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  1. Posted
    Categories
    • Open Working

    OpenPrescribing Newsletter May 2019

    Varied implementation of UTI prescribing guidelines

    One of our recent papers, published in the Journal of Antimicrobial Chemotherapy, highlighted variability in the speed at which different CCGs switched from prescribing trimethoprim to nitrofurantoin (as recommended by PHE for uncomplicated UTI).

    It appears that the practices which changed the most were in CCGs that had taken some action to promote the new guidelines, such as a change in formulary. What are the implications? Read more on this in our blog and you can of course see any region’s performance on this measure on OpenPrescribing.

  2. Posted
    Categories
    • OpenPrescribing

    How can we improve the management of necessary changes in clinical practice?

    Just before Christmas we had a paper published in the Journal of Antimicrobial Chemotherapy. It looked at how GP practices responded to changes to the guidance for antibiotics for urinary tract infections (UTIs).

    It’s an interesting story in itself, but we think that it prompts some wider questions about how GPs are helped to keep up-to-date on guidance on prescribing.

    What is the issue?

    For many years the mainstay of antibiotic treatment of uncomplicated UTIs in women has been trimethoprim. Recently there has been growing concern about the increasing levels of resistance (about a third of urine samples).

  3. Posted
    Categories
    • OpenPrescribing

    All England Alerts : A New Feature on OpenPrescribing

    This week we have launched a new email alerting service that covers all of NHS England. Many users of OpenPrescribing already receive our monthly newsletter and our innovative email alert service for practice and CCG prescribing measures and for price concessions. We have now developed this service covering all of England based on user feedback. To sign up, just go to the All England page and enter your email address in the box beside the measures categories (see screenshot below).

  4. Posted
    Categories
    • Policy Insights

    UK Trials and Brexit

    We recently noticed a very dramatic drop in the number of UK clinical trials post-Brexit on the EU Clinical Trials Register (which would be a catastrophe for British science) and wrote to MHRA to get their view. It turns out that the drop is largely due to bad data management: this is worrying, but not the same thing as a drop in the number of UK clinical trials.

    The Short Story

    We’ve been conducting research on trends in clinical trials globally with one very striking recent finding: examining clinical trials on medicinal products, using the EU Clinical Trials Register (EUCTR), the number of trials with a competent authority decision from the UK has fallen dramatically. As you can see on the graph below: from a long-term trend of around 150 new trials per quarter, after 2016 there is a rapid drop to fewer than 50, and now fewer than 10.

  5. Posted
    Categories
    • OpenPrescribing

    Communicating variation in prescribing - Why We Use Deciles

    On OpenPrescribing.net we provide data for individual practices and CCGs (and now STPs and regions!) making it easier for everyone to explore NHS prescribing patterns in England - supporting safer, more efficient prescribing. However, providing data for an individual location in isolation is rarely useful. We need to provide context, so that some sort of judgement can be made about whether the prescribing in question is especially high or low, and how extreme it is, in comparison with others. On OpenPrescribing we do this using deciles. We think providing transparency in our methods is really important, so in this blog I set out our rationale for doing so.

  6. Posted
    Categories
    • Open Working

    Openness and Transparency: why is openness and transparency important for good data analysis and how does OpenPrescribing embody it?

    At the Bennett Institute we value openness and transparency as we believe open discussion of ideas and methods are the key ingredients for high quality data analysis. We think it is unhelpful that so much NHS data analysis is outsourced, or done behind closed doors. This blog sets out the steps we take with OpenPrescribing.net to ensure all our analysis and methodology is freely available for inspection, review, and importantly re-use, by anyone. We hope other teams will adopt these approaches so we can all collaborate to optimise analysis, generate insights and improve care for patients in the NHS.

  7. Posted
    Categories
    • OpenPrescribing

    NHS price concessions cost charities and local authorities an additional £5.6 million last year

    In the last year we estimate that price concessions have cost an additional £165 million in unplanned expenditure for Clinical Commissioning Groups (CCGs), and our OpenPrescribing.net price concession calculator was featured in a major BBC news story and in the Pharmaceutical Journal this week. However, interestingly, NHS price concessions do not just affect the NHS: they also represent unplanned expenditure for charities, local councils, and others. Here, we report our estimate of the impact on non-CCG organisations as an additional £5.6 million in 2018: a huge four-fold cost increase on top of expected prices for a sector that is already over-stretched.

  8. Posted
    Categories
    • OpenPrescribing

    NHS Regional and STP Dashboards — A new Feature on OpenPrescribing

    Today we launched NHS regional and STP dashboards on <OpenPrescribing.net>, which allow anyone to see NHS prescribing patterns across areas larger than CCGs. You can find these new dashboards under “Area and Practice Dashboards”.

    What is an NHS STP or Region?

    The NHS across England is now organised into Sustainability and Transformation Partnerships (STPs) and NHS England regions. There are 44 STPs made up of NHS organisations such as CCGs and hospital trusts, and local councils, who developed shared proposals to improve health and social care, whilst ensuring services are joined up across all of the organisations they incorporate. STPs are contained within the five NHS England regional teams; these teams support healthcare commissioning and delivery in their area by providing professional leadership on finance, nursing, medical, specialised commissioning, patients and information, human resources, organisational development, assurance and delivery.

  9. Posted
    Categories
    • Research Integrity

    FDAAA TrialsTracker: Milestones and Methodology Updates

    It’s been a busy start to the year for the FDAAA TrialsTracker! As the FDAAA TrialsTracker celebrates its 1 year anniversary, we now show over 1000 trials currently overdue to report under the FDA Amendments Act of 2007 (some background on our tracker and the FDAAA 2007 here). Additionally, we estimate that the FDA could have collected over $2 billion in fines if they were enforcing these requirements. To date, we have no evidence they have issued even a single dollar in fines. But along with the bad comes the good. Over the past year we’ve also heard from many trial sponsors and other organisations and individuals who are using our TrialsTrackers to ensure trials are reported on time and in accordance with the law.

  10. Posted
    Categories
    • OpenPrescribing

    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.

  11. Posted
    Categories
    • Open Working

    OpenPrescribing February 2019 newsletter

    New Price Concessions alerts

    We have introduced a new email alert service, built upon our recently-launched NHS Price Concession calculator, which shows the cost impact of concessions for every single practice, CCG and for all of England combined.

    If you sign up for these new alerts, an email will pop into your inbox soon after a new price concession is announced (approximately once per week) to update you on the impact these costs are predicted to have on your practice/CCG. Read more in our blog, or sign up by going to the price concessions tool from your practice or CCG dashboard.

  12. Posted
    Categories
    • OpenPrescribing

    Ghost Branded Generics - How to fix it

    Ghost Branded Generics are a relatively new category of cost-saving opportunities, caused by prescribers specifying a manufacturer for a generic product, often resulting in a higher reimbursement price compared to the true generic. We estimate the problem costs the NHS £11.6m a year. We have written about this extensively since our first blog on discovering the issue and developed a Ghost Branded Generics dashboard and measure for every practice and CCG in England.

  13. Posted
    Categories
    • OpenPrescribing

    NHS Price Concession Alerts — A new feature on OpenPrescribing

    Today we launched a new feature on OpenPrescribing: an NHS Price Concession email alerts service. This is in addition to our existing calculator that shows cost impact of price concessions, which can already be viewed on every practice, CCG and All England dashboard. You can read more about price concessions (aka NCSO) in our previous blogs.

    Many users of OpenPrescribing receive our monthly newsletter and our innovative email alert service for practice and CCG prescribing measures. Today we are adding a new NHS Price Concession email alerts service. Once signed up, this alert will pop into your inbox a few hours after a new price concession is announced, which will be approximately once per week, to update you on the impact these costs are predicted to have on your practice/CCG.

  14. Posted
    Categories
    • Policy Insights

    Retracted RCTs and clinical guidelines

    As you know, here at the Bennett Institute we are working on the RetractoBot project to reduce the number of cited retracted papers.

    Citations of retracted RCTs are particularly dangerous because such trials provide strong and unbiased evidence of treatment’s safety and efficacy (hierarchy of evidence). Moreover, results of RCTs are often pooled in systematic reviews and meta-analyses, which are used to synthesise the available evidence on a given subject or to justify clinical guidelines.

  15. Posted
    Categories
    • OpenPrescribing

    QIPP Planning: How To…

    …Identify CCG Cost Savings Opportunities using OpenPrescribing.net

    Every year in the NHS local teams around the country put together “QIPP Plans”. QIPP stands for Quality, Innovation, Productivity and Prevention and is a large scale programme introduced across the NHS to ensure the NHS delivers more for the same funding. We make no comment on the programme itself but we think OpenPrescribing is a useful tool in helping develop “QIPP Plans” and to identify new areas for savings related to medicines spend.

  16. Posted
    Categories
    • Research Integrity

    Trial Reporting at NHS Trusts in England

    Nearly all trials of medicinal products conducted in Europe since 2004 are required to post their results directly onto the EU trials register within one year of completion. Since September, our EU TrialsTracker has monitored all clinical trials in the EU to check whether they are compliant. Recently we produced a specific report on data on trial reporting at UK Universities: the House of Commons Science and Technology Committee is currently using this data to alert Universities and monitor their current reporting performance.

  17. Posted
    Categories
    • OpenPrescribing

    Two new measures on OpenPrescribing — Herbal medicines and Freestyle Libre

    We have recently released two new measures on OpenPrescribing — the prescribing costs of herbal medicines, and the quantity of Freestyle Libre.

    Herbal medicines

    For techie reasons, we’re quite excited about the herbal medicines measure. We don’t like to write measures that require a manually managed list of preparations, as these require a lot of curation, and can quickly become inaccurate if a new drug is released. Therefore for most (if not all) of our measures we use the hierarchical BNF codes provided by the NHS Business Services Authority (you can read more on these here).

  18. Posted
    Categories
    • TrialsTracker

    New Year Updates to the EU TrialsTracker

    Our EU TrialsTracker has been live for 4 months providing data on who is and isn’t meeting EU trial reporting guidelines. The tracker reached a major milestone last week when our data was used by the House of Commons Science and Technology Committee to inform UK Universities of their current reporting performance and remind them of their ethical and legal obligations to report their sponsored trials.

    As some of our regular users may have spotted, we’ve recently make some changes to the EU TrialsTracker. We wanted to take some time to describe these updates and let you know why we made them.