Prescribing Audit Report

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1 Medical - In Confidence National Report Prescribing Audit Report Prescribing Services NHS W ales Shared Services Partnership 3rd Floor, Companies House Crown W ay Cardiff CF14 3UB NW SSP Page 1 of 17

2 PRESCRIBING AUDIT REPORT EXPLANATORY NOTES This report summarises the costs incurred by your HB in the current month. At the end of each quarter a more detailed analysis is provided giving an indication of both cost and frequency of prescribing. W herever possible, comparisons are made with: A - The averages for the HBs in W ales. B - Information in the same period last year. Actual Annual Projected Annual Out-turn For practice reports the Actual excludes Community Nurse Prescribing. The amalgamated practices budget to spend on the cost of drugs and appliances in a year.. This is a prediction of a HBs total spending by the end of the year, and uses the formula: Final expenditure last year X Current month cumulative spend this year Current month cumulative spend last year If no data is available for last year the prediction is based on the prescribing in the formula: Cumulative spend this year X Possible number of months prescribed in total Number of months prescribed this year to date NB - All expenditure in the calculation of Out-turn is based on Actual cost (ie Net Ingredient Cost - Discount + Container Allowance). Monthly Summary Annual Profile of Last Year (Equivalent) Welsh Equivalent This is a breakdown of costs for the current period and the cumulative for the current financial year. This is the percentage of the budget that has been spent so far in the year. This is the percentage of the total expenditure that had been incurred at the same time last year. This is the W elsh average cost or frequency per prescribing unit multiplied by the number of prescribing units registered to your HB. Prescribing Unit (PU) No of PUs = (No of patients under 65) + (No of patients 65 and over X 3) + (No of temporary residents) Ratios All ratios compare HB data with equivalent figures for W ales. For current month ratios on the Prescribing Summary comparisons are made with the practice cost and items to the HB equivalent details. % Change from last year Indicates the % change in prescribing for the same period last year. Cost WeMeReC Charts The cost value throughout is expressed as the Net Ingredient Cost (NIC), unless otherwise stated. The charts in sections 10 to 13 are selected each quarter by the W elsh Medicines Resource Centre. They illustrate drug usage in the therapeutic topic covered by the current W emerec bulletin. Page 2 of 17

3 Overview PRESCRIBING STATEMENT OVERVIEW This Year (Projected) Last Year (Actual) Annual Budget for 2018/19: 494,961, ,476,970 Annual Out-turn: 516,255, ,158,180 Over/under spend: 4.3 % 9.1 % Monthly Summary Current Month Cumulative Basic Cost ( ) 46,262,042 (102,234) 185,478,201 (420,967) Less Discount (7.52 %) Cost ( ) -3,478,580 (-7,688) -14,058,948 (-31,912) Plus Container Allowance Cost ( ) 211,822 (48) 842,316 (199) Actual Cost ( ) 42,995,284 (94,595) 172,261,569 (389,253) *Current Discount 6,668,902 (3,622) 26,560,001 (14,928) NB. The figures shown in brackets relate to prescribing by Community Nurses, and are included in the main figures shown above Dispensed outside HB/Wales Cost ( ) 2,811,028 10,835,645 59, ,795 Page 3 of 17

4 Prescribing Days Period Cumulative Spend Prescribing Days Cumulative Days Budget Forecast Outturn Pct Difference Apr ,330, ,961, ,149, % May ,528, ,961, ,370, % Jun ,266, ,961, ,190, % Jul ,261, ,961, ,799, % Page 4 of 17

5 PRESCRIBING STATEMENT BREAKDOWN Cost By Therapeutic Group No. Chapter Cost ( ) Current Month % Cost Change from 2017/18 Cost Cumulative % Cost Change from 2017/18 01 Gastro-Intestinal System 2,303, ,042, Cardiovascular System 5,886, ,582, Respiratory System 6,519, ,047, Central Nervous System 7,748, ,902, Infections 893, ,698, Endocrine System 7,317, ,300, Obstetrics 1,844, ,285, Malignant Disease & Immunosuppression 979, ,814, Nutrition And Blood 3,414, ,586, Musculoskeletal & Joint Diseases 891, ,682, Eye 1,006, ,816, Ear, Nose And Oropharynx 482, ,940, Skin 1,399, ,689, Immunological Products & Vaccines 158, , Anaesthesia 177, , Other Drugs And Preparations 175, , Dressings 835, ,024, Appliances 1,965, ,571, Incontinence Appliances 209, , Stoma Appliances 2,051, ,685, s 46,262, ,478, Page 5 of 17

6 By Therapeutic Group No. Chapter Current Month % Change from 2017/18 Cumulative % Change from 2017/18 01 Gastro-Intestinal System 608, ,430, Cardiovascular System 1,951, ,780, Respiratory System 510, ,024, Central Nervous System 1,365, ,443, Infections 199, , Endocrine System 655, ,605, Obstetrics 172, , Malignant Disease & Immunosuppression 35, , Nutrition And Blood 333, ,312, Musculoskeletal & Joint Diseases 192, , Eye 117, , Ear, Nose And Oropharynx 85, , Skin 184, , Immunological Products & Vaccines 11, , Anaesthesia 8, , Other Drugs And Preparations 6, , Dressings 45, , Appliances 146, , Incontinence Appliances 7, , Stoma Appliances 28, , s 6,668, ,560, Page 6 of 17

7 Annual Profile Of Basic ( ) Current Year 2017/2018 Actual ( ) % Of Annual Dispensed Basic ( ) Actual ( ) % Of Spend Dispensed Apr 44,496,445 41,330, ,377,362 Apr 44,184,413 41,015, ,217,420 May 92,104,892 85,528, ,214,579 May 92,466,732 85,774, ,926,241 Jun 139,216, ,266, ,891,099 Jun 143,348, ,873, ,741,022 Jul 185,478, ,261, ,560,001 Jul 193,069, ,902, ,323,204 Aug 241,897, ,146, ,027,789 Sep 290,891, ,539, ,672,838 Oct 342,179, ,995, ,603,653 Nov 392,206, ,336, ,472,201 Dec 440,411, ,048, ,223,427 Jan 488,250, ,419, ,006,229 Feb 531,435, ,535, ,174,639 Mar 578,427, ,158, ,903,730 Page 7 of 17

8 Actual Health Board Cumulative 2018/19 ( ) PRESCRIBING SUMMARY Current Month Ratio ( ) Annual ( ) Projected Outturn ( ) % Over/under spend Cumulative 2017/18 ( ) Aneurin Bevan 31,939,527 5,213, ,219,939 95,586, ,228,147 5,175,648 Cardiff And Vale Uni 24,177,562 3,355, ,622,520 72,434, ,102,082 3,309,967 Hywel Dda 22,838,898 3,415, ,928,000 68,334, ,853,695 3,418,047 Betsi Cadwaladr Uni 36,203,061 5,781, ,743, ,413, ,948,892 5,765,373 Abertawe Bro Morgannwg Uni 31,257,651 4,762, ,899,698 94,433, ,984,447 4,693,925 Powys Teaching 7,718,825 1,147, ,388,952 23,149, ,994,443 1,139,313 Cwm Taf 18,126,045 2,883, ,158,885 53,916, ,790,763 2,820,931 Page 8 of 17

9 Monthly Cost Variations COST VARIATIONS Actual ( ) Health Board Current Month Month Last Year Variation ( ) % Variation Aneurin Bevan 8,004,018 8,584, , Cardiff And Vale Uni 6,069,790 6,417, , Hywel Dda 5,729,082 6,120, , Betsi Cadwaladr Uni 8,979,324 9,719, , Abertawe Bro Morgannwg Uni 7,748,115 8,207, , Powys Teaching 1,930,858 2,088, , Cwm Taf 4,534,097 4,889, , Page 9 of 17

10 Welsh Cross Boundary Entity CROSS BOUNDARY REPORT Inflow Outflow Net Value 2GETHER NHS FOUNDATION TRUST ADDACTION AIREDALE, WHARFEDALE AND CRAVEN CCG 248 5, , ARDEN,HEREFORDS & WORCESTER AREA , , , , ASHFORD CCG BARKING & DAGENHAM CCG 109 1, , BARNET CCG 58 1, , BARNSLEY CCG BASILDON AND BRENTWOOD CCG 107 2, , BASSETLAW CCG BATH AND NORTH EAST SOMERSET CCG BATH,GLOS,SWINDON & WILTSHIRE AREA ,299 69, ,299 69, BEDFORDSHIRE CCG 69 1, , BERKSHIRE WEST CCG 77 1, , BEXLEY CCG BIRMINGHAM & THE BLACK COUNTRY AREA , , BIRMINGHAM AND SOLIHULL CCG 187 1, , BIRMINGHAM COMMUNITY HEALTHCARE TRUST BLACKBURN WITH DARWEN CCG BLACKPOOL CCG BOLTON CCG BRADFORD CITY CCG 85 2, , BRADFORD DISTRICTS CCG 230 7, , BRENT CCG BRIGHTON & HOVE CCG BRISTOL, N SOM, SOM & S GLOS AREA BRISTOL, N SOM, SOM & S GLOS AREA ,071 25, ,071 25, BRISTOL, NORTH SOMERSET & S GLOS CCG 174 1, , BROMLEY CCG 113 2, , BUCKINGHAMSHIRE CCG BURY CCG s 28, , ,543 3,048, ,969 2,642, Page 10 of 17

11 Entity Inflow Outflow Net Value CALDERDALE CCG CAMBRIDGESHIRE AND PETERBOROUGH CCG 104 1, , CAMDEN CCG 62 1, , CANNOCK CHASE CCG CANTERBURY AND COASTAL CCG CARE UK CLINICAL SERVICES LTD CASTLE POINT AND ROCHFORD CCG CENTRAL LONDON (WESTMINSTER) CCG CHESHIRE & WIRRAL P/S NHS FOUNDATION TR CHESHIRE, WARRINGTON & WIRRAL AREA ,584 68, ,584 68, CHORLEY AND SOUTH RIBBLE CCG CITY AND HACKNEY CCG 223 5, , COASTAL WEST SUSSEX CCG 354 6, , CONCORDIA HEALTH LTD CORBY CCG COVENTRY AND RUGBY CCG CRIME REDUCTION INITIATIVES LTD CROYDON CCG CUMBRIA CCG CUMBRIA,NORTHUMB,TYNE & WEAR AREA , , , , DARLINGTON CCG 36 1, , DARTFORD, GRAVESHAM AND SWANLEY CCG DERBYSHIRE AND NOTTINGHAMSHIRE AREA DEVON,CORNWALL&ISLES OF SCILLY AREA , , , , , , DONCASTER CCG DORSET CCG 415 8, , DUDLEY CCG DUMMY PCT Q , , DURHAM DALES,EASINGTON & SEDGEFIELD CCG 212 4, , DURHAM, DARLINGTON AND TEES AREA EALING CCG 82 1, , EAST AND NORTH HERTFORDSHIRE CCG EAST ANGLIA AREA ,552 1,054, ,552 1,054, s 28, , ,543 3,048, ,969 2,642, Page 11 of 17

12 Entity Inflow Outflow Net Value EAST BERKSHIRE CCG EAST LANCASHIRE CCG EAST LEICESTERSHIRE AND RUTLAND CCG EAST RIDING OF YORKSHIRE CCG 180 4, , EAST STAFFORDSHIRE CCG EAST SURREY CCG EASTBOURNE, HAILSHAM AND SEAFORD CCG 76 1, , EASTERN CHESHIRE CCG 89 1, , ENFIELD CCG 48 1, , ESSEX AREA , , FAREHAM AND GOSPORT CCG FYLDE & WYRE CCG GLOUCESTERSHIRE CARE SERVICES NHS TRUST GLOUCESTERSHIRE CCG 227 1, , GREAT YARMOUTH & WAVENEY CCG GREATER HUDDERSFIELD CCG 149 4, , GREATER MANCHESTER AREA , , , , GREATER PRESTON CCG GREENWICH CCG 104 2, , GTD HEALTHCARE IUCC GUERNSEY GUILDFORD AND WAVERLEY CCG 165 3, , HALTON CCG 96 3, , HAMBLETON, RICHMONDSHIRE AND WHITBY CCG 93 2, , HAMMERSMITH AND FULHAM CCG HARDWICK CCG HARINGEY CCG HARROGATE & DISTRICT FOUNDATION TRUST HARROGATE AND RURAL DISTRICT CCG 219 4, , HARROW CCG 163 2, , HARTLEPOOL AND STOCKTON-ON-TEES CCG 129 4, , HASTINGS & ROTHER CCG 371 6, , HAVERING CCG HEREFORDSHIRE CCG 1,122 8, ,122-8, s 28, , ,543 3,048, ,969 2,642, Page 12 of 17

13 Entity HERTFORDSHIRE & SOUTH MIDLANDS AREA Inflow Outflow Net Value , , HERTFORDSHIRE COMMUNITY NHS TRUST HERTS VALLEYS CCG HEYWOOD, MIDDLETON & ROCHDALE CCG HIGH WEALD LEWES HAVENS CCG HILLINGDON CCG HORSHAM AND MID SUSSEX CCG 125 2, , HOUNSLOW CCG 89 1, , HULL CCG 73 1, , INHEALTH LIMITED IPSWICH AND EAST SUFFOLK CCG ISLE OF MAN ISLE OF WIGHT CCG ISLINGTON CCG KENT AND MEDWAY AREA , , , , KERNOW CCG KINGSTON CCG KNOWSLEY CCG LAKESIDE + LTD LAMBETH CCG LANCASHIRE AREA , , LANCASHIRE NORTH CCG LEEDS CCG , , LEICESTER CITY CCG LEICESTERSHIRE & LINCOLNSHIRE AREA , , LEWISHAM CCG LINCOLNSHIRE EAST CCG LINCOLNSHIRE WEST CCG LIVERPOOL CCG 161 1, , LUTON CCG MANCHESTER CCG 178 1, , MANSFIELD & ASHFIELD CCG MEDWAY CCG 115 2, , MERSEYSIDE AREA , , , , MERTON CCG s 28, , ,543 3,048, ,969 2,642, Page 13 of 17

14 Entity Inflow Outflow Net Value MID ESSEX CCG MILTON KEYNES CCG 86 1, , NENE CCG NEWARK & SHERWOOD CCG NEWCASTLE GATESHEAD CCG 305 8, , NEWHAM CCG 73 1, , NHS PRACTITIONER HEALTH PROGRAMME NORTH DERBYSHIRE CCG 252 4, , NORTH DURHAM CCG NORTH EAST ESSEX CCG 346 5, , NORTH EAST HAMPSHIRE AND FARNHAM CCG 346 6, , NORTH EAST LINCOLNSHIRE CCG 75 1, , NORTH EAST LONDON AREA , , NORTH HAMPSHIRE CCG 153 3, , NORTH KIRKLEES CCG 205 5, , NORTH LINCOLNSHIRE CCG 22 1, , NORTH NORFOLK CCG NORTH STAFFORDSHIRE CCG 211 1, , NORTH STAFFS COMBINED HEALTHCARE TRUST NORTH TYNESIDE CCG 181 5, , NORTH WEST LONDON AREA , , NORTH WEST SURREY CCG 181 5, , NORTH YORKSHIRE AND HUMBER AREA NORTH, EAST, WEST DEVON CCG 76 1, , NORTHUMBERLAND CCG 334 9, , NORWICH CCG NOTTINGHAM CITY CCG 592 2, , NOTTINGHAM NORTH & EAST CCG NOTTINGHAM WEST CCG OLDHAM CCG OXFORD HEALTH NHS FOUNDATION TRUST OXFORDSHIRE CCG PORTSMOUTH CCG REDBRIDGE CCG REDDITCH AND BROMSGROVE CCG RICHMOND CCG s 28, , ,543 3,048, ,969 2,642, Page 14 of 17

15 Entity Inflow Outflow Net Value ROTHERHAM CCG RUSHCLIFFE CCG SALFORD CCG SANDWELL AND WEST BIRMINGHAM CCG SCARBOROUGH AND RYEDALE CCG SE STAFFS & SEISDON PENINSULAR CCG SHEFFIELD CCG 199 3, , SHROPSHIRE AND STAFFORDSHIRE AREA , , , , SHROPSHIRE CCG 2,698 20, ,698-20, SHROPSHIRE COMMUNITY HEALTH NHS TRUST SOMERSET CCG SOUTH CHESHIRE CCG SOUTH DEVON AND TORBAY CCG SOUTH EASTERN HAMPSHIRE CCG SOUTH KENT COAST CCG SOUTH LINCOLNSHIRE CCG SOUTH LONDON AREA , , SOUTH NORFOLK CCG SOUTH SEFTON CCG SOUTH TEES CCG 74 2, , SOUTH TYNESIDE CCG SOUTH WARWICKSHIRE CCG SOUTH WEST LINCOLNSHIRE CCG SOUTH WORCESTERSHIRE CCG SOUTH YORKSHIRE AND BASSETLAW AREA SOUTHAMPTON CCG 61 1, , SOUTHEND CCG SOUTHERN DERBYSHIRE CCG SOUTHPORT AND FORMBY CCG SOUTHWARK CCG 115 2, , SPECTRUM COMMUNITY HEALTH ST HELENS CCG 72 2, , STAFFORD AND SURROUNDS CCG STOCKPORT CCG 200 2, , STOKE ON TRENT CCG 107 1, , s 28, , ,543 3,048, ,969 2,642, Page 15 of 17

16 Entity Inflow Outflow Net Value SUNDERLAND CCG SURREY AND SUSSEX AREA , , , , SURREY DOWNS CCG 74 1, , SURREY HEATH CCG 83 2, , SUSSEX COMMUNITY DERMATOLOGY SERVICE SUTTON CCG SWALE CCG SWINDON CCG TAMESIDE AND GLOSSOP CCG TELFORD & WREKIN CCG THAMES VALLEY AREA ,066 72, ,066 72, THANET CCG THE SOCIETY OF ST JAMES THURROCK CCG 61 1, , TOWER HAMLETS CCG TRAFFORD CCG TURNING POINT VALE OF YORK CCG 118 3, , VALE ROYAL CCG VIRGIN CARE SERVICES LTD WAKEFIELD CCG 335 8, , WALSALL CCG WALTHAM FOREST CCG WANDSWORTH CCG WARRINGTON BOROUGH COUNCIL WARRINGTON CCG 184 7, , WARWICKSHIRE NORTH CCG WESSEX AREA , , WEST CHESHIRE CCG 8,084 70, ,084-70, WEST ESSEX CCG 165 3, , WEST HAMPSHIRE CCG 400 6, , WEST KENT CCG 319 6, , WEST LANCASHIRE CCG WEST LEICESTERSHIRE CCG WEST LONDON (K&C & QPP) CCG 108 1, , WEST NORFOLK CCG s 28, , ,543 3,048, ,969 2,642, Page 16 of 17

17 Entity Inflow Outflow Net Value WEST SUFFOLK CCG WEST YORKSHIRE AREA , , WIGAN BOROUGH CCG WILTSHIRE CCG WIRRAL CCG 187 1, , WIRRAL COMMUNITY NHS TRUST WOLVERHAMPTON CCG WORCESTERSHIRE HEALTH AND CARE NHS TRUST WYRE FOREST CCG s 28, , ,543 3,048, ,969 2,642, Page 17 of 17

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