacteriophage therapy as an emerging treatment for certain bacterial infections, particularly where antimicrobial resistance limits available treatment options. However, while early research and clinical use in individual cases are promising, the current evidence base and overall development landscape remain insufficient to support routine use across the National Health Service.

Bacteriophage therapy is not currently licensed as a medicinal product in the United Kingdom. Where clinicians consider it to be in the best interests of an individual patient, access may be considered on an unlicensed basis through established NHS local governance arrangements, in line with relevant regulatory requirements.

The Government recognises the potential of bacteriophage therapy as an emerging treatment for certain bacterial infections, particularly where antimicrobial resistance limits available treatment options. However, while early research and clinical use in individual cases are promising, the current evidence base and overall development landscape remain insufficient to support routine use across the National Health Service.

Bacteriophage therapy is not currently licensed as a medicinal product in the United Kingdom. Where clinicians consider it to be in the best interests of an individual patient, access may be considered on an unlicensed basis through established NHS local governance arrangements, in line with relevant regulatory requirements.

We have been working with the Environment Agency and the UK Health Security Agency, to trial methods for detecting and quantifying antibiotic resistant bacteria in 3 river catchments in England and to provide example data on their presence and prevalence. The work involved sampling river waters at sites along the length of each river and subject to different land uses and potential sources of resistant bacteria. We expect to publish the results in the summer. The Secretary of State has regular discussions with Cabinet colleagues on a wide range of issues, and Cabinet discussions are considered confidential.

We have been working with the Environment Agency and the UK Health Security Agency, to trial methods for detecting and quantifying antibiotic resistant bacteria in 3 river catchments in England and to provide example data on their presence and prevalence. The work involved sampling river waters at sites along the length of each river and subject to different land uses and potential sources of resistant bacteria. We expect to publish the results in the summer. The Secretary of State has regular discussions with Cabinet colleagues on a wide range of issues, and Cabinet discussions are considered confidential.

There are no plans to perform assessments of possible impacts of raw sewage on levels of antimicrobic substances, and antibiotic resistance in bacterial communities in our surface waters. To do so would require extensive field monitoring, and analytical challenges would need to be robustly addressed to ascertain whether raw sewage discharges in the presence of other sources are responsible for antimicrobial resistance in river bacteria. However, the Environment Agency has been engaged in the cross government PATHSAFE programme to identify the pathways of antimicrobial resistance to humans and if it were decided necessary, the Agency would advise on the practical steps to undertake such assessments.

Defra has been working with the Environment Agency, the UK Health Security Agency, and others, to trial methods for detecting and quantifying antibiotic resistant bacteria in 3 river catchments in England as part of the PATHSAFE programme. The work involved sampling river waters at sites along the length of each river and subject to different land uses and potential sources of resistant bacteria. This work is still in progress, although the Environment Agency has already published some of the preparatory aspects and will publish further reports in the coming months.

Sphaerotilus natans is an aquatic periphyton organism associated with polluted water. It forms colonies commonly known as "sewage fungus", but can be associated with different types of organic pollution such as from agriculture or some industrial effluents. The Environment Agency does not have a specific monitoring programme for sewage fungus itself, but it is used as an indicator of pollution when the Environment Agency responds to pollution incidents, and when it carries out wastewater treatment works or storm overflow inspections. If observed the presence of sewage fungus would usually be recorded by monitoring teams when carrying routine ecological and chemical monitoring. The extent of sewage fungus is often used in evidence as an indicator of gross pollution when taking action under the Environment Agency’s enforcement and sanctions policy.

The pathways through which antibiotic resistance genes can be transferred between bacteria of any origin or strain are complex.

The Department continues to carry out research and surveillance to better assess the potential for, and the frequency of, spread of antibiotic resistance genes between bacteria, including between those of human and animal origin. Examples of recently commissioned or completed projects include:

• Potential risk to human and animal health from the emergence and spread of Beta-lactamase resistance in Great Britain.
• Molecular signature of antibiotic resistance in pigs as a potential source of antibiotic resistance in humans.
• Characterisation of ESBL/Amp C/ Carbapenam resistant E.coli from pigs and poultry to identify resistance genes, circulating plasmids and fitness attributes.

Final reports from completed projects are published via GOV.UK. Results from surveillance of resistance in key zoonotic bacteria are published annually in the Veterinary Antimicrobial Resistance and Sales Surveillance report.

The pathways through which antibiotic resistance genes can be transferred between bacteria of any origin or strain are complex.

The Department continues to carry out research and surveillance to better assess the potential for, and the frequency of, spread of antibiotic resistance genes between bacteria, including between those of human and animal origin. Examples of recently commissioned or completed projects include:

• Potential risk to human and animal health from the emergence and spread of Beta-lactamase resistance in Great Britain.
• Molecular signature of antibiotic resistance in pigs as a potential source of antibiotic resistance in humans.
• Characterisation of ESBL/Amp C/ Carbapenam resistant E.coli from pigs and poultry to identify resistance genes, circulating plasmids and fitness attributes.

Final reports from completed projects are published via GOV.UK. Results from surveillance of resistance in key zoonotic bacteria are published annually in the Veterinary Antimicrobial Resistance and Sales Surveillance report.

The commercial cultivation of genetically modified (GM) crops is subject to regulatory approval at European Union (EU) level. Proposed crops have to undergo a robust, science-based safety assessment, overseen by the independent European Food Safety Authority (EFSA). The UK's input to this process is based on the expert scientific advice that Ministers receive from the independent Advisory Committee on Releases to the Environment (ACRE).

The potential impact of antibiotic resistance marker (ARM) genes has received considerable attention in EU deliberations on the risk assessment of GM crops. EFSA published a key scientific opinion on this matter in 2009, available at:

http://www.efsa.europa.eu/en/efsajournal/doc/1108.pdf

It focuses on two ARM genes that are present in certain GM crops which have been evaluated for possible EU approval. EFSA has concluded that both of these genes are unlikely to have an adverse effect on human health and the environment as a result of GM cultivation. ACRE has agreed with this conclusion, noting that bacteria with resistance to the relevant antibiotics are already widespread in the environment, and that the likelihood of a functional gene being transferred from plants, to bacteria is extremely low.

The Department funds a wide range of research on antimicrobial resistance and related issues concerning the prevention, detection, diagnosis, control and management of infection. This research is funded through the National Institute for Health Research (NIHR) and the Department's Policy Research Programme.

The Department currently provides funding for health protection research at the Health Protection Agency through the NIHR Centre for Health Protection Research (CHPR). In 2011-12, the CHPR spent £1.2 million on projects relevant to antimicrobial resistance.

The Oxford NIHR Biomedical Research Centre has an infection research theme with £4 million funding over five years. Research on methicillin-resistant Staphylococcus aureus (MRSA) is a major focus of the theme. There are also research themes on infection at the Imperial NIHR Biomedical Research Centre and the NIHR Biomedical Research Centre at University College London Hospitals NHS Foundation Trust and University College London.

The NIHR Health Technology Assessment Programme is funding a range of projects on health care-associated infection including a £0.4 million study at Queen Mary, University of London on the cost-effectiveness of genetic markers for antibiotic resistance in tuberculosis.

Currently-funded research training awards in infection include a £0.2 million fellowship at University College London on reducing hospital acquired infections due to antibiotic resistant gram negative organisms.