Static outliers for Norfolk And Waveney Health & Care Partnership (STP)

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 Norfolk And Waveney Health & Care Partnership (STP) is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Pericyazine 21115 Antipsychotic drugs 131339 0.16 0.00 0.02 6.32
Hydrogen peroxide 1 Otitis externa 11450 0.00 0.00 0.00 6.01
Zinc paste 1 Barrier preparations 1357 0.00 0.00 0.00 5.78
Emtricitabine and tenofovir alafenamide 3 HIV infection 22 0.14 0.01 0.03 4.40
Nevirapine 1 HIV infection 22 0.05 0.00 0.01 4.26

Prescribing where Norfolk And Waveney Health & Care Partnership (STP) is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Sodium bicarbonate 59 Sodium bicarbonate 60 0.98 1.00 0.01 -2.98
Combined ethinylestradiol 30mcg 18614 Combined hormonal contraceptives 25042 0.74 0.80 0.02 -2.79
Ethinylestradiol 30microgram / Desogestrel 150microgram tab : 72
Ethinylestradiol 30microg / Levonorgestrel 150microg tab : 357
Ethinylestradiol 30microgram / Gestodene 75microgram tablets : 26
Ethinylestradiol 30microgram / Drospirenone 3mg tablets : 62
Marvelon tablets : 202
Microgynon 30 tablets : 1531
Microgynon 30 ED tablets : 481
Ovranette 150microgram/30microgram tablets : 229
Femodene tablets : 159
Femodene ED tablets : 20
Yasmin tablets : 235
Katya 30/75 tablets : 5
Levest 150/30 tablets (Morningside) : 917
Rigevidon tablets : 11349
Gedarel 30microgram/150microgram tablets : 1652
Millinette 30microgram/75microgram tablets : 443
Cimizt 30microgram/150microgram tablets : 5
Lucette 0.03mg/3mg tablets : 790
Maexeni 150microgram/30microgram tablets : 46
Dretine 0.03mg/3mg tablets : 6
Yacella 0.03mg/3mg tablets : 27
Urea hydrogen peroxide 103 Removal of ear wax and other substances 164 0.63 0.82 0.08 -2.35
Amlodipine 253076 Calcium-channel blockers 415069 0.61 0.74 0.06 -2.35
Apixaban 31932 Oral anticoagulants 192536 0.17 0.39 0.10 -2.32