There are over 10,000 pharmacies in England providing a range of services in addition to the dispensing of prescriptions. Over 790 million prescriptions were dispensed in England in 2007 at a cost of over £8.3 billion. Additionally, the NHS spends about £2.9 billion on medicines used in hospitals.
Publications
Information about services provided by community pharmacies in England and Wales including dispensing of NHS prescriptions over 10 years.
GPs by organisation, headcount, fte, type, age, gender etc
This bulletin reports on use of medicines in primary care, in hospitals and those prescribed in hospitals, but dispensed in the community.
NHS hospital & community staff numbers in the medical & dental professions by organisation, headcount, fte, area of work, age, gender etc
NHS hospital & community staff numbers in the non-medical professions by organisation, headcount, fte, area of work, age, gender etc
ISD maintains a detailed database of all NHS prescriptions dispensed in the community in Scotland. The information is supplied to ISD by Practitioner Services Division (PSD) of National Services Scotland.
An analysis of expenditure, volume and trends on prescribing for diabetes in England.
Prescription items dispensed in the community in England.
Prescriptions dispensed in community by community pharmacists, appliance contractors and dispensing doctors.
Presents a summary of prescriptions dispensed in the community.
Prescribing by Primary Care Trust; items and cost at BNF section level.
Prescribing by Primary Care Trust; items and cost at BNF section level
Monthly Sickness Absence Rates in the English NHS
This bulletin summarises information on people visiting the Needle and Syringe Exchange Scheme and relates to the year ending 31 March.
Overview
Prescribing is the most common intervention in the NHS. As well as information on the different drugs dispensed (categorised by the classification used by the British National Formulary) there are also figures on the medicines dispensed to various groups such as the young and the old. This is possible through the categories of exemption from the prescriptions charge (this data is based on a sample of prescriptions).
The NHS Information Centre also collect information from Primary Care Trusts about pharmacies such as the additional services they provide, including Medicine Use Reviews.
The NHS Information Centre receives data from a commercial company that collects data from most hospital pharmacies. Since many drugs are used only or mainly in hospitals, this source provides important information, particularly on cancer drugs.
Technical Data
The normal process by which a patient receives a medicine is:
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the patient consults a doctor
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the doctor gives the patient a prescription (a form known as an FP10)
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the patient takes the prescription to a community pharmacist
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the pharmacist dispenses the prescription
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the pharmacist sends the prescription to the Prescription Pricing Division (PPD), and then
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the PPD price the prescription and calculate the amount due to the pharmacist as reimbursement for the cost of the medicine and the appropriate dispensing fee
Statistics on prescriptions are based on the data collected by the PPD. The basic measures are the number of items, the physical quantity, the cost and the proportion prescribed by generic rather than brand name . Patients who wish to claim exemption from the prescription charge need to complete the back of the prescription form. The PPD takes a 1 in 20 sample of prescriptions and links the exemption information to the prescription data. It is thus possible to estimate what drugs are received by those aged 60 and over and for other exemption categories.
There are variations on this process. For example, the patient may request a repeat prescription and so receive a prescription without seeing the doctor. The prescription may be for a specialist item and the patient may send the prescription to an appliance contractor who then returns the form to the PPD.
Patients may also receive medicines by processes that do not generate a prescription. Such scenarios include:
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family planning clinics may supply contraception to a patient without using a prescription
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smoking cessation clinics may also supply directly
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pharmacists can supply some medicines to patients under a Patient Group Direction which does not require a prescription, and
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nurses working in the community may supply dressings to patients
In each of these cases no prescription is generated and the PPD data will not hold any information.
The NHS Information Centre collect data directly from Primary Care Trusts on applications to open pharmacies and how many pharmacies provide various enhanced services (these are over and above dispensing prescriptions). This is combined with other information from the PPD to produce an annual bulletin on pharmacies.
The company IMSHealth collect data from pharmacies in most of the hospitals in England. They price the medicines issued using the Drug Tariff or other price lists but it needs to be kept in mind that this is not necessarily what the hospital paid as many hospitals negotiate a discount, either nationally or locally, on the price. IMSHealth provide an extract of this dataset to the NHS Information Centre which holds national data (estimated from the sample) and actual data for each Strategic Health Authority. There is no data at trust or Primary Care Trust level. The release of data from this extract is controlled by a contract between the Secretary of State for Health and IMSHealth which protects the confidentiality of the manufacturers. The restrictions are spelt out in the publication by the Information Centre which combines this information with the figures obtained from the PPD on prescriptions.
Glossary
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Appliance Contractor
Some specialised items are dispensed by companies known as appliance contractors; often the prescription will be sent by post and the item sent by post or delivered by one of the company’s staff.
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FP10
The reference number of the most commonly used prescription form.
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Generic name
When drugs are first marketed they have a chemical name and a brand name; it is good practice to use the chemical or generic name.
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Issue
When a hospital pharmacy dispenses medicine this is known as an issue.
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Item
A single entry on a prescription form is termed an item so a form may contain several items.
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NIC
Net Ingredient Cost; this is the cost of a medicine excluding any discount, container cost, VAT or dispensing fee.
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PCT
Primary Care Trust; there are 152 PCTs in England and each is responsible for patient care within their area.
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PPD
Prescription Pricing Division; the division of the NHS Business Services Authority who process prescriptions and reimburse dispensers.
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SHA
Strategic Health Authority; since April 2002, PCTs have taken control of local health care while strategic Health Authorities monitor performance and standards.
Contact Details
For statistical enquiries about this topic, please contact:
The NHS Information Centre
Email: enquiries@ic.nhs.uk
Telephone: +44 (0) 845 300 6016
1 Trevelyan Square, Boar Lane Leeds LS1 6AE
