Electronic Prescribing and Administration (EPMA) Data in Secondary Care under the COVID-19 Direction

Electronic Prescribing and Medicines Administration (EPMA) data can:

• help identify patients who might be at higher risk of harm if they contract COVID-19
• help researchers understand any patterns of prescribing before, during and after COVID-19
• be linked to other datasets to provide new insights and support research
• be used to model the impact that treatment of serious respiratory tract infections, such as with antibiotics, antivirals and antifungals, has on COVID-19 patient outcomes and antimicrobial resistance

EPMA data can be linked to patient-level NHS Digital datasets such as the NHSBSA medicines dispensed in Primary Care, COVID-19 Hospitalisation in England Surveillance System (CHESS), SUS+/Hospital Episode Statistics and the Second Generation Surveillance System (SGSS).

Linkage of EPMA data with other datasets can support research into the association of medicines and severity of disease experienced by COVID-19 positive patients. It can help identify medicines providing greater protection or linked to poorer outcomes - for example, specific groups such as ACE inhibitors, Angiotensin II receptor blockers, anti-arrhythmic, antimicrobials, beta-blockers, diuretics, as well as individual medicines, such as, heparin, prednisolone, verapamil.

This data is available to a wide range of customers, including researchers, academia and arm’s length bodies through NHS Digital’s Data Access Request Service (DARS).

Since December 2020 NHS Digital has established a daily collection of data from electronic prescription and administration systems.

This data relating to medicines prescribed and administered to patients is sourced from secondary care NHS trusts in England. It's limited to those using electronic prescribing and administration systems (EPMA) supplied by WellSky which overall cover around 9% of the total prescribing activity in secondary care.

Data from Cerner EPMA systems capturing prescribing will be available in Summer 2021 providing an additional 6% of the total prescribing activity.

An average sized hospital will create around 1,750 new prescriptions daily resulting in 8,000 medicine administrations daily.

For this phase of the EPMA Project (Phase 2) in-scope Trusts have submitted historical data covering the period from 1 January 2019 up to the day before they commence a daily (weekly in some cases) ongoing provision of data. This provides a full year of pre COVID-19 EPMA data (depending on when the EPMA system was implemented).

Trusts do not currently use their EPMA system to record all prescribing and administrations. Certain specialities (for example ICU, Oncology, Paediatrics) or medications (for example Warfarin, IV infusions) may not be recorded in the EPMA system. The coverage and exactly what is included/excluded varies from Trust to Trust.

Key data fields being collected include:

• NHS number
• inpatient prescribing
• inpatient medicine administration
• outpatient prescribing
• outpatient medicine administration
• discharge prescribing (including short term leave)

Medicine on admission and Indication for prescribing may be included in the Cerner data available in the summer 2021.

You can read about how NHS Digital are the guardians of patient data, making sure it is protected and handled securely, on our Keeping patient data safe page.

You can find further information about this data collection, including the relevant Electronic Prescribing and Medicines Administration (EPMA) Data - NHS Digital.

You can find further NHS Digital transparency information on the Transparency notice: how we use your personal data page and specifically on the Coronavirus response information governance hub - NHS Digital page.