Secondary Care Data Validation: What do commissioners need to know? Stuart Brown Healthcare Acquired Infection and Antimicrobial Resistance Project Lead NHS England March 2014
Introduction Antimicrobial Usage ESPAUR 2014 Previous data validation Quality Premiums Draft tool CDDFT Experience
Antimicrobial Usage Measuring antibiotic usage in hospitals is essential to an effective local antimicrobial stewardship Can be used for national surveillance data / comparison Links to resistance data
ESPAUR 2014 First national survey on Antimicrobial Consumption for primary and secondary care Information on the use of antibiotics Primary Care NHSBSA database Secondary Care obtained from data held by IMS Health
ARHAI Quality measures Advisory Committee on Antimicrobial Resistance and Hospital Acquired Infections (ARHAI) Recommended Antimicrobial Prescribing Quality Measures. 2014. https://app.box.com/arhai-minutes-papers/1/2152374732/18606265032/1
Data Validation IMS Health is a commercial organisation specialising in the provision of information Data from 99% of NHS Trusts In-house quality assurance No external validation of the data Early data validation from the UK Clinical Pharmacy Association Pharmacy Infection Network Showed wide variations between local data and IMS Health data
Quality Premium Part a) reduction in the number of antibiotics prescribed in primary care Part b) reduction in the proportion of broad spectrum antibiotics prescribed in primary care Part c) secondary care providers validating their total antibiotic prescription data
Quality Premium Part c) secondary care providers with 10% or more of their activity being commissioned by the relevant CCG have validated their total antibiotic prescribing data as certified by PHE
Protocol for Validation (Draft)
Draft Protocol - Method Total Breakdown Consumption data for all inpatient and outpatient issues excluding internal transfers, supply to manufacturing units Inpatient Breakdown dispensed items for hospital inpatients only Raw Data unedited data direct from own pharmacy system Trust DDD Calculator translation tables currently in use by the relevant Trust Summary First national survey on Antimicrobial Consumption for primary and secondary care
Draft Protocol 28 Antibiotics Amikacin Amoxicillin Amoxicillin / clavulanic acid Cefotaxime Ceftriaxone Ciprofloxacin Clindamycin Doxycycline Erythromycin Gentamicin Meropenem Penicillin G Piperacillin / tazobactam Temocillin Cefalexin Ceftazidime Cefuroxime Clarithromycin Daptomycin Ertapenem Flucloxacillin Linezolid Nitrofurantoin Penicillin V Teicoplanin Tigecycline Trimethoprim Vancomycin
Data Validation PHE England Data supplied to Trusts is from IMS Health Trust then enters local consumption data PHE validate data against both IMS Health as well as Rx-info (where data available) Rx-info providers of Define software
CDDFT Data
CDDFT - Data
CDDFT Data
CDDFT Experience Time Highlighted discrepancies in all areas Within this there are significant differences on specific high use antibiotics Includes internal transfer data but missing some over labelled packs
Next Steps Promote the Quality Premium Encourage providers to complete data validation Will improve knowledge on overall antibiotic usage Aid future work on reducing Antibiotic usage
Any questions?