Exciting new developments with hospital medicines data

Before the pandemic, Brian and Ben Goldacre wrote an article for the BMJ describing the barriers to accessing hospital medicines data and advocating better access and use of hospital medicine data.

Since then, we have been very very busy with the OpenSAFELY project, but there have been huge and rapid developments around hospital medicines data. Vicky and Brian thought it might be useful to give a very very brief update!

Open hospital medicines data - now available

Success! In our BMJ piece we described a few sources of NHS hospital medicines data and how they could be made available like primary care medicines data. Magnificently, the NHS made secondary care medicines data (SCMD) openly available in 2020. You can read the full technical specification of the SCMD but briefly: it is hospital pharmacy stock control data, which is collected and processed by Rx-Info, and is now published on the NHS Business Services Authority website in the NHS dm+d standard we know, love, and have documented well.

When the data was released we took a quick look at how the NHS was using biologic medications for severe asthma. Recently, we carved out some time and we are taking a very deep look at the data in advance of OpenPrescribing Hospitals - more on this soon!

Patient level high cost drugs - now available

At the outset of the pandemic, we established the OpenSAFELY platform which established safe and secure access to the nation’s GP records containing all demographic information, diagnoses, blood tests and prescriptions issued by GPs. But there was a huge gap in medications supplied by hospitals. From experience, we knew that there is patient level information recorded and flowing around the NHS in a standard format for a subset of “high cost medications”. The problem was that it was divided into 200 different subsets based on where you lived, and has never been collated in a single place and made accessible for substantial analysis linked to other records.

Working with partners across the NHS, the OpenSAFELY team led the compilation of the 200 datasets into a single comprehensive dataset on high cost drugs and made it available via OpenSAFELY where it is linked to the primary care record, giving a fuller picture of medication use linked to outcomes. This facilitated important analyses such as whether some drugs for the immune system were having an effect on your risk of dying from COVID.

We have written a very detailed technical description of the dataset and have made recommendations to NHS England and others on how this data can be made more accessible and available for research and analysis on all sorts of medications “stuff”.

EPMA data - coming soon!

In December 2020, the NHS established a daily collection of medicines prescribed and administered to patients from Electronic Prescribing and Medicines Administration (ePMA) systems to support the COVID-19 response. Data was collected from 26 NHS hospital trusts in England between December 2020 and August 2023 that all used the same ePMA system. Some (but not all) of the 26 trusts even provided data from January 2019. The dataset contains an impressive 91.9 million prescriptions and 466.6 million medicine administrations. Although data collection has since stopped, researchers are still able to request the final dataset from the Data Access Request Service (DARS) - NHS England Digital.

All good things needn’t come to an end! The great news is that there are plans to enable the routine collection and analysis of patient level medicines data from secondary care.

It is early days and the team at the Bennett Institute have no plans to do anything with it right now but look forward to seeing if others do! If you are an OpenSAFELY user and would like it to be available please get in touch.

There have been lots of other stuff happening with hospital medicines data - please do shout about the ones we haven’t had time to write about here!