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pec report by lindash

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									                                                                       HoB tPCT P.E.C. – May 04
                                                                              Enclosure 11


                  Heart of Birmingham Teaching Primary Care Trust
                                   PEC REPORT

Subject:                       Prescribing Report (December Out-turn)

Date:                          April 2004

Author:                        John Morrison

Recommendations:               Information on financial forecast and position regarding potential
                               performance indicators

1. Introduction

Heart of Birmingham TPCT has a prescribing budget for the year of just under £33 million. This
figure was top-sliced by £500,000 (£200,000 for risk and £300,000 for 28 day prescribing and
dispensing for discharge) leaving a figure of £32.5 for GP prescribing. Prescribing incentive
scheme 2003/4 is set at £150,000, plus further payments depending on PCT performance against
budget.


2. February Out-turn

HoB Prescribing Budget figures 2003/4

GP Prescribing

        GP Prescribing Budget :       £32,452,998

        Forecast out-turn:            £32,153,168

        Forecast underspend:                £299,830


Non-GP Prescribing

        Non-GP Prescribing Budget:          £205,779

        Forecast out-turn:                  £368,582

        Forecast overspend:                 £162,803


All prescribing

        Forecast underpsend:                £137,027




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3. Performance indicators

There were four prescribing performance indicators set by CHI last year. These have been used
to rank practices this year. As yet we have had no indication from CHI that they will be any
different for this year.

The indicators measured are:

       -   Antibiotic Prescribing Rate (Items Star-PU)
       -   Generic Prescribing Rate
       -   Benzodiazepine Prescribing (ADQ/Star-PU)
       -   Atypical Antipsychotic Prescribing

Antibiotic prescribing

As yet we do not have the final quarter figures from the PPA (data for March 2004 expected
May). The quarter data is as previous report. The data we have for January/February, however,
suggests the biggest drop I the use of antibiotics so far this year. Compared to the first two
months of 2003 we have seen a 19% reduction in prescribing volume or 8,727 fewer
prescriptions for antibiotics.

Generic Prescribing

Generic prescribing figure for February – 75.6%

Again there is a massive variation between practices (range 53 – 92%).

Benzodiazepine prescribing

The PCT continues to perform at around the National average. Prescribing is pretty flat across
the PCT with 6 practices continuing to drive the majority of prescribing. Main practices have
been visited and action plans put in place to reduce prescribing where appropriate.

Atypical antipsychotics

Target set for the year at 54%. This was achieved by end of Quarter 2 and a continual increase
seen throughout year. PCT performance 56% against a national average of 57% for Q3.

January/February figures give the PCT a level of 60.5%. Unless there is a dramatic change in
March the PCT will easily hit the target set at the beginning of the year.


4. Recommendations

       -   PEC continues to support drive for quality improvement in prescribing

       -   PCT continues with quality markers listed and adds any additional markers on as
           appropriate.


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