Request

Under the Freedom of Information Act 2000, I request the following information: The number of individuals of all ages who were prescribed contraceptives in the financial years 2019-2020, 2021-2020, 2020-2021, 2021-2022 and 2022-2023 in community settings (GP surgeries and pharmacies) broken down by contraceptive method.

I would also like the proportion these represent of contraception users. For example, X proportion of those on contraception are using the Mirena coil. If possible, I would also appreciate if this were broken down by age of those prescriptions too.

To clarify, I mean patients. I also mean both contraceptive drugs and appliances/devices

Response

A copy of the information is attached. Please read the following information to ensure correct understanding of the data.

Fewer than five
Please be aware that I have decided not to release the full details where the total number of individuals falls below five. This is because the individuals could be identified, when combined with other information that may be in the public domain or reasonably available. This information falls under the exemption in section 40 subsections 2 and 3 (a) of the Freedom of Information Act (FOIA). This is because it would breach the first data protection principle as:  
a - It is not fair to disclose individual’s personal details to the world and is likely to cause damage or distress.
b - These details are not of sufficient interest to the public to warrant an intrusion into the privacy of the individual.  

Please click the weblink to see the exemption in full: www.legislation.gov.uk/ukpga/2000/36/section/40  

NHS Business Services Authority (NHSBSA) - NHS Prescription Services process prescriptions for Pharmacy Contractors, Appliance Contractors, Dispensing Doctors, and Personal Administration with information then used to make payments to pharmacists and appliance contractors in England for prescriptions dispensed in primary care settings (other arrangements are in place for making payments to Dispensing Doctors and Personal Administration). This involves processing over one billion prescription items and payments totalling over £9 billion each year. The information gathered from this process is then used to provide information on costs and trends in prescribing in England and Wales to over 25,000 registered NHS and Department of Health and Social Care (DHSC) users.

Data Source: ePACT2 - Data in ePACT2 is sourced from the NHSBSA Data Warehouse and is derived from products prescribed on prescriptions and dispensed in the Community. The data captured from prescription processing is used to calculate reimbursement and remuneration. It includes items prescribed in England, Wales, Scotland, Northern Ireland, Guernsey/Alderney, Jersey, and Isle of Man which have been dispensed in the community in England. English prescribing that has been dispensed in Wales, Scotland, Guernsey/Alderney, Jersey, and Isle of Man is also included.

The data excludes:
• Items not dispensed, disallowed and those returned to the contractor for further clarification.
• Prescriptions prescribed and dispensed in prisons, hospitals, and private prescriptions. • Items prescribed but not presented for dispensing or not submitted to NHS Prescription Services by the dispenser.

Dataset - The data is limited to presentations prescribed in BNF sections 0703 Contraceptives and BNF section 2104 Contraceptive Devices. Data is presented at BNF Sub Paragraph and BNF Presentation level.

Time Period - Financial years 2019/20, 2020/21, 2021/22, 2022/23 and 2023/24 (April 2023 - January 2024). Data is currently available up to and including January 2024.

Organisation Data - The data is for prescribing in England regardless of where dispensed in the community.

British National Formulary (BNF) Sub Paragraph and Presentation Code – The BNF Code is a 15-digit code in which the first seven digits are allocated according to the categories in the BNF, and the last eight digits represent the medicinal product, form, strength and the link to the generic equivalent product. NHS Prescription Services has created pseudo BNF chapters, which are not published, for items not included in BNF chapters 1 to 15. Most of such items are dressings and appliances which NHS Prescription Services has classified into four pseudo BNF chapters (20 to 23).

Patient Identification - Where patient identifiable figures have been reported they are based on the information captured during the prescription processing activities. Please note, patient details cannot be captured from every prescription form and based on the criteria used for this analysis, patient information (NHS number) was only available for 98.28% of prescription items.

The unique patient count figures are based on a distinct count of NHS number as captured from the prescription image.

Patient ages are based on the age as captured from the prescription image and relates to the patient's age at the time of prescribing/dispensing.  Please note it is possible that a single patient may be included in the results for more than one age band where a patient has received prescribing at different ages during a financial year.

The figures for the number of identifiable patients should not be combined and reported at any other level than provided as this may result in the double counting of patients. For example, a single patient could appear in the results for multiple presentations or both financial years.

Patient Age - Shows the age of the patient, if recorded.

Data Quality for patient age - NHSBSA stores information on the age of the recipient of each prescription as it was read by computer from images of paper prescriptions or as attached to messages sent through the electronic prescription system.     The NHSBSA does not validate, verify or manually check the resulting information as part of the routine prescription processing.

There are some data quality issues with the ages of patients prescribed the products. The NHSBSA holds prescription images for 18 months. A sample of the data was compared to the images of the paper prescription forms from which the data was generated where these images are still available. These checks revealed issues in the reliability of age data, in particular the quality of the stored age data was poor for patients recorded as aged two years and under. When considering the accuracy of age data, it is expected that a small number of prescriptions may be allocated against any given patient age incorrectly.

Application of Disclosure Control to information services (prescriptions) products- ePACT 2 data is not published statistics - it is available to authorised NHS users who are subject to Caldicott Guardian approval. We have no plans to apply disclosure control to data released to ePACT 2 users. These users are under an obligation to protect the anonymity of any patients when reusing this data or releasing derived information publicly. 

All requests that fall under the FOI process are subject to the NHSBSA Anonymisation and Pseudonymisation Standard. The application of the techniques described in the standard is judged on a case-by-case basis (by NHSBSA Information Governance) in respect of what techniques should be applied. The ICO typically rules on a case-by-case basis too so each case or challenge or appeal is judged on its own merits. FOI rules apply to data that we hold as part of our normal course of business.