Skip to main content

If you would like Emis searches that will help with scorecard work then please contact your locality manager.

1. Antimicrobial prescribing targets and has a sepsis lead

Target yes

This is measured quarterly for two indicators. Antibacterial items per Star PU and Trimethoprim items for patients aged ≥70 years in a combined indicator. Practices meeting both of these indicators will show as green on the scorecard.

Antibiotic prescribing data is sent to practices each quarter.

Please visit our Infection Management page for more information.

2. Reduction in radar red and amber alerts

Target <0.5 per 1000 Astro Pu

Eclipse is the best risk reduction tool available to practices.

Medicines Safety Improvement Programme

Please note: any patients excluded from these searches will still count towards the indicator calculation.

3. Percentage LD and Dementia patients prescribed antipsychotics

Target <9%

This indicator measures the number of patients with learning difficulties and/or dementia that are prescribed antipsychotic medication but have no diagnosis of psychosis. People with dementia who are receiving antipsychotic medication should have their prescriptions reviewed at least every 6 weeks.

STOMP stands for stopping over medication of people with a learning disability, autism or both with psychotropic medicines. It is a national project involving many different organisations which are helping to stop the over use of these medicines.

The WHELD programme supports care home staff to deliver patient-centred interventions for residents with dementia. It seeks to reduce the use of antipsychotic drugs in dementia care home residents.

Please note: any patients excluded from these searches will still count towards the indicator calculation.

4. DOAC patients co-prescribed PPI

Target >70%

We measure patients on a DOAC with no PPI or H2RA against all DOAC patients to give us a percentage.

NICE guidelines Assessment of stroke and bleeding risks

Please note: any patients excluded from these searches will still count towards the indicator calculation.

5. Percentage of patients on same inhaler type

Target 90% reduction

This measures the number of patients on mixed pathways. The aim is to have patients on either MDI or DPI inhalers.

Please note: any patients excluded from these searches will still count towards the indicator calculation.

Please visit our Respiratory page.

6. Cost effective LABA and steroid combination inhalers

Target >75%

This measures all LABA/ steroid combination inhalers against the prescribing of the CCG preferred brands.

For an up to date list of Project Positive items please contact your locality medicines manager.

Please visit our Respiratory page for more information.

7. Blood glucose test strips £9.25 or less per pack of 50

Target >70%

Do not routinely offer self-monitoring of blood glucose levels for adults with type 2 diabetes unless: the person is on insulin or there is evidence of hypoglycaemic episodes or the person is on oral medication that may increase their risk of hypoglycaemia while driving or operating machinery or the person is pregnant, or is planning to become pregnant.

For an up to date list of Project Positive items please contact your locality medicines manager.

Please visit our Diabetes page for the most up to date information on test strip prices.

8. Gliflozins as a percentage of all gliflozins+gliptins

Target >50%

This measures SGLT-2 as a percentage of all SGLT-2 and gliptins.

This includes nondiabetic patients who may have dapagliflozin recommended for initiation for chronic heart failure as per NICE TA679. Prescribing of both a gliflozin and gliptin is not recommended and given the growing cardiovascular outcome data for gliflozins in patients with diabetes they should now be favoured ahead of gliptins and suitable patients should be switched to a gliflozin with CVD evidence.

For an up to date list of Project Positive items please contact your locality medicines manager.

9. Reduction in vitamin D and calcium prescribing with no bone sparing agent

Target <4.05 per 1000 Astro Pu

Patients prescribed a bone sparing agent such as a bisphosphonate will need calcium with vitamin D prescribed as part of their treatment regime. Those who are not on a bone sparing medication are not indicated for calcium or vitamin D alone or in combination.

Patients deficient in vitamin D are eligible for self-care.

NICE guidance Bisphosphonates for treating osteoporosis

Please note: any patients excluded from these searches will still count towards the indicator calculation.

10. Increase high intensity statin prescribing as a percentage of all statins

Target >65%

Atorvastatin 20mg or above and rosuvastatin 10mg or above as a percentage of all statins. These reduce LDL cholesterol by more than 40%. Please note that MHRA report an increased risk of myopathy with 80mg simvastatin so this is not a preferred option.

NICE guidelines Cardiovascular disease: risk assessment and reduction, including lipid modification

For an up to date list of Project Positive items please contact your locality medicines manager.

11. CCG Formulary preferred opiate formulations

Target >80%

As a system we try to keep to specific cost effective branded opiate prescribing as this reduces the risk as patients move across boundaries between primary and secondary.

For an up to date list of Project Positive items please contact your locality medicines manager.

Please see the Pain Management page for more resources.

12. Reduce opiate prescribing (excluding injectables)

Target <43 opiate ADQ per 1000 Astro Pu (or Jan -March 2022 data has reduced by 10% compared to baseline)

The volume of prescribing is measured in Average Daily Quantities. For a given drug, the Average Daily Quantity is a value calculated to reflect the daily dose typically prescribed to individual patients within UK General Practices

NICE guidelines Chronic pain in over 16s: assessment of all chronic pain and management of chronic primary pain

Please see the Pain Management page for more resources.

13. Potential generic savings

Target <0.25% per quarter

Savings that could be achieved by changing from proprietary to generic prescribing for drugs identified at a national level as having the greatest potential to release additional resources. This is sent out quarterly in an email from the Medicines Management team. Please review and make the suggested switches.

Somerset CCG could save £300k each year by switching expensive brands to generic.

14. NHSE OTC selfcare indicators

Target <£375 per 1000 patients

The GMC says ‘Prescribing’ is used to describe many related activities, including advising patients on the purchase of over the counter medicines and other remedies.

The NHS has produced a document which lists the conditions which should be classed as self care.

Please see the Self Care page for more resources.

15. Sip feed spend

Target <£513 per 1000 patients over 3 months or reduce spend by 10%

This can be best achieved by

  • recommending a food first approach – including care home residents and prescribing sip feeds only as per the formulary.
  • Only using compact sip feeds in those patients who are clinically fluid restricted (eg renal patients)
  • Setting a weight stabilisation target as per MUST
  • Reviewing all sip feed patients regularly and only putting sip feeds on acute prescription

Please see the Nutrition page for more information.

16. Reduction in hypnotic and anxiolytic prescribing

Target <215 ADQ per 1000 patients

Anxiolytics and Hypnotics are drugs that are prescribed for short-term treatment of conditions such as anxiety and sleep problems. The Royal College of Psychiatrists states that “around 4 in every 10 people who take them every day for more than 6 weeks will become addicted” and therefore they should not be prescribed for longer than 4 weeks. This measure shows the mean Average Daily Quantity (ADQ) given per prescription, for both the older benzodiazepines, such as diazepam and temazepam, and the newer “Z-drugs”, such as zopiclone.

NICE advice Hypnotics

Please see our Hypnotics and Anxiolytics page for more resources.

17. Spend on preferred products as a percentage of all emollients

Target >40%

Please see our Dermatology page for more resources.

Emollient Quick Reference Guide

For an up to date list of Project Positive items please contact your locality medicines manager.

18. Increased statin prescribing for patients with unmet CVD prevention need

Target <3.25

We look at patients in the following groups who are not prescribed a statin

  • CKD eGFR<60 no statin
  • Stroke no statin
  • IHD no statin
  • Diabetes no statin
  • PAD no statin
  • RA statin
  • Suspected FH (Patients> 30yrs with TCL > 9mmol/l)
  • Potential FH (Patients < 30yrs with TCL>7.5mmol/l
  • Hypercholesterolaemia – no statin

Please see NICE guidance on lipid modification and cardiovascular disease.

Please note: any patients excluded from these searches will still count towards the indicator calculation.

19. Inhixa as a % of all enoxaparin prescriptions

Target >50%

Inhixa is the most cost effective brand of enoxaparin injections

Both YDH and Somerset FT have moved to using the Inhixa brand. For patients in the community requiring lower term use we recommend they are reviewed and switched to the Inhixa brand with appropriate training on the new device. Generic prescribing of enoxaparin is not recommended due to the number of different brands now available. Please inform your local community pharmacies before initiating this switch.

20. Solifenacin or oxybutynin tablets as a percentage of all anticholinergic incontinence drugs

Target >65%

It is now nearly two years since solifenacin lost its patent and it is now the most cost effective anticholinergic incontinence drug alongside immediate release oxybutynin. All patients should be regularly reviewed for any anti-cholingeric side effects which may mean they have better outcomes with no prescribing, but if they experience minimal side effects and benefits which warrant continued prescribing of an anti-cholinergic incontinence drug we now recommend a switch to solifenacin. Patients with incontinence problems may restrict fluid intake which could be harmful so please refer them to the Somerset hydration leaflet.

Please note this indicator excludes mirabegron and oxybutynin oral solution.