Request

You asked us:

Thank you for fulfilling my previous request. Following on from this, I have a new request in two parts:

Firstly, I would like an update to this information for the month of August-24 as soon as possible please.

Secondly, I have a query on the information provided in response to 02253, which was quite different from expected values based on the response to 01662.

As I understand it, FOI-01662 requested the number of prescriptions for drug group A where the patient had no prescription for drug group B in the same calendar month. This averaged roughly 20% of total prescriptions issued for drug group A. However FOI-02253, requesting prescriptions for drug group A where the patient had no prescription for drug group B in the previous year, returned very much lower numbers of prescriptions - around 4%. I therefore require additional information on the number of prescriptions in drug group A where the patient HAS had a prescription for drug group B, so that I can assess why the results are so different. If you can please add in the information as follows, this will allow me to evaluate the results in better detail. For all prescriptions of a medicine in the Group A list, I am requesting:

Date

ICBID

BNFID (group A drug)

Items (group A drug)

Quantity (group A drug)

NIC (group A drug)

Drug in group B received this month? Y/N

Drug in group B received in last 12 months (this month + 11 previous months)? Y/N

IF Y (patient has received drug(s) from group B), then for each drug in group B received:

BNFID_B1 (first group B drug)

Items_B1 (first group B drug)

Quantity_B1 (first group B drug)

NIC_B1 (first group B drug)

Latest month_B1 - most recent month this group B drug received

Count of months_B1 - number of months in which this group B drug received

BNFID_B2 (next group B drug)

Items_B2 (next group B drug)

Quantity_B2 (next group B drug)

NIC_B2 (nextgroup B drug)

Latest month_B2 - most recent month this group B drug received

Count of months_B2 - number of months in which this group drug B received

BNFID_B3 (next group B drug) etc

I require information by month from Jan-22 to the latest available date to allow analysis of the prescribing trends.

You subsequently clarified your request as follows:

What I am trying to understand is: for the A scripts that went to people not getting B in the current month, but who DID receive something from list B in the previous 11 months, what B medicine those patients had received (and ideally how recently).

I have attempted to re-phrase the request to make this possible:

Part 1 (as before):

For the most recent months (Aug-24 and Sept-24), per A medicine, per ICB and nationally: How many A medicine scripts went to people not getting any B drug in this or the previous 11 months

Part 2

In order to understand what "B" medicine patients only receiving an "A" medicine in the current month were previously taking, I would like to know the following:

Of the A scripts that went to people not getting B in the current month, but who DID have a B script in the previous 11 months: what were the number of B scripts in each of those previous months, for each "A" BNFID. The "B" scripts could be aggregated to BNF_CHEMICAL_SUBSTANCE or reported at BNFID level if easier.

I am requesting this at national level for Aug-24 and Sept-24.

I understand that these results will not be able to be summed and that the information on Drug B for people getting more than one "A" medicine in the month will feature twice.

Part 3

I would like to know the number of unique patients getting more than one medicine from List A in Aug-24 and Sept-24.

Part 4

I would also like to know the unique patient count for each row in part 2, at national level

Part 5

If possible, I would also like parts 2 and 4 at ICB level.

The NHS Business Services Authority (NHSBSA) received your clarified request on 4 December 2024.

We have handled your request under the Freedom of Information Act (FOIA) 2000.

Our response

I can confirm that the NHSBSA holds the information you have requested and a copy of the information and notes explaining it is attached.

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

The data should not be aggregated as this will result in double counting of both items and patients.

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 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 and Social Care users.

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 Source

The data source was the NHSBSA Information Services Data Warehouse.

Time Period

Drug group A data is limited to August 2024 and September 2024 inclusive. Drug group B data looks at the 11 months before the drug group A month so September 2023 to August 2024.

Organisation Data

The data provided is for prescriptions prescribed in England.

Drugs

Drug group A is limited to drugs with the following BNF prefixes: 0601023AB, 0601023AI, 0601023AQ, 0601023AS, 0601023AW, 0601023AZ, 0601023Y0*

Drug group B is limited to drugs with the following BNF prefixes: 0601011, 0601012, 0601021, 0601022, 0601040, 0601023B, 0601023I, 0601023R, 0601023S, 0601023U, 0601023V, 0601023W, 0601023X, 0601023Z, 0601023A0, 0601023AA, 0601023AC, 0601023AD, 0601023AE, 0601023AF, 0601023AG, 0601023AH, 0601023AJ, 0601023AK, 0601023AL, 0601023AM, 0601023AN, 0601023AP, 0601023AR, 0601023AU, 0601023AV, 0601023AX, 0601023AY*

Identified Patients

Prescriptions are only included if an NHS Number has been captured during NHSBSA processing. 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 available for 99.08% of drug group A prescription items and 99.56% of drug group B prescription items.

The request includes multiple output .csv files, these are;

FOI02364_part_1_England.csv

FOI02364_part_1_ICB.csv

FOI02364_part_2_and_4.csv

FOI02364_part_3.csv

FOI02364_part_5.csv

Part 1 Caveats

The part 1 files are a rerun of previous FOI-02253 for the updated time period.

Patients

Data is limited to prescriptions from patients with prescribing from Drug Group A, with no prescribing from Drug Group B in the same month or the 11 previous months. This is consistent across both organisational data outputs.

BNF 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 8 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. The majority of such items are dressings and appliances which NHS Prescription Services has classified into four pseudo BNF chapters (20 to 23).

Items

Items shows the number of times a product appears on a prescription form not the quantity prescribed.

Total Quantity

The total quantity for a presentation i.e. each specific reimbursed quantity of a drug or appliance multiplied by the number of items, accumulated

Net Ingredient Cost (NIC(£))

Net Ingredient cost (NIC) is the basic price of a drug as stated in Part II Clause 8 of the Drug Tariff but please note that where a price concession for items listed in Part VIII of the Drug Tariff has been agreed between the Department of Health and Social Care (DHSC) and the Pharmaceutical Services Negotiating Committee the NIC will reflect the concession price rather than the Drug Tariff price. NIC is given in Pounds Sterling.

Part 2 And 4 Caveats

Part 2 and 4 are for data at a national (England) level.

Patients

Data is limited to prescriptions from patients with prescribing from Drug Group A, with no prescribing from Drug Group B in the same month but having prescribing from drug group B in the 11 previous months.

A_YEAR_MONTH is the year and month of the A drug

A_PRESENTATION_BNF is the A drug presentation

A_PRESENTATION_BNF_DESCRIPTION is the A drug presentation name

B_YEAR_MONTH is the year and month of the B drug.

B_PRESENTATION_BNF is the B drug presentation

B_PRESENTATION_BNF_DESCRIPTION is the B drug presentation name

B_ITEMS is the B drug item count

B_PATIENT_COUNT is the B drug distinct patient count.

The data should be viewed only for specific drug group A presentations and months. For example limiting to A_YEAR_MONTH = 202408 and A_PRESENTATION_BNF = 0601023AQAAADAD will give all the group B drugs received, the 11 months the group B drugs were received in with item and patient counts for all patients receiving the selected group A drug in the group A month.

As patients can receive multiple drugs from drug group A in multiple months, the drug group B data is repeated for every combination of drug group A drug and drug group A month.

The data should not be aggregated as this will result in double counting of both items and patients.

Part 3 Caveats

Part 3 is at a national (England) level.

Patients

Data is limited to patients who received prescribing of more than one BNF presentation from drug group A in the same month.

Part 5 Caveats

Part 5 data is presented with the prescribing organisation (ICB).

Patients

Data is limited to prescriptions from patients with prescribing from Drug Group A, with no prescribing from Drug Group B in the same month but having prescribing from drug group B in the 11 previous months.

A_YEAR_MONTH is the year and month of the A drug

A_ICB_CODE is the prescribing ICB for the A drug prescription

A_ICB_NAME is the prescribing ICB name for the A drug prescription

A_PRESENTATION_BNF is the A drug presentation

A_PRESENTATION_BNF_DESCRIPTION is the A drug presentation name

B_YEAR_MONTH is the year and month of the B drug

B_PRESENTATION_BNF is the B drug presentation

B_PRESENTATION_BNF_DESCRIPTION is the B drug presentation name

B_ITEMS is the B drug item count

B_PATIENT_COUNT is the B drug distinct patient count.

The data should be viewed only for specific drug group A presentations, months and ICBs. For example limiting to A_YEAR_MONTH = 202408, A_PRESENTATION_BNF = 0601023AQAAADAD and A_ICB_NAME = QHL will give you the group B drugs received, the 11 months the group B drugs were received in with item and patient counts for all patients receiving the selected group A drug in the drug group A month and drug group A ICB.

As patients can receive multiple drugs from drug group A in multiple months and ICBs, the drug group B data is repeated for every combination of drug group A drug, drug group A month and drug group A ICB.

The data should not be aggregated as this will result in double counting of both items and patients.

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: “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.