Please expand the indicators below for more information on the 2026/27 scorecard.
Contact your locality medicines manager to discuss the searches that are available to help with the scorecard work.
Prescribing
The antimicrobial prescribing indicator has changed for 2026/27
- In addition to the new measures introduced last year, including duration of courses of amoxicillin 500mg capsules and doxycycline 100mg capsules, we have added an additional target of five day prescribing for phenoxymethylpenicillin tablets. These antimicrobials will be monitored for five day prescribing in accordance with the infection management guidance.
The antibiotic duration of therapy workstream is one of 16 national medicines optimisation opportunities. “Research increasingly demonstrates that short courses of antibiotics are as effective as longer courses in treating patients with uncomplicated infection (Lee et al, 2023), (Garwan et al, 2023). Reflecting this evidence, NICE guidance for common infections routinely recommends the shortest effective course of treatment, to reduce selection pressure for antimicrobial resistance and inadvertent patient harm from antibiotic treatment. Five-day courses are recommended when antibiotics are indicated for sinusitis, sore throat, COPD infective exacerbation, cough (acute), pneumonia (community-acquired) and otitis media.”
Resources to support the work on the amoxicillin and doxycycline work can be found under the Shorter is Better banner on the ICB Antimicrobials webpage, with a helpful one minute video explaining the rationale.
Antimicrobial targets
- We continue to include the NHSE target for the overall quantity of antimicrobial prescriptions. (This is currently <0.871 Antibacterial Items per STAR-PU).
- Five day prescribing for amoxicillin target ≥ 80%
- Five day prescribing for doxycycline target ≥ 55%
- Five day prescribing for phenoxymethylpenicillin ≥ 55%
Practices will need to achieve three of these four targets and have a practice sepsis lead in order to be green on this scorecard indicator.
ICB Infection Management Guidance should be used to guide prescribing decisions. Please visit our Infection Management page for more information.
Target > 90% reviewed
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 > 20%
Eclipse is the best risk reduction tool available to practices. Please see our Medication Safety page for more information on Eclipse.
Target >70%
For an up to date list of Project Positive items please contact your locality manager.
Please see our Respiratory page for more resources.
Target >70%
For an up to date list of Project Positive items please contact your locality manager.
Please see our Respiratory page for more resources.
Target = Practice achieves 2 out of 3 of the following CVDPrevent indicators by Q4 (Mar 26 or Dec 25 data publication)
60% Patients with GP recorded chronic kidney disease (G3a to G5), who are currently treated with lipid lowering therapy - CVDP010CHOL
65% Patients with no GP recorded CVD and a GP recorded QRISK score of 20% or more, who are currently treated with lipid lowering therapy - CVDP003CHOL
85% Patients with GP recorded CVD (narrow definition), who are currently treated with lipid lowering therapy - CVDP009CHOL
Resources: Somerset Score Card - Cardiovascular Indicator Supporting Tool May 25
Target <15 per 1000 patient list size. Please see the updated Eclipse search:
Medications which require contraception/ avoidance of pregnancy - Review ahead of pregnancy needed. Scorecard 26/27:
Patients biologically able to become pregnant taking any: warfarin, rivaroxaban, apixaban, dabigatran, edoxaban, carbimazole, modafinil, pregabalin, methotrexate, zonisamide, carbamazepine, phenytoin, phenobarbital, atorvastatin, fluvastatin, pravastatin, rosuvastatin, simvastatin, ezetimibe, bempedoic acid, epiduo, differin, GLP1s, SGLT2s, DPP4s, tirzepatide, chlordiazepoxide, topiramate, valproate, valproic, isotretinoin, dronedarone, letrozole, anastrozole, exemestane, tamoxifen, fingolimod, ruxolitinib and clascoterone.
This is not an exhaustive list, refer to individual SmPCs, MHRA warning and Pregnancy Prevention Programmes. To review patients with no oral contraceptives, coded as infertile, sterilised, post-menopausal or fitted with a LARC.
This indicator aims to improve pregnancy planning, support families to stay well and improve information on access to contraception and safely taking medications while having potential to become pregnant.
For helpful resources please see our Pregnancy Planning with Long Term Conditions - NHS Somerset ICB, Medicines used in pregnancy and Medication safety pages.
Please note: any patients excluded from these searches will still count towards the indicator calculation. This indicator does not aim to stop treatment that is needed, but to improve informed consent, contraception conversations and access to support in planning pregnancy with long term conditions.
% of denosumab prescribed as a biosimilar
Target > 75% measured from Oct 2026 - Mar 2027
Achievement of all 3 NDA targets (statin, BP and HbA1C)
National Diabetes Audit Core Report 1: Care Processes and Treatment Targets 2024-25 Underlying data
Target ≥ 50%
Target <39 opiate ADQ per 1000 Astro Pu (or Jan - March 2026 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 our 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 £450k each year by switching expensive brands to generic.
Target <£500 per 1000 patients over 3 months (or Jan to March 2026 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 including resources for the Food First Approach.
Target <4.00 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 who are deficient in vitamin D (<25nmol/l) should be prescribed a fixed loading dose as advised in formulary chapter 09.06.04. Patients with insufficient vitamin D levels should be signposted to self-care.
NICE guidance Bisphosphonates for treating osteoporosis
Please note: any patients excluded from these searches will still count towards the indicator calculation.
Generic dapagliflozin as a % of all diabetes drugs
Target > 350 dapagliflozin items per 1000 items for antidiabetic drugs
See our Diabetes page for more information.
Reduction in use of edoxaban in favour of formulary cost-effective choices, including generic rivaroxaban and generic apixaban, as clinically appropriate.
This workstream spans five indicators from a 10% reduction, 20% reduction, 30% reduction, 40% reduction and 50% reduction from the October 2025 baseline.
This is in line with the NHSE Operational note: Commissioning recommendations for national procurement for direct-acting oral anticoagulant(s) (DOACs) which focuses on switching patients with atrial fibrillation. The scorecard indicator covers all edoxaban use.
See CVD page for more information and the pregnancy, children and lactation page for anticoagulation in pregnancy and lactation.
Reduction in use of edoxaban in favour of formulary cost-effective choices, including generic rivaroxaban and generic apixaban, as clinically appropriate.
This workstream spans five indicators from a 10% reduction, 20% reduction, 30% reduction, 40% reduction and 50% reduction from the October 2025 baseline.
This is in line with the NHSE Operational note: Commissioning recommendations for national procurement for direct-acting oral anticoagulant(s) (DOACs) which focuses on switching patients with atrial fibrillation. The scorecard indicator covers all edoxaban use.
See CVD page for more information and the pregnancy, children and lactation page for anticoagulation in pregnancy and lactation.
Reduction in use of edoxaban in favour of formulary cost-effective choices, including generic rivaroxaban and generic apixaban, as clinically appropriate.
This workstream spans five indicators from a 10% reduction, 20% reduction, 30% reduction, 40% reduction and 50% reduction from the October 2025 baseline.
This is in line with the NHSE Operational note: Commissioning recommendations for national procurement for direct-acting oral anticoagulant(s) (DOACs) which focuses on switching patients with atrial fibrillation. The scorecard indicator covers all edoxaban use.
See CVD page for more information and the pregnancy, children and lactation page for anticoagulation in pregnancy and lactation.
Reduction in use of edoxaban in favour of formulary cost-effective choices, including generic rivaroxaban and generic apixaban, as clinically appropriate.
This workstream spans five indicators from a 10% reduction, 20% reduction, 30% reduction, 40% reduction and 50% reduction from the October 2025 baseline.
This is in line with the NHSE Operational note: Commissioning recommendations for national procurement for direct-acting oral anticoagulant(s) (DOACs) which focuses on switching patients with atrial fibrillation. The scorecard indicator covers all edoxaban use.
See CVD page for more information and the pregnancy, children and lactation page for anticoagulation in pregnancy and lactation.
Reduction in use of edoxaban in favour of formulary cost-effective choices, including generic rivaroxaban and generic apixaban, as clinically appropriate.
This workstream spans five indicators from a 10% reduction, 20% reduction, 30% reduction, 40% reduction and 50% reduction from the October 2025 baseline.
This is in line with the NHSE Operational note: Commissioning recommendations for national procurement for direct-acting oral anticoagulant(s) (DOACs) which focuses on switching patients with atrial fibrillation. The scorecard indicator covers all edoxaban use.
See CVD page for more information and the pregnancy, children and lactation page for anticoagulation in pregnancy and lactation.
