Antimicrobial resistance (AMR) is a growing global health threat, and many public health surveillance programmes rely on blood cultures as a means to track this process. Blood cultures are diagnostic tests taken from patients with suspected sepsis or bloodstream infections, where timely results can be lifesaving. When blood culture-based AMR surveillance is instituted for global AMR monitoring, these investments might not realise their full potential in supporting patient care if their role as a diagnostic is not optimised, creating the risk that local hospitals see little benefit from surveillance activities and making such programmes less sustainable. We argue that blood cultures should be viewed first and foremost as a key diagnostic tool to guide patient care. By ensuring that local hospitals can use and act on their own data, we can both improve outcomes for patients and strengthen global AMR surveillance efforts.