Public Value

Introduction

Value means that the statistics and other numerical information are accessible, remain relevant and benefit society; helping the public to understand important issues and answer key questions.

Value is a product of the interface between the statistics or other numerical information and those who use them as a basis for forming judgements.

These statistics are important because they answer a number of key questions, including the number of active community pharmacies and how many pharmacies have opened and closed in any given year; the number of prescription items dispensed by community pharmacies each year and what proportion of these were electronic prescriptions; and how many seasonal influenza vaccines are administered by community pharmacies each year. Known key users of the statistics include ministers and officials in government departments including the Department for Health and Social Care (DHSC) and NHS England & Improvement (NHSE&I); policy advisors for community pharmacy and primary care; primary care and community pharmacy commissioners; business analysts and strategists in manufacturing and sales in the pharmaceutical industry; and businesses offering data analytics and business intelligence solutions for the healthcare and pharmaceutical sectors.

Findings

User engagement

Community pharmacies and appliance contractors provide a range of vital services on behalf of the NHS to the general public. This includes essential services such as dispensing medications, appliances, and medical devices to NHS patients. Additionally, pharmacies provide advanced services, such as flu vaccinations, and locally commissioned services, such as smoking cessation. The GPhS publication shows details on community pharmacy and appliance contractor activity in England across the whole financial year. This includes the number of prescription items they have dispensed, the number of single activity fees they have received, and further details on essential and advanced services that they have provided. The statistics have a wide range of uses including informing government or local NHS policy, and allowing public scrutiny of national and regional dispensing activities. These statistics can be used to understand the activity of community pharmacies and appliance contractors in England, including essential and advanced services provided to NHS patients.

NHSBSA has published a customer service and user engagement policy which sets out its customer service commitment and customer engagement procedures for all its statistics publications. It has also published a user engagement strategy for the GPhS publications. This outlines its approach to engaging both with existing customers and with new and potential customers.

Since NHSBSA took responsibility for publication of the GPhS statistics, it has been seeking to engage proactively with users of these statistics. NHSBSA acknowledges that identifying and engaging new users has been challenging. However, the user engagement strategy outlines several activities that NHSBSA undertakes to continue to identify existing and potential users of the GPhS statistics. These include reviews of Freedom of Information (FoI) requests, data requests and data analytics initiatives and Google alerts. The statistics team regularly collaborates with colleagues in other directorates and teams within NHSBSA to identify additional potential users that may emerge through their on-going work including user research, customer insight and stakeholder engagement.

In addition to these activities, NHSBSA has an ongoing feedback survey for the publication that it reports having had some success with. As a result of this it now has a small collection of known users that it can engage actively with.

Users we spoke to told us that they find the statistics relevant to their needs. Those that have engaged with the NHSBSA statistical team told us that they have found the team to be open and responsive, and the team has dealt with their queries quickly and constructively.

Accessibility

All of the users we spoke to told us they have accessed the GPhS statistics through NHSBSA’s dedicated website and found the information easy to access and navigate.

Some users said that they would like to see information being published more frequently than on an annual basis. NHSBSA has told us that it receives a monthly FoI request around payments made to all pharmacies in England. It is planning to publish this information as monthly management information so that it is equally accessible to a broad range of users. NHSBSA told us that this management information will be complementary to the data that are available via its Open Data Portal, meaning that a broader range of data is available overall to suit the needs of a wider user base.

NHSBSA follows guidelines on accessibility both for the GPhS publication and for its website, as noted in the accessibility statement for official statistics narratives. The statistical bulletin provides details on how to contact the organisation for information in a different format, such as accessible PDF, large print, easy read, audio recording or braille.

NHSBSA plans to review the accessibility of the figures in the statistical bulletin to ensure they are fully accessible to a broad range of users.

Clarity and insight

The key findings are clearly stated at the start of the publication, and the main report is simple and clearly laid out. Many of the users we spoke to told us they were interested in the summary statistics alone. These users were happy with the level of detail in the publication.

The report describes changes in the figures over time; for example, the 2020 publication outlines that the number of items dispensed via the Electronic Prescription Service (EPS) in 2019/20 has increased by almost 42% since 2015/16, such that electronic prescriptions now make up 77% of all items dispensed. Similarly, the number of seasonal influenza vaccines administered by community pharmacies in 2019/20 has increased almost threefold since 2015/16. Further commentary is limited, however, and there is also little explanatory text to help users in interpreting some of the figures. For example, NHSBSA could provide more information on possible reasons for changes over time. Figure 7 in the 2020 publication, which provides information on costs and fees for flu vaccinations provided by contractors, is difficult to understand and there is currently no explanation of the figure within the text. NHSBSA told us that it is planning to improve the commentary from the 2021 publication to give more context of the systems that pharmacies in England operate in, including more information on the Community Pharmacy Contractual Framework and the essential and advanced services that contractors can provide.

Since the last publication covered the period up to March 2020, the impact of the coronavirus pandemic has not yet been explored in the publication. NHSBSA is planning to report all activity carried out by contractors linked to England’s response to the COVID-19 pandemic. It is keen to provide this information for users in a harmonised way with other UK nations, and will be exploring this with statisticians in the devolved nations to ensure a consistent story for users.

NHSBSA is in the process of establishing a UK Prescribing Statistics working group that responsible statisticians for prescribing statistics from each of the devolved administrations will be part of. This group is being established in response to a requirement in our assessment of NHSBSA’s Prescription Costs Analysis statistics, and its aim is to help improve the harmonisation and comparability of outputs across the UK nations.

Users told us that Table 1 in the supporting summary tables in the 2020 publication was too long and contained too many different types of information. This table contains a wide range of information on pharmacy and appliance contractor activity. This includes, but is not limited to: number of pharmacies and number of items dispensed; information on electronic prescribing; costs and fees relating to items dispensed; number of pharmacies opening and closing; and various items of information on services provided by pharmacies. Given the diverse range of information contained within the table, users reported that it was confusing and difficult to retrieve data from for their own analysis. Most users felt that the information presented in this table would be better spread across several separate tables. NHSBSA should implement improvements to the supporting summary tables to make them more user friendly and easier to extract data from. It should consult with users on any planned changes to ensure that the tables better meet users’ needs.

Innovation and improvement

NHSBSA has a Reproducible Analytical Pipeline (RAP) in place for this publication, which covers the process from receipt of the data to publication of the statistics. Currently this involves producing the publication using R code, version control with Git, and peer review of the code. It plans to publish the code for the existing RAP on its public GitLab repository in the near future. It is also currently upskilling junior members of the team in R to create fully functioning packages, and the Responsible Statistician is a member of the GSS RAP network.