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Publication

Prescribing for Diabetes in England 2008/09 - 2018/19

This is part of

Official statistics
Publication date:
Geographic coverage:
England
Geographical granularity:
Clinical Commissioning Groups, Country
Date range:
01 Apr 2008 to 31 Mar 2019

Data sources and quality

Data sources

The data is extracted from ePACT2, a data warehouse hosted by NHS Prescription Services, which is part of the NHS Business Services Authority. NHS Prescription Services process prescriptions in order to reimburse dispensers.

The data presented in this report covers prescriptions that are written in England by prescribers working in primary care (including general practitioners, nurses and pharmacists), and that are dispensed in the community in the UK

For data at Clinical Commissioning Group (CCG) level, a prescription dispensed in a CCG different to the one in which it was written will be categorised as the CCG in which the prescription was written. 

The CCG stucture from 1st April 2019 is used.

Information on prescriptions that are written but not dispensed is not available. Prescriptions written in hospitals/clinics that are dispensed in the community, prescriptions dispensed in hospitals, dental prescribing and private prescriptions are not included. This is important to note as some BNF sections have a high proportion of prescriptions written in hospitals that are dispensed in the community. Also note that the Prescription Cost Analysis publication contains data on prescriptions that are written in the UK and dispensed in England, which is different to the format of the ePACT2 data presented here.

This report also incorporates data from the Quality and Outcomes Framework diabetes register. Participation in QOF is voluntary, though participation rates are very high at 95.1% of General Practices in England.

ePACT vs ePACT2

The ePACT system has been updated since the previous versions of this publication. Data is provided on ePACT2 for the most recent five financial years, so caution needs to be taken when comparing figures in this publication to those of previous years.

Data quality

This section provides data quality information for the data sources used in this publication. It aims to provide users with an evidence-based assessment of the quality of the statistical output by reporting against the quality dimensions of the European Statistical System (ESS) that are appropriate to this output.

In doing so, this meets our obligation to comply with the UK Statistics Authority (UKSA) Code of Practice for Official Statistics, particularly Pillar 2, Principle Q3, which states: “Producers of statistics and data should explain clearly how they assure themselves that statistics and data are accurate, reliable, coherent and timely”.

Users and uses of this report

This publication is used by many stakeholders with an interest in diabetes prescribing. Known users of this publication include academics, central government, charities, clinical groups, commercial organisations, commissioners, health and social care providers, media and members of the public. The information is used to support decision making, inform policy, analyse medicine use, provide advice to ministers and answer Parliamentary Questions.

Relevance

This publication allows users to see how the use of medicines prescribed for diabetes, and associated costs, has changed over time from 1st April 2008 to 31st March 2019. It contains a time series of national-level statistics and one year of CCG-level statistics in the form of charts, data tables and supporting commentary.

Accuracy and reliability

Prescribing figures in this publication are based on information systems at NHS Prescription Services, part of the NHS Business Services Authority. The figures used are collected as an essential part of the process of reimbursing dispensers (mainly pharmacists and dispensing doctors) for medicines supplied. All prescriptions that are prescribed in England and dispensed in the community in the UK need to be submitted to NHS Prescription Services if the dispenser is to be reimbursed, so coverage should be complete. If a prescription was issued but not presented for dispensing or was not submitted to NHS Prescription Services by the dispenser, then it is not included in the data.

The prescription item is recorded in the month in which NHS Prescription Services received it. In the majority of cases prescriptions will be issued, dispensed and submitted to NHS Prescription Services in the same month. However, prescriptions can be presented for dispensing up to six months after issue, and the dispensing organisation may submit the prescription for payment late. Prescription data may be attributed to organisations that have since closed for three potential reasons:

  • An issuing organisation may close after writing a prescription but before the prescription is dispensed
  • NHS Prescription Services may receive the reimbursement claim late from an organisation
  • A prescription pad from a closed organisation may still be in use by a prescriber previously at that organisation

NHS Prescription Services have internally audited their prescription processing accuracy to 99.7% over the period Jun 2018 – May 2019.

Timeliness and punctuality

Following a publication consultation and user feedback this annual publication is now published in November to coincide with the latest data available from QOF and Clinical Audit. The publication date is determined by the availability of the data from NHS Prescription Services and allows adequate time for the compilation of the report.

This publication has been released in line with the pre-announced publication date and is therefore deemed to be punctual.

Accessibility and clarity

This publication is available annually via the NHS Digital website as a combination of web pages and downloadable data files. The publication may be requested in large print or other formats through NHS Digital’s contact centre: enquiries@nhsdigital.nhs.uk (please state that your query relates to Prescribing for Diabetes).

Coherence and comparability

The NHS Prescription Services data presented here differs from that presented in NHS Digital publications based on the Prescription Cost Analysis (PCA) system. This is because the PCA database is based on all prescriptions dispensed in England irrespective of where they were written and includes prescriptions written by dentists and hospital doctors. The figures in this publication are based on prescriptions written in primary care in England and dispensed anywhere in the UK.

Users should note that the data relates to prescription items dispensed, not to the number of patients. One individual may have a prescription item, for the same medicine, dispensed a number of times over a year.

Comparisons over time

Changes to the figures over time need to be interpreted in the context of changes in available medicines and their cost, and changes in NHS practice. For example, a reduction in items dispensed for a particular medicine may be due to the introduction of alternative medicines or a change in prescribing behaviour, especially in the length of treatment each item is intended to cover. Changes in cost may be due to the introduction of newer drugs, drugs coming off patent, or regulations under the Category M scheme, the Pharmaceutical Pricing Regulation Scheme (PPRS), or the recent Voluntary Scheme for branded medicines pricing and access. These schemes are agreements between the Department of Health and Social Care and the pharmaceutical industry to place a level of control on the costs of medicines to the NHS and applies to all branded, licensed NHS medicines.

Previous versions of Prescribing for Diabetes can be found here, but care needs to be taken when comparing figures from the current publication to those in previous publications, due to changes in the data source (see Data sources section above).

Performance cost and respondent burden

The figures used in this publication are collected as part of the process of reimbursing dispensers for drugs supplied. The publication therefore uses an existing administrative source. Information about the administrative source and its use for statistical purposes is included in NHS Digital’s Statement of Administrative Sources.

Confidentiality, transparency and security

Disclosure risk, impact and likelihood are low for all the data included. Data refers to prescription items dispensed and not individual people. No patient level data or patient identifiable data is available.

The data included in this publication is already publicly available.

Some data is presented at CCG level. However, the smallest CCG has a population of approximately 70,000 so there is little risk of disclosure.

This is an Official Statistics publication. The Code of Practice for Official Statistics is adhered to from collecting the data to publishing.

The standard NHS Digital data security and confidentiality policies have been applied in the production of these statistics.

The Freedom of Information Act gives you the right to obtain any further information required.

Feedback

NHS Digital welcomes all feedback relating to any aspect of this publication. In particular we would welcome feedback on the usefulness of the information to different users, the ways in which the information is used and what further information would be useful. Feedback can be provided to NHS Digital via enquiries@nhsdigital.nhs.uk or 0300 303 5678 (please state that your query relates to Prescribing for Diabetes).

Last edited: 1 November 2019 7:27 am