Presenting this data in a user-friendly format has the potential to save the NHS phenomenal amounts of money... Doctors and others in the NHS can get useful simple feedback on prescribing behaviours that are potentially wasteful, or even harmful. Crucially this service is fully open: that means everyone can see the data and use it. - Dr Ben Goldacre, University of Oxford.
Openprescribing.net is the first website of its kind to enable health professionals, patients and the public to easily explore patterns of prescribing nationally, in Clinical Commissioning Groups (CCG) and by individual GP practices.
The project has been developed by researchers at the University of Oxford’s Nuffield Department of Primary Care Health Sciences in collaboration with epidemiologists, doctors and coders and turns raw data from the NHS into a fully functioning live service. It provides feedback on every prescribed drug through easy-to-read graphs and dashboards and aims to make NHS prescribing data clear, open and accessible to everyone. The project has received funding and additional collaborative support from the West of England Academic Health Science Network.
Dr Ben Goldacre, a Senior Research Fellow at the University of Oxford, who leads the project, said:
“If we want to improve standards in healthcare we need good data that can be accessed and interpreted quickly. With a very small amount of funding we’ve taken prescribing data from the NHS and made it open to everyone and free to access. Doctors and others in the NHS can get useful simple feedback on prescribing behaviours that are potentially wasteful, or even harmful. Crucially this service is fully open: that means everyone can see the data and use it, whether they are a practice manager, a patient, a journalist, a member of the public, a doctor, or a researcher.
“Presenting this data in a user-friendly format has the potential to save the NHS phenomenal amounts of money. By giving individual GPs, practice managers and clinical commissioning groups the power to scrutinise their efficiency, they can start to routinely monitor their performance against national or regional trends. OpenPrescribing.net lets anyone spot outliers, so we can see who is prescribing an unusually high quantity of antibiotics, or whether a practice or CCG is responding to recommendations to prescribe generic drugs over their branded equivalents, which is a top cost-saving tactic in the NHS.”
Currently in early “beta” phase, the site can produce dashboards, maps and graphs on any drug the user selects. There also six standard measures that can be rapidly visualised for any CCG or practice, to illustrate the best ways the service can be used, each with an explanation of what they mean. Future development work seeks to add around 100 such standard measures, chosen in consultation with healthcare professionals and patients, and many more innovative new features, though additional funding is needed to make this possible.
Using the website comes with a caveat, however. “It’s important to be thoughtful about how you interpret this data,” warns Ben Goldacre. “If any one practice is using a high or low quantity of a particular drug, that could mean that the doctors’ decision making processes are different, or it could mean that their patients are different. For example, if a practice is prescribing a lot of valium, that may mean the doctors there have a lower threshold for giving out such drugs; or it could mean that the practice specialises in providing services for patients with substance misuse problems.”
The site contains advice on interpreting the data, and the researchers have developed new statistical methods for identifying outliers more accurately which will be implemented on the site and published shortly.
Openprescribing.net utilises raw data on GP practice prescribing from the Health and Social Care Information Centre. This is updated monthly and has been in the public domain under an Open Government License since 2012, but until now has yet to be offered in a format that allows for quick and easy reporting at the practice, CCG or national level.
www.OpenPrescribing.net is one of a range of projects built by the EBMDataLab to help make complex medical and scientific data more accessible and more impactful in the real world. Phase 1 of the project was funded through a £50,000 grant from the West of England Academic Health Science Network and the site is currently in beta. The coding lead is Anna Powell-Smith, the academic lead is Dr Ben Goldacre from the Centre for Evidence-Based Medicine in the Nuffield Department of Primary Care Health Sciences at the University of Oxford. Any drug can be explored, but the pre-built practice and CCG dashboards show prescribing data on six measures to get users started:
- Cost-effective statin prescribing - Rosuvastatin vs Atorvastatin.
- Prescribing of generic vs branded drugs - Cerazette vs. Desogesterel.
- Second line antibiotic prescribing - Cephalosporins vs “oral antibiotics STAR-PU”.
- Overall antibiotic prescribing - All antibacterial drugs vs “oral antibiotics STAR-PU”.
- Prescribing of antidiabetes medication with different costs and risk profiles - Pioglitazone vs all antidiabetic drugs.
- Prescribing of pain killers with different costs and risk profiles - Celecoxib vs all non-steroidal anti-inflammatory drugs (NSAIDs).
The website also shows national prescribing trends for all drugs in the BNF, and chemicals by their name or code, which can also be analysed by CCG or practice.