Static outliers for NHS Southport And Formby CCG

There is substantial variation in prescribing behaviours, across various different areas of medicine. Some variation can be explained by demographic changes, or local policies or guidelines, but much of the remaining variation is less easy to explain. At OpenPrescribing we are piloting a number of data-driven approaches to identify unusual prescribing and collect feedback on this prescribing to inform development of new tools to support prescribers and organisations to audit and review prescribing.

This report has been developed to automatically identify prescribing patterns at a chemical level which are furthest away from “typical prescribing” and can be classified as an “outlier”. We calculate the number of prescriptions for each chemical in the BNF coding system using the BNF subparagraph as a denominator, for prescriptions dispensed between April 2021 and August 2021. We then calculate the mean and standard deviation for each numerator and denominator pair across all practices/CCGs/PCNs/STPs. From this we can calculate the “z-score”, which is a measure of how many standard deviations a given practice/CCG/PCN/STP is from the population mean. We then rank your “z-scores” to find the top 5 results where prescribing is an outlier for prescribing higher than its peers and those where it is an outlier for prescribing lower than its peers.

It is important to remember that this information was generated automatically and it is therefore likely that some of the behaviour is warranted. This report seeks only to collect information about where this variation may be warranted and where it might not. Our full analytical method code is openly available on GitHub here.

The DataLab is keen to hear your feedback on the results. You can do this by completing the following survey or emailing us at ebmdatalab@phc.ox.ac.uk. Please DO NOT INCLUDE IDENTIFIABLE PATIENT information in your feedback. All feedback is helpful, you can send short or detailed feedback.

Prescribing where NHS Southport And Formby CCG is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Amphotericin 9 Oropharyngeal anti-infective drugs 172 0.05 0.00 0.01 10.11
Oils for the ear 10 Removal of ear wax and other substances 31 0.32 0.01 0.04 7.99
Aceclofenac 65 Non-steroidal anti-inflammatory drugs 10257 0.01 0.00 0.00 6.82
Ramipril with calcium channel blocker 45 Angiotensin-converting enzyme inhibitors 48862 0.00 0.00 0.00 5.79
Zoledronic acid 1 Bisphosphonates and other drugs 7574 0.00 0.00 0.00 5.49

Prescribing where NHS Southport And Formby CCG is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Miconazole 163 Oropharyngeal anti-infective drugs 172 0.95 1.00 0.01 -10.11
Urea hydrogen peroxide 13 Removal of ear wax and other substances 31 0.42 0.84 0.11 -3.92
Somatropin 0 Hypothalamic & anterior pituitary hormone & antioestrogens 3 0.00 0.87 0.25 -3.48
Macrogol 3350 7542 Osmotic laxatives 14429 0.52 0.71 0.07 -2.78
Macrogol compound oral powder sachets NPF sugar free : 2104
Macrogol compound half-strength oral pdr sach NPF sugar free : 3
Macrogol compound oral liquid NPF sugar free : 17
Movicol oral powder 13.8g sachets lemon & lime : 351
Movicol-Half oral powder 6.9g sachets : 23
Movicol Plain oral powder 13.7g sachets : 121
Movicol Chocolate oral powder 13.9g sachets : 13
Movicol Liquid : 14
Movicol Paediatric Plain oral powder 6.9g sachets : 594
Movicol Paediatric Chocolate oral powder 6.9g sachets : 32
Laxido Orange oral powder sachets sugar free : 4165
Laxido Paediatric Plain oral powder 6.9g sachets : 77
CosmoCol Orange Lemon and Lime oral powder sachets : 11
CosmoCol Orange Flavour oral powder sachets : 3
CosmoCol Lemon and Lime Flavour oral powder sachets : 8
CosmoCol Paediatric oral powder 6.9g sachets : 4
CosmoCol Plain oral powder sachets : 2
Beclometasone dipropionate 374 Drugs used in nasal allergy 9243 0.04 0.24 0.08 -2.50