OpenPrescribing Improvement Radar¶

What this tool does¶

This tool identifies sub-ICB locations (SICBLs) which have shown substantial improvement across each of our OpenPrescribing measures. The five SICBLs with the largest improvement are reported. We hope this will stimulate discussion with areas that have made effective changes so that successful strategies can be shared.

How it works¶

The tool currently uses the following criteria to identify improvement:

SICBLs needed to be, on average, in the highest 20% during the first 6 months of the time period shown.
SICBLs needed to improve to be, on average, in the lowest 50% of SICBLs during the last 6 months of the period shown.
The rate of the measure has to decrease by at least 5% across the time period shown (calculated as the difference between the average rate for the first 6 months and the last 6 months).
There needed to be, on average, at least 50 prescription items written.

We are continuing to review how we might further optimise these criteria to detect even more interesting changes in future. For example, we may be able to introduce elements of a ‘trend indicator saturation’ methodology (which we have used in previous research). You can find more information on this here, including a podcast on our work with Professor Ben Goldacre.

Interpretation notes¶

These pilot results are provided for the interest of advanced users, although we don't know how relevant they are in practice. There is substantial variation in prescribing behaviours, across various different areas of medicine. Some variation can be explained by demographic changes, or local policies or guidelines, but much of the remaining variation is less easy to explain.

We are keen to hear your feedback on this tool and how you use it. You can do this by emailing us at [email protected]. Please do not include patient identifiable information in your feedback.

This tool currently uses prescribing data between June 2019 and June 2024. We plan to update the tool every 3 months.

Table of Contents

Prescribing of Amino Acid Formula (AAF) and Extensively Hydrolysed Formula (EHF))
Antibiotic stewardship: volume of antibiotic prescribing
Antibiotic stewardship: courses for amoxicillin 500mg greater than 15 capsules
Anxiolytics and Hypnotics: Average Daily Quantity per item
Anxiolytics and Hypnotics: Average Daily Quantity per 1000 patients
Antibiotic stewardship: co-amoxiclav, cephalosporins & quinolones
Antibiotic stewardship: co-amoxiclav, cephalosporins & quinolones prescribing volume
Environmental impact of inhalers - average carbon footprint per salbutamol inhaler
Prescribing of continuous glucose monitoring sensors
Ciclosporin and tacrolimus oral preparations prescribed generically
Cost of milk formulae for Cow's Milk Protein Allergy (CMPA) per listed patients aged 0-4
Diltiazem preparations (>60mg) prescribed generically
Antibiotic stewardship: courses for doxycycline 100mg greater than 6 capsules/dispersible tablets
Proportion of Direct Acting Oral Anticoagulants (DOACs) not prescribed as edoxaban or generic apixaban
Environmental impact of inhalers - Prescribing of the less environmentally friendly Metered Dose Inhaler (MDI) (excluding salbutamol)
Possible excess quantities of semaglutide and tirzepatide
Antibiotic stewardship: fluoroquinolone items per 1000 patients
Topical treatment of fungal nail infections
Prescribing of gabapentin and pregabalin (DDD)
Prescribing of gluten free products
High-cost drugs for erectile dysfunction
High dose inhaled corticosteroids
Antibiotic stewardship: Injectable preparations for the treatment of infection
Non-preferred NSAIDs and COX-2 inhibitors
Items which should not routinely be prescribed in primary care - aliskiren
Items which should not routinely be prescribed in primary care - amiodarone
Items which should not routinely be prescribed in primary care - bath and shower emollients
Items which should not routinely be prescribed in primary care - co-proxamol
Items which should not routinely be prescribed in primary care - dosulepin
Items which should not routinely be prescribed in primary care - doxazosin modified release
Items which should not routinely be prescribed in primary care - dronedarone
Items which should not routinely be prescribed in primary care - immediate release fentanyl
Items which should not routinely be prescribed in primary care - glucosamine and chondroitin
Items which should not routinely be prescribed in primary care - herbal medicines
Items which should not routinely be prescribed in primary care - homeopathy
Items which should not routinely be prescribed in primary care - lidocaine plasters
Items which should not routinely be prescribed in primary care - liothyronine (including Armour Thyroid and liothyronine combination products)
Items which should not routinely be prescribed in primary care - lutein and antioxidants
Items which should not routinely be prescribed in primary care - minocycline
Items which should not routinely be prescribed in primary care - insulin pen needles costing ≥£5 per 100 needles
Items which should not routinely be prescribed in primary care - omega-3 fatty acid compounds (excluding icosapent ethyl [Vazkepa®])
Items which should not routinely be prescribed in primary care - oxycodone and naloxone combination product
Items which should not routinely be prescribed in primary care - perindopril arginine
Items which should not routinely be prescribed in primary care - rubefacients, benzydamine, mucopolysaccharide and cooling products
Items which should not routinely be prescribed in primary care - silk garments
Items which should not routinely be prescribed in primary care - paracetamol and tramadol combination
Items which should not routinely be prescribed in primary care - travel vaccines
Items which should not routinely be prescribed in primary care - trimipramine
Items which should not routinely be prescribed in primary care - all items
Methotrexate 10 mg tablets
Blood glucose testing strips not included in NHS England commissioning recommendations
Blood glucose testing lancets not included in NHS England commissioning recommendations
Prescribing of opioids (total oral morphine equivalence)
High dose opioids per 1000 patients
High dose opioid items as percentage regular opioids
Bile acid sequestrants, fibrates, nicotinic acid, and omega 3 fatty acids
Higher dose Proton Pump Inhibitors (PPIs)
Prescribing of pregabalin (total mg)
Probiotics that have been removed from the drug tariff
Short acting beta agonist inhalers
Seven Day Prescribing for Long Term Conditions
Silver dressings
Soluble/effervescent forms of paracetamol and co-codamol
Low and medium intensity statins
Toothpaste Prescribing
Antibiotic stewardship: three-day courses for uncomplicated UTIs
Vitamin B complex per 1000 patients

Environmental impact of inhalers - Prescribing of the less environmentally friendly Metered Dose Inhaler (MDI) (excluding salbutamol)

Number of organisations with improvement identified: 3

Items which should not routinely be prescribed in primary care - liothyronine (including Armour Thyroid and liothyronine combination products)

No organisations met the technical criteria for detecting substantial change on this measure.

Items which should not routinely be prescribed in primary care - omega-3 fatty acid compounds (excluding icosapent ethyl [Vazkepa®])

Number of organisations with improvement identified: 3

Items which should not routinely be prescribed in primary care - rubefacients, benzydamine, mucopolysaccharide and cooling products

No organisations met the technical criteria for detecting substantial change on this measure.