Static outliers for Clacton PCN

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 Clacton PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Lidocaine hydrochloride 4 Topical local anaesthetics and antipruritics 126 0.03 0.00 0.00 21.00
Co-flumactone (Hydroflumethiazide/spironolactone) 52 Potassium sparing diuretics and compounds 422 0.12 0.00 0.01 13.93
Enzalutamide 3 Prostate cancer and gonadorelin analogues 308 0.01 0.00 0.00 10.61
Hydrocortisone butyrate 85 Topical corticosteroids 3019 0.03 0.00 0.00 6.87
Nedocromil sodium 1 Cromoglycate and related therapy 1 1.00 0.03 0.15 6.67

Prescribing where Clacton PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Sodium cromoglicate 0 Cromoglycate and related therapy 1 0.00 0.97 0.15 -6.67
Sumatriptan succinate 676 Treatment of acute migraine 1401 0.48 0.66 0.07 -2.66
Naproxen 3963 Non-steroidal anti-inflammatory drugs 7154 0.55 0.69 0.06 -2.17
Macrogol 3350 2390 Osmotic laxatives 4227 0.57 0.72 0.07 -2.15
Macrogol compound oral powder sachets NPF sugar free : 441
Macrogol compound half-strength oral pdr sach NPF sugar free : 9
Macrogol 3350 oral powder 8.5g sachets sugar free : 10
Movicol oral powder 13.8g sachets lemon & lime : 142
Movicol-Half oral powder 6.9g sachets : 16
Movicol Plain oral powder 13.7g sachets : 40
Movicol Chocolate oral powder 13.9g sachets : 6
Movicol Liquid : 6
Movicol Paediatric Plain oral powder 6.9g sachets : 125
Movicol Paediatric Chocolate oral powder 6.9g sachets : 2
Laxido Orange oral powder sachets : 2
Laxido Orange oral powder sachets sugar free : 1364
Laxido Paediatric Plain oral powder 6.9g sachets : 90
Molaxole oral powder sachets : 1
CosmoCol Orange Lemon and Lime oral powder sachets : 17
CosmoCol Orange Flavour oral powder sachets : 59
CosmoCol Lemon and Lime Flavour oral powder sachets : 42
CosmoCol Paediatric oral powder 6.9g sachets : 16
CosmoCol Half oral powder 6.9g sachets : 2
Oxybutynin 243 Drugs for urinary frequency enuresis and incontinence 3462 0.07 0.18 0.06 -1.94