1. Release of Practice Level Prescribing Data Sue Faulding, Programme Manager, Prescribing and Primary Care Services

2. Why release the data? Plan for Growth: “ … will look to publish prescribing data at practice level, subject to an evaluation and impact assessment by the NHS Information Centre.” Transparency agenda: “Open data must become the organising principle of public services.” PM letter to Cabinet, July 2011, restated the commitment to make available "prescribing data by GP practice by December 2011".

3. Considerations Practical issues – how? what? where? Information Governance issues Risks of release –Risk of disclosure –Jigsaw identification –Risk to viability of primary care longitudinal databases –Misuse and misinterpretation –Unintended consequences

4. Source of the data? NHS Prescription Services, part of NHS Business Services Authority. From information systems that support dispenser reimbursement –operational data NOT a collection Hence the data refers to prescriptions dispensed (not written) in a given month.

5. What has been released? …. over 4 million lines of data…. For each practice in England, and for each dispensed medicine (by chemical name), dressings and appliances (at section level) … –Total number of items that were prescribed and then dispensed. –Net Ingredient Cost. –Actual Cost. Supporting detail: FAQs, sample data, glossary NB: a released– not a publication

6. What has been released? Data for September 2011 released on 14 December 2011. One very large CSV file with practices identified only by national code. Supplementary file of practice codes, names and addresses. October 2011 data to be released January 2012, and so on …

7. What has been released? Prescriptions written in England, and dispensed at community pharmacies in the UK. Includes prescriptions written by GPs and by non- medical prescribers (e.g. nurses, pharmacists, optometrists, chiropodists) where these can be linked to GP practices. Includes ‘dummy’ practices (specialist clinics, prisons, hospices, etc)

8. Open Government License Information available under this license can be used an re-used freely and flexibly –Copy, publish, distribute and transmit –Adapt –Exploit commercially Users are obliged to –Acknowledge the source –Ensure you do not mislead or misrepresent the information No warranty - so ‘warts and all’

9. Existing data availability Data provided by this release already available to GP practices through the Electronic Prescribing & Financial Information for Practices (ePFIP) system provided by NHS Prescription Services. Also available to PCTS via ePACT The NHSIC publishes more detailed data at England level (PCA data). The NHSIC publishes less detailed data at PCT level (via iView)

10. Some points to note…. No patient level information – no patient or condition-specific information is collected on prescribing forms. No available data gives ‘dose’ ICO advised: –…that data for single-handed practices technically constitutes personal data – Given that GPs are funded from the public purse, and are ‘publicly’ accountable…., our view is that disclosure could be considered fair; and the balance of privacy versus transparency would probably favour transparency.

11. Using the data Can be linked to other datasets that hold national practice code. Can be used to construct comparators of practice prescribing, for example some QIPP measures of prescribing. Advise caution on interpretation and comparative analysis.

12. The Future….. Opportunities? –Very large data file each month may be difficult for some potential users to analyse – requires appropriate software. –Requirement for subsets of data Autumn Statement 2011 –Practice level data at presentation level, giving quantity prescribed, by September 2012 subject to further analysis of costs, benefit and affordability issues subject to a review of charging regimes

13. The Future…. NHSIC is monitoring responses and queries Welcome feedback on approach We will review approach to data release in the coming months to inform any future releases Keen to from users – how are you using or planning to use this data?

14. Web links http://www.ic.nhs.uk/gpprescribingdata Comments on the data to enquiries@ic.nhs.uk enquiries@ic.nhs.uk