OpenPrescribing Newsletter: October 2019

New Paper in BMJ

Our newest paper is now out in the BMJ! Here we show huge variation in adoption of warranted changes in prescribing behaviour, using some exciting new openly available change detection methods.

New measures

We now have over 80 measures!

This month we have launched a range of new measures. As always, measures are prioritised on your dashboard by potential for improvement so you can quickly and easily spot where your organisation is an outlier. You can also sort by potential savings or group measures by clinical condition.

Our latest measures are summarised below, and please do get in touch with us with any ideas for more!

Zuclopenthixol acetate: a new kind of measure

This measure flags up an important but rare safety event related to mental health: prescribing of zuclopenthixol ACETATE, not recommended in primary care on safety grounds, which may be prescribed instead of zuclopenthixol DECANOATE. This measure complements our email alert service, and to receive notifications, practice and CCG staff must sign up to their organisation’s bespoke email alert from their dashboard. Read more.

Seven day prescribing for long-term conditions

NHS guidance is that prescription duration for most long-term conditions should be clinically appropriate. The British Medical Association has reported increasing GP workload associated with requests for seven day prescriptions to fund Medicines Compliance Aids (MCAs), sometimes known as dosette boxes. The Royal Pharmaceutical Society has advised against MCAs in the majority of cases. We propose this measure of seven day prescriptions for long-term conditions as a surrogate measure for MCAs. Read more.

Inhalers and the Environment

The NHS has committed to reducing its carbon footprint by 51% by 2025 to meet the target in the Climate Change Act. This includes a shift to dry powdered inhalers (DPI) to deliver a reduction of 4%; DPIs are less harmful to the environment than traditional metered dose inhalers. Read more.

Toothpaste

It is generally recommended that if toothpaste must be prescribed it should be prescribed by a dentist. We show that in the past year, GPs have issued nearly 130,000 items for toothpaste, with substantial variation observed throughout the country. Explore.

New: more data download options

We have now added new functionality to our measures so that you can download all the data shown on the page. For example, when comparing all practices in a CCG, or all CCGs in England on a measure, you can download the data for all of the organisations with one click (example).

PCN Dashboards — coming soon

We get lots of requests to show PCN groupings on the website. We’ve done some preparatory work behind the scenes but we cannot complete these dashboards without a list of PCN membership for England. We are hoping this will be released soon. Read more in our blog — and see how you can help on our PCN holding page.

Interested in monitoring blood test requests?

As you know, we are now building OpenPathology.net, modelled on OpenPrescribing: this will help everyone understand variation in use of blood tests across the NHS.

We have lots of interesting things to tell you about so we’re launching a new newsletter! Please opt-in to get the updates.

In case you missed it…

All the best bits from the previous newsletter

• New Feature! Measures linked to Analyse page: We have created links from most of our measures to the corresponding search on the Analyse page: useful if you want to see multiple practices or CCGs on one chart, view the results on a map, or see exactly which products are included in the measure.
• More Improvements to PPU Tool — In our “price-per-unit” (PPU) tool, which helps identify the cheapest presentation for a given drug or treatment, we have recently:
  • reduced the minimum threshold for savings: from £50 per month to £10 for practice savings, and £1000 to £200 for CCGs.
  • Corrected a previous underestimation of the potential savings (around 5%). For the details, read more in our source code here.
• Explore PPU savings for your practice or CCG by clicking “Savings on individual presentations” on your dashboard page.

Prescribing data update!

We’ve updated OpenPrescribing with August’s data. Head over to openprescribing.net to explore.