Building new prescribing measures - we need your help

At OpenPrescribing we have a range of prescribing measures that makes it easier for everyone to explore NHS prescribing patterns in England - supporting safer, more efficient prescribing. We now have 70 measures including our two latest on Freestyle Libre and herbal medicines, that we recently blogged about. The measures are available for for every single practice and CCG in England and cover a range of clinical areas such as medication safety and antimicrobial stewardship to support better prescribing.

This March we are collaborating with some of the Chief Pharmaceutical Officer’s Clinical Fellows to collect ideas for a host of new measures from our users, via a simple form. We will build these and make them available on OpenPrescribing.net. As always, we will make all our code available; for free, in public, to be built upon by other teams.

What is a measure?

On OpenPrescribing most of our measures fall into two categories:

• Volume based - The amount of items for a particular product or quantity of units prescribed.
• Cost based - The cost of the prescriptions to the NHS.

In order to make meaningful comparisons between organisations we then generally apply one of two denominators

• List size - This is the total number of patients registered at a general practice. Dividing by list size allows some comparison between large and small practices. For example our NHS England Low Priority measures which are all cost per 1000 patients.
• Proportion - We divide the item of interest by the total group of items in that clinical area. For example our Ciclosporin and tacrolimus oral preparations prescribed generically measure.

We then compare all practices and CCGs across England and people can use OpenPrescribing.net as an indicator of their prescribing quality, reflect on it locally and decide if there is further action, such as a clinical audit or medication reviews needed.

Where do we get measures from?

National guidance: A variety of national organisations issue prescribing guidance and sometimes measures. We then build these on OpenPrescribing, sometimes very quickly, so our users can see the impact on their practice or CCG. A good example is NHS England’s Low Priority items consultation where we built all the measures and made available within an hour of the guidance being made available.

Users: At the Bennett Institute we pride ourselves on developing our tools in response to the needs of our users and this includes prescribing measures. Over the years we have had many suggestions via feedback@openprescrbing.net such as Pregabalin prescribing and antibiotic smoothing.

How can you contribute?

Please just fill out this form or drop us an email at <feedback@openprescribing.net.> We are happy to explore building measures for any prescribing issue although some of it we may not be able to do currently due to limitations of the data available. For example, there is no detail on age or gender of patients receiving each prescription, nor the combinations of items given to individuals.

We hope that by building more measures for you, that you will be free to focus on improving the prescribing in your area. For example you might be leading a local quality improvement project on prescribing or perhaps you are a CCG lead and have a new measure in your prescribing incentive scheme. Please tell us your ideas!