Clinical Practice Research Datalink

Quality improvement: prescribing and patient safety reports

The RCGP and Clinical Practice Research Datalink (CPRD) have developed confidential bespoke practice and patient-level drug prescribing reports, available for free for GP practices contributing to CPRD. There are two sets of reports, distributed every six months to practices in all four nations of the UK. You can sign up to receive the reports on the CPRD website

Aims of the project

The project supports quality improvement within general practice by developing and distributing innovative data reports for GPs that focus on prescribing and patient safety.

Key outputs 

The Heart and Circulatory System report includes three indicators taken from the RCGP patient safety toolkit and one that was suggested by NICE: 

  • Prescription of glitazones to patients with heart failure
  • Prescription of NSAIDs to patients with heart failure
  • Prescription of NSAIDs to patients with chronic kidney disease (CKD)
  • Aspirin monotherapy for stroke prevention in patients with atrial fibrillation

The Learning Disabilities report includes indicators developed from the Stopping over medication of people with a learning disability, autism or both (STOMP) project:

  • Prescription of anti-psychotics to over-16s with Learning Disabilities and/or Autism
  • Prescription of anti-depressants to over-16s with Learning Disabilities and/or Autism

Both reports show: 

  • The practice’s prescription rate benchmarked against all practices in the CPRD network
  • Pseudonymised identifiers to enable re-identification of patients whose care might need review
  • Recommendations for next steps, based on NICE guidance
  • Links to further information 
  • Heart and Circulatory System report

The reports are distributed to GP practices in the CPRD network every six months. Because the reports are based on the CPRD data extract, practices that are not already in the CPRD network will need to sign up by completing the application form on the CPRD website. (Please tick the box ‘RCGP/quality improvement’ under ‘How did you hear about us?’ on the joining form.) 

Participating practices are surveyed every time the reports are sent out, and qualitative feedback is also gathered face to face and by phone. From this feedback, we know that the reports are used in these ways:

  • To review the care of individual patients highlighted in the reports – where necessary, patients have their treatment changed.
  • As the starting-point for discussions involving all clinicians within the practice around safe prescribing.
  • As evidence for annual appraisals, under Domain 2 – Safety and Quality.

You can find out more about how practices are using the reports for quality improvement:

  •  In the videos below, Dr Scott Jamieson, RCGP Scotland Quality Improvement lead, provides an overview of the data reports and how they can be used by practices. 




  • Dr Tommy Hunter has written a blog on how he has used the reports as part of his work to improve outcomes for patients within his practice.
  • David Mullett, the RCGP Champion for this project, has written a blog about how the project uses patient data to improve patient safety for Understanding Patient Data, which is aimed at patients and the public.
  • There is also a project page on the CPRD website. 

    Forthcoming work

    The project is currently being evaluated to determine its impact on prescribing rates.
    We are always keen to hear from GPs and other practice staff about how you would like the project to develop. Please email David Mullett with any feedback or suggestions for additional topics that could be covered by the reports.

    Clinical team 

    David Mullett

     

    David Mullett

    The RCGP Champion for this project is David Mullett. David’s background is in using data for quality improvement across the healthcare system –both in primary care and acute settings. His first role with RCGP was at the Research and Surveillance, from where he moved to set up this Quality Improvement project. You can email him at david.mullett@rcgp.org.uk

     

     

     

     

     


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