Freedom of Information request - prescribing of antibiotics

The request was successful.

Dear NHS West Suffolk Clinical Commissioning Group,

We are currently researching the change in GP prescribing behaviour in urinary tract infections.

Please can you provide us with the following information:

Do you have a formulary used by primary care prescribers? If so, what is the current status of nitrofurantoin and trimethoprim with respect to urinary tract infections (e.g. first line, second line, etc)

Has the status of either nitrofurantoin or trimethoprim changed in the formulary since November 2014? If so, can you please provide the previous status(es) and details of the date(s) of change.

Have you had any work plans in place with respect to nitrofurantoin and trimethoprim prescribing since 2014? If so, can you please provide documents and start date.

Have you had any GP prescribing incentive schemes or similar which relate to trimethoprim or nitrofurantoin prescribing since November 2014? If so, can you please provide the documents.

Yours faithfully,

Ben Goldacre and Richard Croker

SuffolkFOI, NHS West Suffolk Clinical Commissioning Group

Thank you for your request for information under the Freedom of
Information Act 2000.
We will respond to you as soon as possible and within 20 working days.
We will contact you if we require further information or if there is a
delay in responding.

Buckle Tony (Suffolk NHS), NHS West Suffolk Clinical Commissioning Group

1 Attachment

 

Freedom of Information Act

 

I write further to your e-mail of 7 November 2017 regarding information
held by Ipswich and East Suffolk Clinical Commissioning Group and West
Suffolk Clinical Commissioning Group. Your request has been dealt with in
accordance with the Freedom of Information Act 2000.

 

In response to your request,

 

We are currently researching the change in GP prescribing behaviour in
urinary tract infections.

 

Please can you provide us with the following information:

 

 

                               All the responses below are the same for
both CCGs apart from the last question.  

 

Do you have a formulary used by primary care prescribers?  If so, what is
the current status of nitrofurantoin and trimethoprim with respect to
urinary tract infections (e.g. first line, second line, etc)

 

                Yes, we do
([1]http://www.westsuffolkccg.nhs.uk/wp-cont...)

 

o UTI, simple (female [not pregnant] and male patients), No fever or
flank pain: First line - Nitrofurantoin; Second line - Trimethoprim

 

o UTI, in PREGNANCY: First line - Nitrofurantoin (to be avoided in 3rd
trimester of pregnancy); Second line - Trimethoprim; Third line -
Cefalexin

 

o UTI, lower in CHILDREN: First line - Trimethoprim; Second line -
Cefalexin

 

 

Has the status of either nitrofurantoin or trimethoprim changed in the
formulary since November 2014?  If so, can you please provide the previous
status(es) and details of the date(s) of change.

 

o UTI, simple (female patient), No fever or flank pain, Not pregnant:
1st episode only – Trimethoprim; Recurrent episodes: Nitrofurantoin
(changed autumn 2017)

 

o UTI, simple (male patient), No fever or flank pain: 1st episode only –
Trimethoprim; Recurrent episodes: Nitrofurantoin (changed autumn 2017)

 

o UTI in PREGNANCY: Nitrofurantoin, Trimethoprim, Cefalexin (not changed
but now stated as first line, second line and third line since autumn
2017)

 

o UTI, lower in CHILDREN: Trimethoprim, Nitrofurantoin (changed autumn
2017)

 

 

Have you had any work plans in place with respect to nitrofurantoin and
trimethoprim prescribing since 2014?  If so, can you please provide
documents and start date.

 

                Yes - promoting the Suffolk Antibiotic Formulary and
strongly encouraging primary care prescribers to prescribe in line with
the formulary. Suffolk Antibiotic Formulary published in 2014 attached.

 

 

Have you had any GP prescribing incentive schemes or similar which relate
to trimethoprim or nitrofurantoin prescribing since November 2014?  If so,
can you please provide the documents.

 

                               West Suffolk CCG

 

                               No

 

 

                               Ipswich & East Suffolk CCG

 

                               Yes – part of the Prescribing Incentive
Scheme 2017/18

 

                               Relevant section from contract copied
below:

 

                               Antibiotics

 

·        Achieve a 10% reduction (or greater) in the Trimethoprim:
Nitrofurantoin prescribing ratio

·        Achieve a 10% reduction (or greater) in the number of
trimethoprim items prescribed to patients aged 70 years or greater

·        Reduce the number of antibiotic items per Specific Therapeutic
group Age Sex Related Prescribing Unit (STAR-PU) prescribed in general
practice to <1.161  items per STAR-PU

 

 

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Suffolk Clinical Commissioning Group and West Suffolk Clinical
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I hope that we have been able to answer your enquiry to your satisfaction
and that you find the information provided useful.

 

Yours sincerely

 

 

Tony Buckle

 

Risk Manager

Ipswich & East Suffolk and West Suffolk Clinical Commissioning Groups

Endeavour House

8 Russell Road

Ipswich

IP1 2BX

01473 770212

[5][email address]

 

[6]www.westsuffolkccg.nhs.uk

[7]www.ipswichandeastsuffolkccg.nhs.uk

 

 

References

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