Eight prescribing indicators have been selected to help reduce the risk of harms from potentially hazardous prescribing and reduce unplanned hospital admissions.
For each form of harm, there are 2 indicators:
Count of patients at risk of harm from potentially hazardous prescribing.
Count of patients admitted to hospital for diagnoses associated with potentially hazardous prescribing.
The main purpose of the indicators is to identify patients at risk of harm from potentially hazardous prescribing so that those patients can be reviewed and prescribing changed as appropriate.
The supplementary purpose is to provide an outcome measure of potentially hazardous prescribing. By counting the number of at-risk patients who subsequently experience an associated admission the indicator helps to monitor the real-world impact of prescribing practices and the effectiveness of risk-reduction interventions.
But not all the admissions will necessarily be caused by the prescribing, as the indicators are not adjusted for confounding factors such as frailty, and therefore identify association rather than causation.
Approach to metric selection
The indicators were selected by a Short Life Working Group of pharmacists and other clinicians through an assessment of existing indicators on medication safety. Out of all existing medication safety indicators reviewed at the time, these 8 cover the forms of potentially hazardous prescribing with greatest risk of admission.
The indicators selected by the group were originally developed by NHS Digital in response to the World Health Organisation (WHO) global challenge – Medication Without Harm. More information can be found in the report of the Medication Errors Short Life Working Group.
What the comparators show
The comparators show the number of patients at risk of hospital admission associated with different forms of potentially hazardous prescribing and those who go on to be admitted to hospital.
There are views by ICB and sub-ICB levels showing the number of patients at risk and the number admitted. The number of patients at risk is also available at GP practice level to help practices identify patients who could benefit from a review.
Purpose
The purpose of the indicators is to:
support local reviews of prescribing, alongside other risk factors for potential harm
minimise the use of medicines that are unnecessary and where harm may outweigh benefits
identify where the risk of harm can be reduced or mitigated including prescribing of alternative medicines or medicines that mitigate risk - gastro-protective agents, for example
reduce the number of hospital admissions that may be associated with medicines
reduce the number of patients that are potentially at increased risk of hospital admission that may be associated with medicines.
How to use these comparators
We see these comparators being used by GP practices as well as ICBs, alongside relevant and appropriate education and training support that is in place.
Clinical pharmacists working with GP practices will play an important role in supporting GP practices to identify and address specific patients who are deemed at risk of harm from potentially hazardous prescribing and who require a review of prescribing as a priority.
Accessing the dashboard
If you’re registered for ePACT2, you can access the harms dashboard via ePACT2.
Contact us
Our email address for all enquiries is [email protected].
We're available Monday to Friday, 8am to 4pm.
Dashboard specification documents
View more detailed information about the indicators and the data in the Harms Dashboard Specification (Word: 787KB).