Request

Following on from (FOI-01671, FOI-01975) we would like to request all antibiotic prescriptions split by 5yr age bands and sex at the level of GP practices and ICB for the same time periods. However, instead of monthly (as in previous FOI) can we get these levels annually? to get over the issue of small numbers.

On the 10 October 2024 you clarified the following:

10 yr age bands is fine, apart from for children. Would it be possible ( and likely ok as fewer smaller numbers ) to ask for 0-5, 5-10 and then 10 yr age bands for all other ages?

Response

A copy of the information is attached.

Please read the below notes to ensure correct understanding of the data.

We have considered this request under the Freedom of Information Act 2000 and we are issuing a refusal notice under section 17 of the FOIA for part of the information.

Section 40(2) - Personal information

We can confirm that we do hold the requested information, but this information is exempt under section 40(2) of the FOIA (personal information).

Section 40(2) is an absolute, prejudice-based exemption and therefore is exempt if disclosure would contravene any of the data protection principles. In order for disclosure to comply with the lawfulness, fairness, and transparency principle, we either need the consent of the data subject(s) or there must be a legitimate interest in disclosure. In addition, the disclosure must be necessary to meet the legitimate interest and finally, the disclosure must not cause unwarranted harm. As we do not have the consent of the data subject(s), the NHSBSA is therefore required to conduct a balancing exercise between legitimate interest of the applicant in disclosure against the rights and freedoms of the data subject(s).

The NHSBSA acknowledges that you have a legitimate interest in disclosure of the information in order to provide the full picture of the requested data held by the NHSBSA; however, we have concluded that disclosure of the requested information would cause unwarranted harm and therefore, section 40(2) is engaged. This is because there is a reasonable expectation that patient data processed by the NHSBSA remains confidential.

Please see the following link to view the section 40 exemption in full - https://www.legislation.gov.uk/ukpga/2000/36/section/40

Section 41 – Provided in Confidence

In addition, this information is also exempt under section 41 of the FOIA (information provided in confidence). This is because the requested information was provided to the NHSBSA in confidence. In order for Section 41 to be engaged, the following criteria must be fulfilled:

· the authority must have obtained the information from another person,

· its disclosure must constitute a breach of confidence,

· a legal person must be able to bring an action for the breach of confidence to court, and

· that court action must be likely to succeed.

The NHSBSA can confirm that the information has been obtained from a third party and that subsequent disclosure of that information would constitute a breach of confidence. In addition, disclosure could result in a legal person being able to bring action for the breach of confidence to a court and that court action.

NHSBSA Prescription Services process prescriptions and information is then used to make payments to pharmacists and appliance contractors (in England) for prescriptions dispensed in primary care settings. This involves processing approximately 1 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 users.

Data Source: NHSBSA Information Services Data Warehouse.

Time Period: The data covers the period April 2015 to December 2023 inclusive and is provided in financial years.

Contents: The data shows the number of unique patients and prescription items for prescribing of antibiotic medicines.

Prescribing Organisation: Data is shown for prescribing in GP practices in England only; the data is presented at practice level and at ICB level, separately. To allow mapping to parent organisation levels, a lookup file has been provided which shows the sub ICB location, ICB and NHS region for all practices included in the data, based on the current NHS organisation structure. Where a practice has closed in a period prior to the formation of the current structure, it may be mapped to a closed or since-merged CCG, area team or region record.

Dispensing Organisation: No restrictions have been placed on dispensing location.

Medicines: Data is shown for prescribing of antibiotic medicines, as defined as those medicines contained in BNF section 5.1. The data is presented at chemical substance level. BNF chemical substance code is included in each data file, with the mapping from code to description included for all chemical substances in the lookup file.

Patient data: Unique patient counts are calculated for the other attributes shown in each row of the data, and do not include unidentified patients (item counts do include unidentified prescribing). For context, 96.7% of all prescription items included in this analysis can be attributed to an identifiable patient. 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.

Age Bands: Patient age bands are based upon the age captured on the prescription form during payment processing. While age is not captured on all forms, in this data 97.4% of all items can be associated with a patient with a known age.

Gender: Patient gender has been reported using the latest patient gender information held by the NHSBSA Information Services data warehouse at the time that the data was extracted. This uses information from either the most recent Electronic Prescription Service (EPS) message or from the last time that NHSBSA received data about the patient's gender from NHS Personal Demographics Service. Gender is either: Male, Female, Not Known (where no information is held) or Indeterminate (where information is held which does not confirm either Male or Female).

Redaction of small numbers: Data points relating to fewer than 5 unique patients or items have been suppressed. Suppressed cells have been replaced with an asterisk ('*') as a placeholder. Where a zero is reported in a cell this should be interpreted as showing that we have no identified data relating to that category. A placeholder this should be interpreted as 'between 1 and 4' or 'a small number' of the fact in question.

Exclusions:

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.

Data Queries

Please contact foirequests@nhsbsa.nhs.uk ensuring you quote the above reference if you have any specific questions regarding this response; or, if you feel you may be misunderstanding or misinterpreting the information; or, if you plan on publishing the data. Reusing the data and copyright

If you plan on producing a press or broadcast story based upon the data please contact communicationsteam@nhsbsa.nhs.uk. This is important to ensure that the figures are not misunderstood or misrepresented.

The information supplied to you continues to be protected by the Copyright, Designs and Patents Act 1988 and is subject to NHSBSA copyright. This information is licenced under the terms of the Open Government Licence detailed at:

http://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/

Should you wish to re-use the information you must include the following statement: “NHSBSA Information Services Data Warehouse NHSBSA Copyright 2024” Failure to do so is a breach of the terms of the licence.

Information you receive which is not subject to NHSBSA Copyright continues to be protected by the copyright of the person, or organisation, from which the information originated. Please obtain their permission before reproducing any third party (non NHSBSA Copyright) information.