Secondary care electronic prescribing and medicine administration (ePMA) data collection

This collection is of patient-level (identifiable) data for medicines prescribed and administered to patients by secondary care providers (acute, mental health, specialist, and community hospitals in England), when this is recorded on their electronic Prescribing and Medicines Administration (ePMA) systems.

ePMA data comprises records of prescribed medicines, alongside details of how and when those medicines were administered to patients. To explain the relationship between prescribing and administration; if an item is prescribed to be administered to a patient in the morning and evening, the ePMA data will show 1 prescription or medication order, and 2 administrations for that patient for a single day, if the patient stayed in the hospital for 5 days the data would show 1 prescription and 10 administrations.

It is common for secondary care providers to have more than 1 ePMA system, perhaps using a ‘main’ system for most wards and specialties, and different systems for example for cancer treatments, maternity, and intensive care - our intention is to collect from the ‘main’ ePMA system, defined as the one used by the majority of wards and specialties.

Every week from 13 January 2025, we will collect from each trust information for the preceding 7 days, and shortly after each trust’s weekly collection has started we will arrange for collection of historical information back to June 2018. The information is from the main ePMA systems used.

The information is identifiable because NHS Number is collected alongside each medicine prescription and administration.

It is necessary for us to collect NHS Number so that:

• all prescribing and administration episodes relating to a single patient can be linked
• the collected information can be linked to information for that patient in other datasets held by NHS England (if requested and there is lawful basis to do so). This will allow complex analysis and research, and ‘follow’ the patient as they move between different care locations

We aim to make the data comparable and make it available for analysis and research purposes to organisations with a lawful basis.

All organisations accessing the data will be required by the Directions to do so using a Secure Data Environment. NHS England will access the data for the purposes of medicine monitoring and optimisation or other statutory purposes. The data will be de-identified by use of Token Person ID which will allow it to be linked (if permitted) to other de-identified datasets held by NHS England in a Secure Data Environment.

NHS England will also use the data to provide feedback reports to the trusts for data quality purposes and to give information about their adoption of the dictionary of medicines and devices standard (dm+d). The data shared will not contain patient identifiable data or the Token Person ID.

All other organisations who want to access are required to seek approval by completing NHS England’s Data Access Request Service process which examines why the organisation wants access, what the benefits will be, that cyber security and restricted access mechanisms are in place, along with a suitable Data Sharing Agreement or Data Sharing Framework Contract. Requests may be subject to Advisory Group for Data independent oversight where necessary.

We expect the following outcomes, with a general expectation that these will deliver benefits in terms of improvements in health outcomes and patient safety across the NHS:

• make prescribing safer for patients by improving understanding of why some people experience complications or side effects caused by taking a mixture of medicines
• provide more evidence of the effectiveness of medicines at treating specific illnesses such as improving our knowledge of the benefits and risks of new medicines
• identify areas where overprescribing can be prevented so patients are not given medicines they do not need or want, or where potential harm outweighs the benefit of the medication
• improving the health outcomes of patients by improving understanding of how antibiotics are used and why some conditions are becoming resistant to them
• through linkage to other health data understand the impact of medicines on the health and care of patients
• ensure that patients have equal access to medication, regardless of where they live
• provide information that informs future healthcare plans
• support national strategies relating to medicines use

Under section 258 of the Health and Social Care Act 2012, before establishing a new collection NHS England must consult with the issuing organisation, representatives of those who are likely to use the information collected, representatives of those from whom the information will be collected, any other person it is appropriate to consult.

The Digital and Interoperable Medicines Programme team has consulted with a range of stakeholders, including patients, patient representatives, prospective data users, hospital trust personnel, ePMA system suppliers, clinician’s professional groups, and the Department of Health & Social Care. All are supportive of this collection with the expectation this will reveal areas where safety improvements can be made. Consultations were conducted by surveys, group meetings, telephone conversations, provision of written information, and presentations.

The Secondary Care ePMA Directions 2024 signed by the Department of Health & Social Care provide the legal basis for this collection. As a result of receiving Directions to collect ePMA data, under sections 259(1)(a) of the Health and Social Care Act 2012 NHS England has published a Data Provision Notice which provides details of the data collection including: purpose, scope, form, manner and frequency, what we are allowed to do with the data (publish, disseminate).

The Data Provision Notice is a legal obligation which hospital trusts must comply with.

An Information Standards Notice has been issued to hospital trusts to require them to provide information to this collection.