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Header image for the current page Understanding and managing spend on prescribing

Understanding and managing spend on prescribing

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With prescribing being the highest cost to the NHS after staffing, it is essential that Clinical Commissioning Groups (CCGs) have the tools to understand and proactively manage spending on medicines.

NHS Lincolnshire West CCG approached NHS Arden & GEM Commissioning Support Unit (CSU) to create a GP prescribing dashboard which would help the CCG and individual GP practices track spend on medicines.

By taking the time to understand the intended outcomes from access to this information, and considering the wider benefits to GPs and practice managers, Arden & GEM expanded the brief to create a fully interactive, intuitive suite of prescribing data reports. As a result, the CCG and GP practices across Lincolnshire are able to analyse variances, share best practice and adapt their approach to tackle budget overspend.

Understanding the challenge

NHS Lincolnshire West CCG commissioned Arden & GEM to create a prescribing dashboard that would show prescribing spend against a set budget per practice. This information would enable the CCG to identify improvements against the budget, or spot and prepare for the possibility of overspend. This is particularly useful in assessing QIPP Schemes or budgeting for the next year during the Contracting Cycle.

Building on our experience of working with GP practices, Arden & GEM’s team of analysts realised that this was an opportunity to create a tool which not only provided facts and figures about spend, but which could be interrogated to provide real insight into the reasons behind variances between practices.

Developing a solution

Our solution was developed around three principles:

  •          Make it easy and intuitive to use
  •          Make it relevant for practices and CCGs
  •          Provide the layers of data needed to identify potential solutions to budget issues.

In agreement with Lincolnshire West CCG, we approached Lincolnshire East CCG to broaden the reach of the tool. Our team then obtained the budgets, phasing plan and other local intelligence needed across the area. The data extracted was quality assured by Arden & GEM CSU’s prescribing experts.

Using this data, our BI specialists developed a suite of reports built on a flexible, dashboard-based system, which allows the CCGs to look at spend and variances overall, by medicine and by practice. GP practices can interrogate why particular prescribing decisions have been made.

Reports include:

  •          Spend v Actual
  •          Cost and items per 1,000 List Size
  •          Range of drugs prescribed
  •          Benchmarked Maps
  •          High Cost Drugs (per Unit)
  •          Growth between years

We designed the tool as an intuitive report with simple user interaction using the Tableau Platform.

This enables users to change the data they see and the way it is presented, simply by including different parameters. For example, visually striking ‘heat maps’ can be used to identify spend against budget across a locality.


“The Prescribing Data reporting tool Arden & GEM has developed has been well received by the practices, i.e. the end user. It is easy to see and will be really helpful in managing our prescribing.”

Dr Sunil Hindocha, Chief Clinical Officer, NHS Lincolnshire West Clinical Commissioning Group


Commissioners and practices in East and West Lincolnshire now have the information to manage prescribing readily available when they need it. Since its launch in September 2016, practices have already begun to identify opportunities to take proactive action to address budget issues. For example, by including the facility to benchmark not only across a local area but also against comparable practices (in term of list size/patient demographics), practices can easily identify opportunities to share best practice to tackle overspend.

Our team is in the process of attending locality meetings to train practices on how to get the most from the reports.

These meetings are enabling practices to identify variances and delve deeper into the data to share learning and best practice across the locality.

The new prescribing data reports are checked monthly by Arden & GEM’s BI team, and overspends are reported to the CCG. These reports are one of a series of interactive reports developed by Arden & GEM to support commissioners and GP practices in their efforts to improve patient care and identify efficiencies.

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