Request

I would like to make a request under Freedom of Information with the same format, inclusions, groupings and caveats as a previous request you kindly dealt with for us. The previous request is 24380 and we would like the data to cover the period January 2022 until April 2022.

Request 24380 was as follows -

‘I would like to make a request for an extract similar to the one requested in 21278. I would like to request total items, total quantity and total Net Ingredient cost for each BNFID reimbursed by NHSBSA for each of the last 24 months (each month separately please) ending December 2021. I require the totals to be presented at BNFID level, divided into the standard 5 year age bandings and further separated by patient gender. Ideally this will include include all items dispensed in England, whether prescribed in the community (FP10) or in secondary care (FP10H). However if this is unfeasible then FP10 will suffice. If the data for 24 months is unfeasible then the 12 months Jan-Dec 2021 will suffice.’

Response

Due to the large size of the files we cannot email these to you. The dataset is over 1 million rows of data and it may be that you will need to use add-ons already existing on Microsoft Excel to enable you to view the data set in its entirety.

Microsoft PowerPivot add-on for Excel can be used to handle larger data sets. The Microsoft PowerPivot add-on for Excel is available using the link in the 'Related Links' section - https://www.microsoft.com/en-us/download/details.aspx?id=43348

Once PowerPivot has been installed, to load the large files, please follow the instructions below:

1. Start Excel as normal

2. Click on the PowerPivot tab

3. Click on the PowerPivot Window icon (top left)

4. In the PowerPivot Window, click on the "From Other Sources" icon

5. In the Table Import Wizard e.g. scroll to the bottom and select Text File

6. Browse to the file you want to open and choose the file extension you require e.g. CSV

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

Fewer than 5 Items

Please be aware that I have decided not to release the exact number of items, where the total number of items falls below 5, for certain drugs/patient combinations.

Where suppression has been applied a * is shown in place of the number of items, please read this as 1-4 items.

Suppression was applied in the following instances:

• Female Sex Hormones & Their Modulators (BNF Paragraph Code 60401) and the gender identified on the prescription is Male

• Male Sex Hormones and Antagonists (BNF Paragraph Code 60402) and the gender identified on the prescription is Female

• Preparations For Vaginal/Vulval Changes (BNF Paragraph Code 70201) and the gender identified on the prescription is Male

• Vaginal And Vulval Infections (BNF Paragraph Code 70202) and the gender identified on the prescription is Male

• Combined Hormonal Contraceptives/Systems (BNF Paragraph Code 70301) and the gender identified on the prescription is Male

• Progestogen-only Contraceptives (BNF Paragraph Code 70302) and the gender identified on the prescription is Male

• When the Progestogens (BNF Paragraph Code 80302) and the gender identified on the prescription is Male

• Drugs For Erectile Dysfunction (BNF Paragraph Code 70405) and the gender identified on the prescription is Female

• Premature Ejaculation (BNF Paragraph Code 70406) and the gender identified on the prescription is Female

This is because the patients 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 3A (a) of the Freedom of Information Act.

This is because it would breach the first data protection principle as: a. it is not fair to disclose patients 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 patients.

Please click the below web link to see the exemption in full.

https://www.legislation.gov.uk/ukpga/2000/36/section/40

Breach of Patient confidentiality

Please note that the identification of patients is also a breach of the common law duty of confidence. A patient who has been identified could make a claim against the NHSBSA or yourself for the disclosure of the confidential information.

The information requested is therefore being withheld as it falls under the exemption in section 41(1) ‘Information provided in confidence’ of the Freedom of Information Act.

Please click the below web link to see the exemption in full.

https://www.legislation.gov.uk/ukpga/2000/36/section/41

Remaining Information

Please find the data attached.

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.

Data Source

The data source was the NHSBSA Information Services Data Warehouse.

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.

Time Period

Monthly files from January 2022 to April 2022 inclusive.

Prescribing

The data provided is for prescriptions dispensed and prescribed in England. Prescribing has been split by Clinical Commissioning Groups (CCGs) and limited to prescribing within a CCG.

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

Total quantity is the number of items multiplied by the quantity prescribed. e.g. 2 items prescribed, one with a quantity of 2 and one with a quantity of 3, the total quantity would show as 5 (1 item x quantity of 2) + (1 item x quantity of 3)

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.

Gender

Sometimes a patient can have more than one identified gender in a time period. This can be due to data collection issues or a change in gender. Our categories are; female, male and unknown. Patients are placed in the gender they are captured in during NHSBSA processing. Patients who have transitioned may appear in the data in more than one gender category owing to prescribing at different points in time.

If you have any queries regarding the data provided, or if you plan on publishing the data, please contact nhsbsa.foirequests@nhsbsa.nhs.uk ensuring you quote the above reference. This is important to ensure that the figures are not misunderstood or misrepresented.

If you plan on producing a press or broadcast story based upon the data please contact nhsbsa.communicationsteam@nhs.net. 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: “Prescribing, NHSBSA Copyright 2022” This information is licenced under the terms of the Open Government Licence:

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

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.