Researchers behind the Open Prescribing website - developed by a team including doctor and evidence-based medicine campaigner Dr Ben Goldacre - told delegates at the RCGP annual conference 2018 in Glasgow how practices could use the tool to find areas of prescribing for which their practice was an outlier on cost or volume.
An audit of changes at practices that used the website regularly, found that within three months of the site's launch it had saved £243,000 at practice level and £1.47m at CCG level. If all practices used Open Prescribing to change their practice, extrapolated savings across England would be £26.8m per year, the researchers said.
Dr Goldacre, who has been appointed by health and social care secretary Matt Hancock to lead a new tech advisory board, said in a speech earlier at the conference that there were often ‘unwarranted variations’ in the way drugs were prescribed.
GP prescribing
He highlighted how the tool could identify practices whose prescribing did not match NICE guidance, allowing commissioners or peers to begin conversations to find out why and support the practice to change. University of Oxford researcher Georgia Richards showed how the group had used data to build heatmaps highlighting high-dose opioid prescribing and identify factors that were linked to this, such as deprivation and practice size.
'The whole manifesto is better access to data,' Dr Goldacre said. 'We want to make it as easy as possible for people to spot problems and fix them.'
In the past, only a select few NHS staff were able to access comprehensive data, but with limited functionality, he said. 'GPs couldn’t access it. We want data in the hands of everyone.'
The 'tragedy of academia', he said, was that there was funding to create clinical research papers, but not for tools that could be used by health professionals on the frontline. In England he said there was 'nowhere to go' for funding to build this kind of tool - while in other countries people were 'queuing up' to ask the team behind Open Prescribing to build practical data tools.
Primary research
He said that if it was up to him, all primary research would cease for a year, with the funding diverted to pay for better dissemination of information across the health service. He said that taking the data tool to the next level would involve having people who could help practices act on results from data analysis.
'People who can talk to practices about their reasons for being an outlier, to tell them they are an outlier and to talk about it. We need a patchwork of lots of different operators, but there is no one willing to pay for it.'
Analysis of trends in NHS prescribing enabled by the Open Prescribing tool have revealed 'spectacular' cost effectiveness on the part of GPs - with rapid moves to generic prescribing of statins, for example.
A paper to be published soon by the group is expected to show that an NHS England edict on items that should not routinely be prescribed by NHS doctors has had little or no impact on prescribing habits.
An NHS chair in the audience said it was 'ridiculous' that most CCG were not making use of Open Prescribing data.
