Request

1. In a previous FoI response [Ref: FOI 10274] you provided an excel table showing the number of antidepressant prescriptions issued broken down by the individual ages of the patients. Could you provide me with a similar table but for the number of these prescriptions issued in 2021?

2. In addition could you provide me with a spreadsheet detailing the geographical spread of the prescribing of antidepressant medications in that the sheets should have the following columns: i) The name of the Clinical Commissioning Group (CCG), ii) The total number of patients registered at that CCG, iii) The total number of unique patients at the CCG who were prescribed antidepressants at some point during the 2021 calendar year, iv) The total number of anti-depressant prescriptions issued by that CCG in the calendar year.

Response

A copy of the information is attached. Please note the following when reviewing the attached information.

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 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.

Time period for this request

Calendar year 2021 (January 2021 to December 2021).

Please note

CCG names have now been replaced by Sub Integrated Care Board Location (SICBL) names reflecting the new NHS organisational structure.

A date with the letter 'C' in brackets - example (C 01-Apr-21) against a CCG name indicates that this organisation is closed as of the date stated. These closed CCGs are at the bottom of the list.

The data is shown in two parts: • Part 1 shows number of items prescribed from BNF section 0403 Antidepressant drugs and individual patient ages for those items for the calendar year of 2021. • Part 2 shows number of items prescribed from BNF section 0403 Antidepressant drugs and number of unique patients prescribed those items per SICBL for the calendar year of 2021.

Organisation

Part 1 is for items prescribed in England and Part 2 is for items prescribed in SICBLs only.

Items

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

Patient Age

Where patient ages 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. Patient ages are based on the age as captured from the prescription image and relate to the patient's age at the time of prescribing/dispensing. Patient Age of ‘0’ represents patients aged under 1 year. Patients who are aged 110 year or older have been grouped together. Please note it is possible that a single patient may be included in the results for more than one age where a patient has received prescribing at different ages during a calendar year.

Data Quality

NHS Prescription Services have a variety of validation streams throughout prescription processing to support accurate capture of the data. In addition, a retrospective sample is completed in the month following reimbursement to identify the accuracy of prescription processing information. The check includes the accuracy of prescriber, practice and drug information, but does not include the personal details of the patient. The information is used to populate a number of Key Performance Indicators, the results of which are published on a monthly basis on the NHSBSA website at: https://www.nhsbsa.nhs.uk/pharmacies-gp-practices-and-appliance-contractors/payments-and-pricing/how-we-process-prescriptions

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. However an additional check is carried out on a yearly basis to check the capture rate and accuracy of the stored patient information. The results of this check for the most recent time period available (January 2020 to December 2020) show that for both paper and electronic prescriptions patient age was captured from 94.88% of prescription forms and the accuracy of age data captured was 99.95%.

The NHSBSA has tested a sample of data, comparing it to the images of the paper prescription forms from which the data was generated. These checks revealed issues in the reliability of data for prescribing of antidepressants in patients aged 6 years and under. In some cases either the drug or patient age may have been captured incorrectly during the processing of the paper prescription.

Patient list size

This is the average list size for the calendar year 2021. Please note closed CCGs do not usually have a patient list size against them – represented as N/A here. However in this dataset BRENT CCG (C 01-Apr-21) is showing a list size of 1 as this is the information still held against this record.

No. of items where patient identified

This shows only those items where the patient has been able to be identified.

No. of items where patient not identified

This shows only those items where the patient has not been able to be identified.

Total no. of items

This shows all items whether a patient has been identified or not.

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 99.54% of prescription items.

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

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 SICBLs.

Please note that this request and our response is published on our Freedom of Information disclosure log at: https://opendata.nhsbsa.net/dataset/foi-26603

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: “ePACT2, 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.