I suppose this is like school league tables, condensing something which 
is quite complex into something so simplistic as to be meaningless.
This  will then, be acknowledged as such but will be acted on as if an 
ultimate fact, as it is easy to measure, which seems to be the only 
thing required for something to be seen as valid by any politician, of 
course assuming it allows them to do what they wanted to, due to their 
preconceived biased original opinion.
Karen

Mary Hawking wrote:
> Looking at the IC website, there are 2 phases
> The audit aims to collect data on the prescribing of antipsychotic drugs
> from GP practices in England. The audit has been broken down into two
> phases:
> 
> Phase 1
> 
> The first part of the audit will focus on a non-patient identifiable data
> extract from selected GP practices to provide a picture of antipsychotic
> prescribing trends for people with dementia. Where possible the audit will
> use date of prescription to show trends over a five-year period, using the
> implementation of the Quality and Outcomes Framework (QOF) for Dementia in
> 2006 as the base point.
> 
> An automated data-extract process will be used to extract diagnosis and
> prescribing data from clinical systems. Non-identifiable patient-level data
> from selected practices will be obtained, including details of age, sex,
> antipsychotic prescribing and date of dementia diagnosis.
> 
> The audit aims to highlight progress in the reduction of the use of
> antipsychotic medication by practices since the report by Sube Banerjee in
> 2009.
> 
> Phase 1 will investigate data quality and data completeness issues and the
> accuracy of clinical coding. Any issues identified will be used to inform
> the audit requirements for phase 2.
> 
> MH How will "data quality and data completeness issues and the accuracy of
> clinical Coding" be investigated unless a good deal more data is extracted:
> no indication what that might be?
>  
> Phase 2
> 
> The second part of the audit, which will be carried out later in 2011, will
> develop the data extract and expand on the requirements to gain national
> coverage using an automated extract facility across all GP practices in
> England.
> 
> Section 251 approval from the National Information Governance Board (NIGB)
> has been sought to facilitate the proposed automated data extract. The audit
> will also be entering a full consultation process with the British Medical
> Association's (BMA) General Practitioners Committee (GPC).
> 
> MH. great.
> 
> The audit is done and there is an assumption that practices will not be
> prepared to release patient identifiable data (almost by definition,
> patients with dementia are unlikely to be able to give informed consent)
> 
> Discussion with the BMA and GPC does not appear to have commenced.
> 
> Then thee is the question of whether the data extraction will be limited to
> the GP record or include data entered by other SystmOne organisations
> treating the same patient: i.e. the unresolved Data Controllers in Common
> question.
> 
> Even more worrying: is this the shape of things to come?
> 
> The only question being asked appears to be whether GPs have reduced their
> prescribing of antipsychotics to patients with dementia, and to prevent
> opting out. (must check whether it is possible to refuse a section 251 and
> what the penalty is).
> 
> Mary Hawking
> 
>  
> 
>   _____  
> 
> From: GP-UK [mailto:[log in to unmask]] On Behalf Of Tilbrook Tim
> Sent: 21 April 2011 07:34
> To: [log in to unmask]
> Subject: Re: National Dementia and Antipsychotic Prescribing Audit.
> 
> 
> 
> The TPP (The Phoenix Partnership) aka SystmOne notification for this reads
> as follows:
> 
>  
> 
> "PP have been approached by the NHS Information Centre for Health and Social
> Care to provide anonymised information that shows the prescribing of
> anti-psychotic drugs for patients with dementia. 
> 
>  
> 
> The attached PDF is a letter from Julie Henderson (Head of Clinical Audit
> Support Unit at the NHS ICHSC) and Professor Alistair Burns (National
> Clinical Director for Dementia) which explains the audit in more detail. It
> also details the arrangements whereby practices can opt out of the process
> if they so wish. No further action is required if the practice is happy for
> their anonymised data to be transmitted to the Information Centre. 
> 
>  
> 
> Please direct any specific enquiries about this data extract to Julie's team
> at the IC or via email to [log in to unmask] 
> 
>  
> 
> Note: You will need Adobe Reader to open the file (available free from
> www.adobe.com).
> 
> Follow-up: Update regarding the Dementia Audit from Dr John Parry, TPP
> Clinical Director.
> 
>  
> 
> Following concerns expressed by users the deadline for opting out of the
> Dementia Audit has been extended. The new deadline will be published as soon
> as this information is available. 
> 
>  
> 
> The web link in the original letter has produced some confusion around
> whether patient identifiable information is included. The Information Centre
> has created a FAQ web link for this audit at:
> 
> http://www.ic.nhs.uk/services/national-clinical-audit-support-programme-ncas
> p/the-national-dementia-and-antipsychotic-prescribing-audit/frequently-asked
> -questions
> 
>  
> 
> The audit being undertaken is the phase 1 analysis which provides NO patient
> identifiable information at all. The information is to be aggregated and
> will be 'non disclosive'. 
> 
>  
> 
> A further communication from Professor Alistair Burns (National Clinical
> Lead for Dementia) will follow shortly.
> 
> Posted Wed 20 Apr 2011 10:49, Expires Wed 27 Apr 2011"
> 
>  
> 
>  
> 
>  
> 
> This had an attached letter from the National Clinical Director for Dementia
> Prof. Alistair Burns, in which there is this link to the Audits page at the
> Information Centre site. 
> 
>  
> 
> http://www.ic.nhs.uk/services/national-clinical-audit-support-programme-ncas
> p/the-national-dementia-and-antipsychotic-prescribing-audit
> 
>  
> 
>  
> 
>  
> 
> 
>  
> 
>  
> 
> Tim Tilbrook BSc (hons) F. R.A.M.I
> 
> Clinical Informatics Manager
> 
> Carlton Medical Practice
> 
> Bradford
> 
> Tel. 01274 362809 Ext 319
> 
> Mob. 07807 059999
> 
> Fax 01274 483362
> 
>  
> 
>  
> 
> Please Note extension change
> 
>  
> 
> -----Original Message-----
> From: GP-UK [mailto:[log in to unmask]] On Behalf Of Mary Hawking
> Sent: 20 April 2011 22:29
> To: [log in to unmask]
> Subject: Re: National Dementia and Antipsychotic Prescribing Audit.
> 
>  
> 
> It sounds as though the messages are a very mixed bag: is there any system
> for drawing attention to important items such as this?
> 
>  
> 
> Who are "they" in this context? TPP or someone else enabled by TPP?
> 
>  
> 
> Did the message give any background on the "National Dementia and
> Antipsychotic Prescribing Audit" or who was running this audit? (we did this
> as part of Med 6 last year: 2 patients, both prescibed by community
> psychogeriatrics for genuine psychoctic problems)
> 
> Is this an opt-in or an opt-out system for GP practices?
> 
>  
> 
> If individual practices are allowed to opt out, has this been made clear to
> the whole of the GP and any other organisations using TPP?
> 
>  
> 
> Does this audit require ethical approval and if so, has it been obtained?
> 
>  
> 
> I think my unease about this is that this implies - without further details
> could well be wrong - that a system supplier is acting as a Data Controller,
> whereas legally I believe the Data Controller is the GP practice and the
> same applies in hosted and enterprise systems: system suppliers are Data
> Processors - and the recent Zurich case should be a warning about the
> consequences if your Data Processor loses even a data stick: the Data
> Controller remains liable.
> 
>  
> 
> There is also the question of Data Controllers in Common: is this audit
> limited to the GP components of the TPP record database?
> 
>  
> 
>  
> 
>  
> 
> Mary Hawking
> 
>  
> 
>  
> 
>  
> 
>   _____  
> 
> From: GP-UK [mailto:[log in to unmask]] On Behalf Of Trefor Roscoe
> Sent: 20 April 2011 15:43
> To: [log in to unmask]
> Subject: National Dementia and Antipsychotic Prescribing Audit.
> 
> TPP sends out a few messages a day to users about things such as software
> updates, menu bar changes, extra features and general company news.
> 
> Amongst these this week one of my colleagues spotted an item about the
> National Dementia and Antipsychotic Prescribing Audit.
> 
> Apparently they are going to search the whole TPP GP database and extract
> anonymised information about patients with a diagnosis of dementia and those
> with a current or recent prescription of an antipsychotic.
> 
>  
> 
> Some other TPP users have worried about how anonymised it will be and how
> complete the data, especially considering individual practices can opt out.
> 
>  
> 
> I am sure one of the outcomes will be a GP bashing exercise accusing us of
> causing thousands of strokes in the elderly.
> 
>  
> 
> Thoughts team?
> 
>  
> 
> Trefor
> 
> 
>   _____  
> 
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> 
>