David Mullett, a clinical champion for the Royal College of General Practitioners, tells us about his work to use patient data to directly benefit patients.
I am the Royal College of General Practitioners (RCGP) clinical champion for quality improvement in prescribing and patient safety. The RCGP is the professional membership body for family doctors in the UK. By joining RCGP, GPs get advice, information and training to help them give their patients the best possible care. My work is all about helping doctors to give even better care to their patients.
One of the ways I do this is by working with the Clinical Practice Research Datalink (CPRD). CPRD is jointly funded by the NHS National Institute for Health Research (NIHR) and the Medicines and Healthcare products Regulatory Agency (MHRA), a part of the Department of Health. GP practices across the UK have been contributing anonymised data to CPRD for over 30 years. Before patient data reaches CPRD it’s anonymised, so that that CPRD does not have a patient’s name, address, NHS number or full date of birth. Instead, the patient information is given an identifier by the GP practice system; for example, this could be a mix of numbers and letters such as ‘9pC6’. The anonymised data is used for vital public health research.
CPRD data was used to show that there was no link between the MMR vaccine and autism. The data was also used in research that has helped doctors to diagnose cancer as early as possible. You can read more about this research in case studies on CPRD’s website.
The benefits of working together
Together, RCGP and CPRD have created a report that helps GP Practices review patient care. By contributing anonymised data to CPRD, GPs are not only supporting public health research but also making sure that their patients are represented in research evidence that is used to inform clinical guidance. An additional benefit, and a ‘thank you’ for taking part is a prescribing and patient safety report that can help GPs to directly improve their patients’ care.
In July, we sent a first report to GP practices that have been contributing anonymised data to CPRD. The report had information about prescriptions for its patients with heart failure, particularly:
- Non-steroidal anti-inflammatory drugs (NSAIDs) – drugs used to treat pain, such as ibuprofen
- Thiazolidinediones (glitazones) – drugs used to treat diabetes
Generally, these drugs should not be given to patients with heart failure as they may interfere with the way the heart works and make symptoms worse.
- Shows how each practice compares with the national picture for prescribing these drugs to heart failure patients.
- Gives GPs information that enables them to re-identify patients whose prescriptions may need to be reviewed.
When the GP practice receives the report about its own patients the GP uses the identifier code (eg '9pC6') to re-identify which patient the information was from and to review that patient’s care. Because the reports are practice-specific the patients can only be re-identified by their own practice.
This means that the report can show where discussions with particular patients might be needed. Prescriptions may need to be changed, but this will depend on a patient’s circumstances.
What GPs have told me
To make the reports as useful as possible I ask GPs for their feedback.
After receiving the report, doctors will decide if any patient’s care needs to be reviewed, and then discuss this with their patient. Then, depending on the patient’s circumstances:
- a prescription could change to a different medication
- a prescription can change to a different dosage
- no action is needed.
As well as the benefits for patient care, there are benefits for GPs too. They have told me that the report is useful:
- to discuss safe prescribing with other doctors at their practice
- to see how their prescriptions compare with the national average
- for the future, when they may have other patients on these prescriptions.
One GP I have spoken with is Dr Tommy Hunter, a GP in Scotland. Dr Hunter said:
“The report is a helpful addition to the processes I already use to review patient care.
“Finding straightforward and effective ways to improve patient safety is a particular interest of mine, as I can then easily incorporate changes into my day to day work. This report has been a very useful example of this, and has therefore been of benefit to my patients.”
The next reports will be going out soon and they will focus on safe prescriptions for patients with chronic kidney disease and cardiovascular disease.
There are plans to add more prescription drug information to future reports, so that we can help to give patients an excellent level of care by making the best use of data.
Find out more
Find out more about the CPRD and how anonymised data is used for patient and public benefit.
You can also find out more about the reports on this page for GPs.