Items which should not routinely be prescribed in primary care - silk garments

Below are the database queries which are used to create this measure. These are run against a copy of the BSA prescribing data which we store in Google BigQuery. We're working on making our BigQuery tables publicly available at which point it will be possible to run and modify these queries yourself. But even where code and database queries are not directly useable by others we believe it is always preferable to make them public.

Description Silk garments per 1000 patients
Why it matters

NHS England guidance states:

Silk garments are typically prescribed for eczema or dermatitis.

These products are knitted, medical grade silk clothing that can be used as an adjunct to normal treatment for severe eczema and allergic skin conditions.

Four brands of knitted silk garments are currently listed as an appliance in part IX A in the NHS Drug Tariff and are relatively expensive. The PrescQIPP document on silk garments states that the evidence relating to their use is weak and is of low quality.

In addition, due to limited evidence supporting the efficacy of silk clothing for the relief of eczema, the NIHR HTA programme commissioned the CLOTHES trial, to examine whether adding silk garments to standard eczema care reduced eczema severity in children with moderate to severe eczema, compared to use of standard eczema treatment alone. The trial concluded that using silk garments for the management of eczema is unlikely to be cost-effective for the NHS.

NHS England recommend that GPs:

  • Do not initiate.
  • Deprescribe in patients currently prescribed this medicine.
Tags Cost Saving, Efficacy, NHS England - items which should not routinely be prescribed in primary care
Implies cost savings Yes
Authored by richard.croker
Checked by andrew.brown
Last reviewed 2023-08-29
Next review due 2025-08-29
History View change history on GitHub →

Numerator SQL

SELECT
     CAST(month AS DATE) AS month,
     practice AS practice_id,
     SUM(actual_cost) AS numerator
 FROM hscic.normalised_prescribing
 WHERE bnf_code IN ("20200000100", "20200000101", "20200000102", "20200000103", "20200000104", "20200000105", "20200000106", "20200000107", "20200000108", "20200000109", "20200000110", "20200000111", "20200000112", "20200000113", "20200000114", "20200000115", "20200000116", "20200000117", "20200000118", "20200000119", "20200000120", "20200000121", "20200000122", "20200000123", "20200000124", "20200000125", "20200000126", "20200000127", "20200000128", "20200000129", "20200000130", "20200000131", "20200000136", "20200000137", "20200000138", "20200000139", "20200000140", "20200000141", "20200000142", "20200000143", "20200000144", "20200000145", "20200000146", "20200000147", "20200000148", "20200000150", "20200000151", "20200000152", "20200000153", "20200000154", "20200000155", "20200000156", "20200000157", "20200000158", "20200000159", "20200000161", "20200000162", "20200000163", "20200000164", "20200000165", "20200000166", "20200000167", "20200000168", "20200000169", "20200000170", "20200000171", "20200000172", "20200000173", "20200000175", "20200000176", "20200000177", "20200000178", "20200000179", "20200000180", "20200000181", "20200000182", "20200000184", "20200000185", "20200000186", "20200000187", "20200000188", "20200000189", "20200000190", "20200000191", "20200000192", "20200000193", "20200000194", "20200000195", "20200000196", "20200000198", "20200000200", "20200000201", "20200000202", "20200000203", "20200000204", "20200000206", "20200000207", "20200000208", "20200000209", "20200000210", "20200000211", "20200000212", "20200000213", "20200000214", "20200000216", "20200000217", "20200000218", "20200000219", "20200000220", "20200000221", "20200000222", "20200000223", "20200000224", "20200000225", "20200000226", "20200000227", "20200000228", "20200000229", "20200000230", "20200000231", "20200000232", "20200000233", "20200000234", "20200000235", "20200000236", "20200000237", "20200000238", "20200000239", "20200000240", "20200000241", "20200000242", "20200000243", "20200000244", "20200000245", "20200000246", "20200000247", "20200000248", "20200000249", "20200000250", "20200000251", "20200000252", "20200000253", "20200000254", "20200000255", "20200000256", "20200000257", "20200000258", "20200000259", "20200000260", "20200000261", "20200000263", "20200000264", "20200000265", "20200000266", "20200000267", "20200000268", "20200000269", "20200000270", "20200000271", "20200000272", "20200000273", "20200000274", "20200000275", "20200000276", "20200000277", "20200000278", "20200000279", "20200000280", "20200000281", "20200000282", "20200000283", "20200000284", "20200000285", "20200000286", "20200000287", "20200000288", "20200000289", "20200000290", "20200000291", "20200000292", "20200000293", "20200000294", "20200000295", "20200000296", "20200000297", "20200000298", "20200000299", "20200000300", "20200000301", "20200000302", "20200000303", "20200000304", "20200000306", "20200000307", "20200000308", "20200000309", "20200000310", "20200000311", "20200000312", "20200000313", "20200000314", "20200000315", "20200000316", "20200000318", "20200000319", "20200000320", "20200000321", "20200000322", "20200000324", "20200000325", "20200000326", "20200000327", "20200000328", "20200000329", "20200000330", "20200000331", "20200000332", "20200000333", "20200000334", "20200000335", "20200000336")
 GROUP BY month, practice_id

Denominator SQL

SELECT
     CAST(month AS DATE) AS month,
     practice AS practice_id,
     SUM(total_list_size / 1000.0) AS denominator
 FROM hscic.practice_statistics
 GROUP BY month, practice_id
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