Static outliers for South Southall 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 South Southall PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Heparin calcium 1 Parenteral anticoagulants 21 0.05 0.00 0.00 21.44
Tretinoin 4 Topical preparations for acne 635 0.01 0.00 0.00 19.98
Hydrocortisone acetate 1 Local corticosteroid injections 47 0.02 0.00 0.00 16.39
Gripe mixtures 4 Sodium bicarbonate 4 1.00 0.01 0.07 13.77
Buserelin 1 Prostate cancer and gonadorelin analogues 119 0.01 0.00 0.00 10.80

Prescribing where South Southall PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Sodium bicarbonate 0 Sodium bicarbonate 4 0.00 0.99 0.07 -13.77
Sodium cromoglicate 0 Cromoglycate and related therapy 1 0.00 0.97 0.15 -6.67
Colecalciferol 7912 Vitamin D 8836 0.90 0.97 0.01 -4.94
Colecalciferol 3,000unit tablets : 2
Colecalciferol 800unit capsules : 155
Colecalciferol 1,000unit tablets : 90
Colecalciferol 1,000unit capsules : 23
Colecalciferol 400unit capsules : 1
Colecalciferol 10,000units/ml oral solution : 1
Colecalciferol 400unit / Calcium carbonate 1.5g tablets : 122
Colecalciferol 2,000units/ml oral drops sugar free : 4
Colecalciferol 200unit / Calcium carbonate 1.25g chew tab : 37
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 8
Colecalciferol 440unit/Calcium carb 1.25g efferv gran sach : 5
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 418
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 12
Colecalciferol 400unit / Calcium carbonate 1.25g tablets : 26
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 13
Colecalciferol 400units/dose oral spray sugar free : 5
Colecalciferol 2,200unit tablets : 3
Colecalciferol 10,000unit tablets : 1
Colecalciferol 20,000unit tablets : 23
Colecalciferol 800unit tablets : 61
Colecalciferol 40,000unit capsules : 7
Colecalciferol 2,000unit tablets : 2
Colecalciferol 3,200unit capsules : 2
Colecalciferol 25,000units/1ml soln ud amp sugar free : 2
Colecalciferol 800unit / Calcium carbonate 2.5g chewable tab : 1
Colecalciferol 2,400units/ml oral drops sugar free : 9
Colecalciferol 20,000unit capsules : 100
Colecalciferol 10,000unit capsules : 1
Colecalciferol 400unit tablets : 2
Colecalciferol 400units/ml oral drops sugar free : 2
Pro D3 400unit capsules : 10
Pro D3 1,000unit capsules : 8
Pro D3 2,500unit capsules : 1
Pro D3 20,000unit capsules : 4
Pro D3 2,000units/ml liquid drops : 1
Pro D3 2,000units/ml liquid : 27
Pro D3 800unit capsules : 14
Accrete D3 tablets : 628
Accrete D3 One a Day 1000mg/880unit chewable tablets : 13
Valupak Vitamin D3 1,000unit tablets : 39
Adcal-D3 chewable tablets tutti frutti : 386
Adcal-D3 Lemon chewable tablets : 172
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 64
Adcal-D3 750mg/200unit caplets : 1261
Calceos 500mg/400unit chewable tablets : 761
Calcichew D3 chewable tablets : 152
Calcichew D3 Forte chewable tablets : 151
Calcichew D3 500mg/400unit caplets : 2
Calcichew D3 1000mg/800unit Once Daily chewable tablets : 3
Calfovit D3 oral powder sachets : 4
SunVit-D3 1,000unit tablets : 1
SunVit-D3 10,000unit tablets : 1
SunVit-D3 2,000units/ml oral drops : 5
Fultium-D3 800unit capsules : 981
Fultium-D3 3,200unit capsules : 52
Fultium-D3 20,000unit capsules : 372
Fultium-D3 2,740units/ml oral drops : 5
DLux 400 oral spray : 1
Pro D3 forte 3,000units/ml liquid : 2
Hux D3 20,000unit capsules : 556
Hux D3 3,200unit capsules : 2
Aciferol D3 10,000unit tablets : 3
Desunin 800unit tablets : 72
Plenachol D3 20,000unit capsules : 7
Plenachol D3 40,000unit capsules : 2
OsteoCaps D3 20,000unit capsules : 2
Evacal D3 1500mg/400unit chewable tablets : 2
InVita D3 25,000units/1ml oral solution : 375
InVita D3 2,400units/ml oral drops : 42
InVita D3 800unit capsules : 34
Stexerol-D3 1,000unit tablets : 105
Stexerol-D3 25,000unit tablets : 397
Calci-D 1000mg/1,000unit chewable tablets : 54
Somatropin 0 Hypothalamic & anterior pituitary hormone & antioestrogens 15 0.00 0.89 0.25 -3.49
Furosemide 2985 Loop diuretics 4753 0.63 0.85 0.07 -3.19