Prescribing and medicines team

Summary

The prescribing and medicines team extracts and analyses prescribing data to identify trends and variations, and to support national policy. We also release open data for analysis by other organisations. 

Prescribing is the most common patient-level intervention in the NHS, and covers all sectors of health care, including: 

  • primary care
  • hospital
  • public health
  • community services

This is the second highest area of spending in the NHS, after staffing costs, with the overall medicines cost (at list price) in hospitals and the community in England reaching £17.4 billion during 2016/17. Most prescribed items are medicines. Dressings, appliances and equipment can also be prescribed. 

The prescribing and medicines team extracts and analyses prescribing data to identify trends and variations, and to support national policy. We also release open data for analysis by other organisations. 

The team works in collaboration with:

Aggregate prescribing data is publicly available and is used by other organisations, who can visualise it in a user-friendly format. This allows individual GP practices and clinical commissioning groups (CCGs) to compare their prescribing patterns to other providers.

Collect

Primary care prescribing information is derived from reimbursement to dispensers. This is collected by NHS Prescription Services, a division of the NHS Business Services Authority (NHS BSA), who enhance the data with additional information such as the cost of the medicines supplied to the NHS. The data is aggregated at national and provider level. National data is provided directly to us. Data at provider level is available through the ePACT2 system, also provided by NHSBSA.

Data for hospital use of medicines is provided by IQVIA (formerly known as QuintilesIMS and previously IMS Health) and is collected from NHS trusts in England.

Other data required for publications is collected as required from specific providers (such as the Commercial Medicines Unit in NHS England), either via a data request, routine data flow or previously published data (such as World Health Organization (WHO) or Office for National Statistics (ONS) data).

Data is also collected about the NHS services provided by community pharmacies.

Assemble

We assemble data in a variety of ways.

Prescription Cost Analysis (PCA)

This covers the number of items and net ingredient costs of all medicines provided in the UK and dispensed in the community in England. The data includes prescriptions written by:

  • GPs
  • hospital doctors
  • dentists 
  • non-medical prescribers, such as nurses and pharmacists

The net ingredient cost is the basic cost of a drug, not including discounts, dispensing costs, fees or prescription charges, so the amount the NHS paid will be different. This data is assembled into the prescription cost analysis system.

Prescribing costs in hospitals and the community

Data for hospital use of medicines is provided by IQVIA (formerly known as QuintilesIMS and IMS Health) and taken from most NHS Trusts in England. ePACT (electronic Prescribing Analysis and Cost Tool) data for primary care and hospital medicines prescribed in the community is then added, provided by the NHS Prescriptions Services.

Prescribing for diabetes in England

This data covers all prescriptions written for diabetic medication by prescribers working in primary care in England. This includes GPs, nurses and pharmacists.

Innovation scorecard

The innovation scorecard measures the uptake of new or innovative medicines by the NHS. It uses a variety of data sets: 

  • primary care prescribing data from prescription services
  • hospital pharmacy audit data from IQVIA
  • Pharmex data from the commercial medicines unit (NHS England)
  • volume purchase data from NHS Supply Chain
  • Hospital Episode Statistics (HES)
  • mid-year population estimates from the Office for National Statistics
  • defined daily doses from the World Health Organization
  • cardiac rhythm management devices annual audit (from the National Institute for Cardiovascular Outcomes Research)
  • pharmaceutical industry data

General pharmaceutical services: England

This report shows information about community pharmacy contractors (community pharmacies) and appliance contractors in England, and the NHS services they provided. Data is incorporated from:

Analyse and interpret

We analyse and interpret information in a variety of ways.

Prescription cost analysis

These are analysed by British National Formulary (BNF) Therapeutic Class. One prescription item is a single item written on a prescription form, known as an FP10. This publication shows greatest granularity per prescription item.

Data is analysed for:

  • number of items dispensed
  • net ingredients costs
  • free versus charged prescribing
  • trends in prescribing by therapeutic area
  • trends in volumes of prescribing and shifts in cost

This analysis is interpreted as change against the same figures in recent years to portray trends over the last 10 years.

Prescribing costs in hospitals and the community

Costs from the drug tariff and standard price lists by net ingredient costs are applied to the data. However, trusts often access NHS negotiated price discounts, so these costs are not necessarily truly reflective of what the NHS paid. The costs are compared to the previous year and expressed as percentage annual increase or decrease.

Prescribing for diabetes in England

Prescribing for diabetes examines prescribing trends on medicines prescribed in primary care in England for the treatment and monitoring of diabetes over a 10-year period. This is analysed as a proportion of the total prescribing spend in the UK and split by BNF classifications for differing types of diabetes drugs by number of items and cost. 

The prescribing data is interpreted against the prevalence of diabetes over time by financial year and down to CCG level.

Innovation scorecard

The data is analysed by product, condition and geography. The analysis is compared against previous years to monitor the change of use, with the headline interpretation being whether more of these innovative technologies are being used in relation to the previous report.

General pharmaceutical services: England

Information about NHS services provided by community pharmacies and appliance contractors in England is analysed. The number of sites, the number of prescriptions, the fees charged, and the average fees are all analysed. The number of dispensed medicines via community pharmacy, appliance contractors and dispensing GPs is aggregated by region. 

Distribute

The team produces a range of national and official statistical publications and data releases. We also produce and support answers to parliamentary questions, freedom of information requests and other ad hoc requirements.

Change

The data is used to identify trends in prescribing rates and costs. These can reflect the availability of new medicines or changes in the evidence base for the clinical and cost effectiveness of prescribed items. The data enables investigation of cost effective choice of medicines and indicates where there will be future cost pressures.

The data is also used to monitor the impact of changes in policy and for investigations, such as the use of controlled medicines or the use of antibiotics.

Individual GP practices and CCGs can use prescribing data to compare their prescribing patterns to those of other providers across the country. This helps them to identify where prescribing patterns vary from the average or from similar organisations, and enables more detailed investigation.

Work is underway to enable the submission of patient level prescribing data. This would enable more granular insights and linkage with other data sets. There are plans to make this data available through the Data Access Request Service (DARS).