Scorecard 2023/24

Target yes

This is measured monthly using two indicators. The quantity of all antibiotics must be within the national target and reducing trimethoprim items for patients aged ≥70 years. To be green practices will need to achieve both parts of the indicator and have a practice sepsis lead.

Antibiotic prescribing data is sent to practices each month.

Please visit our Infection Management page for more information.

Target <0.5 per 1000 Astro Pu

Eclipse is the best risk reduction tool available to practices. Please see our Medication Safety page for more information on Eclipse.

Medicines Safety Improvement Programme

Please note: any patients excluded from these searches will still count towards the indicator calculation.

Target <7%

This indicator measures the number of patients with learning difficulties and/or dementia that are prescribed antipsychotic medication but have no diagnosis of psychosis. People with dementia who are receiving antipsychotic medication should have their prescriptions reviewed at least every 6 weeks.

STOMP stands for stopping over medication of people with a learning disability, autism or both with psychotropic medicines. It is a national project involving many different organisations which are helping to stop the over use of these medicines.

The WHELD programme supports care home staff to deliver patient-centred interventions for residents with dementia. It seeks to reduce the use of antipsychotic drugs in dementia care home residents.

Appropriate prescribing of antipsychotic medication in dementia provides guidance and information on uses, risks and alternatives to antipsychotic medication, risk reduction in antipsychotic prescribing, and support for local systems to deliver best practice in antipsychotic prescribing and de-prescribing where appropriate.

Please note: any patients excluded from these searches will still count towards the indicator calculation.

Target <0.70% of patients with an anticholinergic burden of 6 or more

An increasing number of systematic reviews and meta-analyses report that medicines with anticholinergic effects are associated with an increased risk of cognitive impairment, falls and all-cause mortality in older people.

The term anticholinergic burden refers to the cumulative effect of using multiple medications with anticholinergic properties concomitantly.

Please see our Deprescribing page for more information.

Target >7.60 ADQ per 1000 Astro Pu

Increasing ezetimibe use will support the two new CVD focused indicators in QOF and adoption of the NICE lipid management guidance.

Using ezetimibe in patients unable to tolerate high dose statins/any statin or not reaching LDL targets on their statin is a cost effective way to get further lipid improvements.

Target <8%

This measures the number of patients on mixed pathways. The aim is to have patients on either MDI or DPI inhalers.

Please note: any patients excluded from these searches will still count towards the indicator calculation.

Please visit our Respiratory page.

Target >60%

For an up to date list of Project Positive items please contact your locality manager.

Please see our Respiratory page for more resources.

Target >60%

For an up to date list of Project Positive items please contact your locality manager.

Please see our Respiratory page for more resources.

Target <15 per 1000 patient list size

Please see the Eclipse search Medications to avoid in pregnancy due to increased risk – Contraception and planning ahead of pregnancy reviews needed.

The list of medication includes: warfarin, rivaroxaban, apixaban, dabigatran, carbimazole, modafinil, topiramate, pregabalin, zonisimide, valproate, valproic acid, carbamazepine, phenytoin, phenobarbital, atorvastatin, fluvastatin, pravastatin sodium, rosuvastatin, simvastatin, ezetimibe, methotrexate, isotretinoin, epiduo or differin. 

This is not an exhaustive list, refer to individual SPCs, MHRA warnings and Pregnancy Prevention Programmes. Searches exclude patients coded as infertile (such as hysterectomy), post menopausal, fitted with a LARC or on oral contraceptive.

For helpful resources please see our Medicines used in pregnancy and Medication safety pages.

Please note: any patients excluded from these searches will still count towards the indicator calculation.

Target >35% of all GnRH patients

The recommended dose of Decapeptyl SR 22.5 mg is 22.5 mg of triptorelin (1 vial) administered every six months (twenty four weeks) as a single intramuscular injection.

Switching suitable patients currently prescribed a three monthly GnRH will support the ICB carbon footprint reduction strategy. Two less devices used each year and two less patient journeys for administration. It will also free up nursing time so supporting the access agenda.

Target >35% of all GnRH patients

The recommended dose of Decapeptyl SR 22.5 mg is 22.5 mg of triptorelin (1 vial) administered every six months (twenty four weeks) as a single intramuscular injection.

Switching suitable patients currently prescribed a three monthly GnRH will support the ICB carbon footprint reduction strategy. Two less devices used each year and two less patient journeys for administration. It will also free up nursing time so supporting the access agenda.

Target >70% of all 8 care processes undertaken in the last twelve months

The tests are HbA1c, blood pressure, cholesterol, weight/BMI, eGFR, microalbuminuria, smoking and foot screening.

NHS Pathways has the most current data on your practice. If you do not have an account please contact support@prescribingservices.org

Target <120ml per 1000 analgesic Star Pu

Liquid morphine has a high sugar and alcohol content.

Please see our Pain Management page for more resources

Target <2% of all metformin and/or gliptin patients

Patients with Type 2 Diabetes prescribed metformin and/or gliptin do not require regular blood glucose monitoring and so should not be prescribed blood glucose testing strips on repeat.

Reducing such prescribing will support the ICB carbon footprint reduction strategy (similarly these patients will not require lancets), reduce waste and ensure patients are not having inappropriate finger prick tests.

NICE Guidance: Type 2 diabetes in adults

Target <39 opiate ADQ per 1000 Astro Pu (or Jan -March 2024 data has reduced by 10% compared to baseline)

The volume of prescribing is measured in Average Daily Quantities. For a given drug, the Average Daily Quantity is a value calculated to reflect the daily dose typically prescribed to individual patients within UK General Practices.

NICE guidelines Chronic pain in over 16s: assessment of all chronic pain and management of chronic primary pain

Please see the Pain Management page for more resources.

Target <215 ADQ per 1000 patients

Anxiolytics and Hypnotics are drugs that are prescribed for short-term treatment of conditions such as anxiety and sleep problems. The Royal College of Psychiatrists states that “around 4 in every 10 people who take them every day for more than 6 weeks will become addicted” and therefore they should not be prescribed for longer than 4 weeks. This measure shows the mean Average Daily Quantity (ADQ) given per prescription, for both the older benzodiazepines, such as diazepam and temazepam, and the newer “Z-drugs”, such as zopiclone.

NICE advice Hypnotics

Please see our Hypnotics and Anxiolytics page for more resources.

Target <0.25% per quarter

Savings that could be achieved by changing from proprietary to generic prescribing for drugs identified at a national level as having the greatest potential to release additional resources. This is sent out quarterly in an email from the Medicines Management team. Please review and make the suggested switches.

NHS Somerset could save over £300k each year by switching expensive brands to generic.

Target <£375 per 1000 patients

The GMC says ‘Prescribing’ is used to describe many related activities, including advising patients on the purchase of over the counter medicines and other remedies.

The NHS has produced a document which lists the conditions which should be classed as self care.

Please see the Self Care page for more resources.

Target <£500 per 1000 patients over 3 months (or Jan -March 2024 data has reduced by 10% compared to baseline)

This can be best achieved by

• recommending a food first approach – including care home residents and prescribing sip feeds only as per the formulary.
• Only using compact sip feeds in those patients who are clinically fluid restricted
• Setting a weight stabilisation target as per MUST
• Reviewing all sip feed patients regularly and only putting sip feeds on acute prescription

Please see the Nutrition page for more information.

Target >40%

Please see our Dermatology page for more resources.

For an up to date list of Project Positive items please contact your locality medicines manager.

Target <4.05 per 1000 Astro Pu

Patients prescribed a bone sparing agent such as a bisphosphonate will need calcium with vitamin D prescribed as part of their treatment regime. Those who are not on a bone sparing medication are not indicated for calcium or vitamin D alone or in combination.

No vitamin D or combination vitamin D and calcium product is licensed for fracture prevention when used without
a bone sparing agent.

Patients deficient in vitamin D are eligible for self-care.

NICE guidance Bisphosphonates for treating osteoporosis

Please note: any patients excluded from these searches will still count towards the indicator calculation.