Brian
brianmackenna.bsky.social
Brian
@brianmackenna.bsky.social
MPharm MPH working for the NHS and at bennett.ox.ac.uk building tools, analysis and papers from health data opensafely.org openprescribing.net
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hospitals.openprescribing.net
September 25, 2025 at 3:35 PM
Why does this matter?
✅ More convenient for patients
✅ Less time in hospital
✅ Saves NHS resources

This is an incredible achievement by hospital teams across England. Delivering change safely, quickly, and under huge pressure. 👏
September 25, 2025 at 3:33 PM
What the data show is phenomenal.

Hospitals switched to Phesgo almost overnight.

Atezolizumab is showing the same rapid adoption.

Too early to say for nivolumab. But you can follow along with the new measures to see how your trust is doing.
September 25, 2025 at 3:32 PM
An aside: I know they aren't literally "super jabs". They are subcutaneous injections - but "super jabs" is what NHSE called them when launching the news NHSE would be launching them!
September 25, 2025 at 3:32 PM
We often hear: “the NHS can’t implement new treatments quickly or consistently.”

But the hospital prescribing data tell a different story.

Cancers once treated with IV infusions lasting hours can now be treated with quick subcutaneous injections — the “super jabs” 💉
September 25, 2025 at 3:31 PM
To go alongside our slightly older measure on Phesgo

hospitals.openprescribing.net/measures/phe...
Measures · Uptake of Phesgo® | OpenPrescribing Hospitals
hospitals.openprescribing.net
September 25, 2025 at 3:30 PM
There was some transient blood test delays….

Encouragingly, most indicators recovered by late 2021. NHS practices and teams showed remarkable resilience in protecting medication safety under huge strain.

The delays were probably a sign of correct prioritisation during the lockdown.
September 22, 2025 at 7:42 PM
Now for the questions - did hazardous prescribing increase during the pandemic?

Nope

Potentially hazardous prescribing was largely unaffected by the covid-19 pandemic in primary care health records in England.
September 22, 2025 at 7:41 PM
Read the paper for the detailed methods but briefly

we were able to analyse adherence to a whole range of complex pathways in the timelines of every patient in the country, securely, with their data remaining in situ, with a single command.

This is a revolutionary - 57millions peoples records
Changes in medication safety indicators in England throughout the covid-19 pandemic using OpenSAFELY: population based, retrospective cohort study of 57 million patients using federated analytics
Objective To implement complex, PINCER (pharmacist led information technology intervention) prescribing indicators, on a national scale with general practice data to describe the impact of the covid-1...
doi.org
September 22, 2025 at 7:41 PM
Now in the pandemic - you can’t really have everyone doing this manual data labour because there are more important things to do!

So we set out to see if we could use OpenSAFELY to monitor the PINCER measures.

As everyone suspected that meds safety went out the window with COVID-19 priorities.
September 22, 2025 at 7:40 PM
To evaluate the pharmacists work - the PINCER team monitored how certain medicine safety measures changed in GP. To collect this data-individual practices download their data and send it to Nottingham.

This is fine - but slow, not everyone sends its, not everyone measures at the same time etc etc
September 22, 2025 at 7:39 PM
Background: PINCER is a pharmacist-led hazardous prescribing primary care.

Full RCT here doi.org/10.1016/s014...

TLDR: it works

It’s one of the NHS’s flagship safety programmes.

One of the reasons the NHS invested substantially in pharmacy folk in general practice over the past decade.
September 22, 2025 at 7:38 PM
We used OpenSAFELY to analyse 57 million patient records from over 6,000 general practices – one of the largest medication safety analyses ever done in England........and possibly ever in the world!
September 22, 2025 at 7:37 PM