Organising Organisations: Hospital Trusts in OpenPrescribing Hospitals

The SCMD contains data on medications issued at the level of NHS Trusts. This allows analysis of variation in medicines usage across different hospitals. But the NHS has a complex hierarchical structure which is often changing. Before analysing the SCMD, you therefore need to understand what NHS Trusts are, how they can be identified and how they change over time. You also need to be aware of any potential data quality issues as the coverage and completeness of data within the SCMD is dependent on Trusts submitting their data. That is the topic of this series of blog posts.

In the first blog in this series, we will describe which NHS Trusts are included, how they are identified in the SCMD and how they can change over time. In the two blogs that follow, we will outline two Trust-level data quality issues to be aware of when working with the SCMD. We will then show the Submission History feature we have developed as part of the OpenPrescribing Hospitals platform to make all of this easier to understand.

Which Trusts are included in the SCMD?

The SCMD data contains data from all NHS Trusts in England including all NHS Acute, Teaching, Specialist, Mental Health and Community Trusts (it does not include medications dispensed by community pharmacies, but this is available separately). These Trusts are identified using NHS Organisational Data Service (ODS) codes. ODS codes have a structured format consisting of alphanumeric characters, usually 3 to 5 characters long. The structure and length can vary depending on the type of organisation the code represents. The Trusts in the SCMD all have 3 character ODS codes. For example, Manchester University NHS Foundation Trust has the ODS code R0A.

Trusts vs Sites

NHS Trusts can have multiple sites. For example, Manchester Royal Infirmary and Wythenshawe (amongst others) are sites belonging to Manchester University NHS Foundation Trust. Data within the SCMD is reported at Trust level, so although individual sites contributing to a Trusts data can be identified, their contribution cannot be disambiguated.

Trusts can change over time

From time to time Trusts merge or are acquired by another Trust. When this happens, any future data published in the SCMD will be aggregated under a single ODS code (that of the successor Trust) but historical data does not get updated. To map historical data from a Trust whose code is no longer active (a predecessor Trust), you need to understand when these mergers and acquisitions take place. Information on when these changes occur and new Trust name or ODS codes that are created can be found via the ODS Portal provided by NHS Digital or the associated ORD API (a way to programmatically access the data).

Due to the way data is submitted to the SCMD, a small number of Trusts may continue to submit data as separate Trusts following a merger or acquisition. One reason for this is that they maintain separate pharmacy systems which can make it difficult to submit aggregated data. A supplementary mapping file is provided with the SCMD data detailing these cases.

Mapping Trusts to ICB and regions

As well as identifying individual Trusts within the SCMD data, it can be useful to explore trends in medicines across multiple Trusts under the same parent organisation or in the same geographical region. In addition to indicating relationships between Trusts and their predecessors, if they have one, the ORD API also allows you to derive the hierarchy of NHS organisations, including the Integrated Care Board (ICB) and region in England for a Trust.

How many Trusts are there in SCMD?

As of September 2024, there were 224 Trusts identified with unique ODS codes who had submitted data to the SCMD since January 2019. Due to organisational changes that can occur to Trusts, the number of Trusts submitting data each month varies, as shown below. In September 2024, 196 Trusts submitted data.

What does the Trust data look like?

Once all of the information above has been found for individual Trusts, it looks something like the table below. There is one row for every Trust included in the SCMD (at any point), with an indication of succession, and higher level geography.

ODS Code	ODS Name	Successor ODS code	Succession date	ICB	Region
RBZ	Northern Devon Healthcare NHS Trust	RH8	2022-03-31	NHS Devon	South West
RH8	Royal Devon University Healthcare NHS Foundation Trust	-	-	NHS Devon	South West

This information can then be used to aggregate medicines usage for related Trusts and allows you to see patterns in the data they submit over time, including any changes that might occur around organisational changes. The patterns in this aggregated data will be discussed in the following blogs in this series.

We’d love your feedback

If you have any feedback about our approach to Trusts or if you would like to be involved in the development of OpenPrescribing Hospitals, please send an email our way: bennett@phc.ox.ac.uk. You can also keep up with updates to OpenPrescribing.net or OpenPrescribing Hospitals by signing up to our newsletter.