Monitor your prescribing

Reflecting on personal prescribing habits is a useful learning exercise for appraisal, explains Dr Tillmann Jacobi.

ePFIP can be a great tool for personal refection on prescribing habits or auditing the whole practice
ePFIP can be a great tool for personal refection on prescribing habits or auditing the whole practice

Have you ever wondered how much money you spend on prescribing in a month? Would you like a detailed summary of the medicines you are using, either for audit purposes or for your appraisal folder?

Many doctors do not even know about the online resources provided by NHS Prescription Services but these are exactly the kinds of questions it can answer.

Customised information
Various tools and reports can be accessed via the Prescription Services website (part of NHS Business Services Authority).

Electronic prescribing analysis and cost (PACT) allows online analysis of the previous 60 months' prescribing data held on the NHS prescription services prescribing database.

The online resources, which have replaced the paper PACT prescribing information, are much better at providing specific and customised information.

The website lets you over-view, analyse and drill down information in a way that makes it relevant, interesting and useful for daily practice.

There is an area specifically for GP practice data.

Using ePFIP
Electronic Prescribing and Financial Information for Practices (ePFIP) is a resource specifically for GP practices. It allows GPs to monitor the prescribing habits of the practice or themselves as individuals and compare these against national and PCT comparators.

ePFIP can take a little time to get used to. The opening screen of the website can appear complicated and the navigation is not quite intuitive at first.

Luckily, the help files available for ePFIP have recently been updated and explain the various functions and steps to get the results you want.

You may wonder what ePFIP adds to the searches and reports you can obtain from your practice computer system. It adds the cost of what you have prescribed and compares it with peers - this can be quite revealing.

It also gives a better and more comprehensive overview (especially prescribing of high-cost drugs, which may need reviewing) in a useful format, with the option to go into almost as much detail as you want.

Data for all practitioners
Also useful is that clinicians who were not necessarily clearly identified in the previous paper version of PACT (for example, salaried GPs) are now able to review their prescribing habits within the practice.

The icing on the cake, for me, is that you can access this information from anywhere in the world via the internet. As a downside, there is a couple of months' delay before the data are displayed.

To make the most of ePFIP, you need to learn the system and use it with specific aims in mind to obtain the precise results you want.

ePFIP can be a great tool for personal reflection on prescribing habits, auditing of specific prescribing for the whole practice or groups and individuals in the practice and feedback. It may inspire the use of a practice formulary and adherence to it.

ePFIP may even be used for validation of dispensing figures and summaries for potential negotiations with pharmaceutical companies.

To obtain a password-protected account you can apply online, or have it arranged by the prescribing lead in your surgery.

  • Dr Jacobi is a salaried GP in York

Generic scrip rates
For your generic scrip rate, click through the following sequence: prescribing analysis report, quarterly reports, then choose the desired quarter.

Click through the report and you will see an overview of the number of items prescribed (in my case about 4,000), the percentage of generics used (83 per cent for me; that is not bad) and the total cost, as well as the average cost per item.

You can compare your rate with the other doctors in the practice. It also shows prescribing from trainees, practice nurses or deputising services if any of them apply.

During that process you will incidentally see the spend of the entire practice during that period, the top 20 or 40 drugs prescribed (in terms of cost) and all the data benchmarked against local PCT and national data.

This may be provide food for thought, especially if the practice is significantly below or above the averages.

Types and quantities of drugs
Perhaps you would like to know more about your prescribing of a specific group of medicines, for example, types and quantities of statins used in a specific month.

From the main screen go to 'PDPI', click on the month or period you want to look at and choose your name from the drop-down menu in the prescriber row. Then select the chapter 'cardiovascular system' and 'total BNF' in the next two rows.

Click on 'total' and 'prescribing', 'fully detailed' and 'prescriber' and then submit. With a few further obvious clicks you will reach the overview of the numbers and costs of each brand.

You can see how it compares with your prescribing last year, which can reveal if your habits have changed, deliberately or not.

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