Before Christmas we wrote about Ghost Branded Generics, a very nerdy story about a problem we uncovered that costs the NHS………£11.6million a year. Since then we have launched a freely accessible Ghost Branded Generics dashboard on for every practice and CCG in the country; and a Ghost Branded Generics measure so practices and CCGs can track their prescribing of Ghost Branded Generics over time.

We have also had lots of people get in touch about this whole new category of NHS savings. In particular we were contacted by TPP who produce SystmOne, the “electronic health record” (EHR) system used by approximately 40% of GPs in England.

We identified SystmOne as the EHR used in general practices where most of the excess costs related to Ghost Branded Generics occured. As we suspected in the first blog, the SystmOne team were unaware of this problem. This is entirely understandable: as we explained, the problem was largely unforeseeable. To our delight TPP responded very positively, and immediately wanted to use our analysis to inform a review of their user interfaces, in order to help GPs and others prescribe more cost-effectively.

To our even greater delight, TPP informed us today that they have reviewed our work on Ghost Branded Generics and will be making changes to the user interface of SystmOne immediately. This will be deployed to general practices across the country beginning on February 14th with the aim of reducing the chance of prescribers erroneously choosing a Ghost Branded Generic for any new prescriptions. Importantly, prescribers will still be able to prescribe Ghost Branded Generics if absolutely necessary, for example Category 1 antiepileptics. This is great, rapid work, which is likely to save the NHS millions of pounds.

Is that all?

There’s more. Additionally SystmOne are creating “searches” to be rolled out to practices as well as a report to identify any templates that have been created using Ghost Branded Generics. This will help practices rapidly switch existing patients over to more cost-effective treatments.

What’s the bigger picture?

Collaborative open working! We think this story is a great illustration of how things should work in the era of modern data-driven healthcare.

Our small team of clinicians, researchers, and software engineers pool their skills and knowledge to find problems in clinical practice, using open tools and open data. We found a problem with prescribing, especially in one EHR vendor’s practices, costing the NHS millions. We shared our work, and then the vendors got in touch, very rapidly, working collaboratively, swiftly, and positively to produce a solution.

This story also demonstrates the value of sharing your working out in the open: documenting your code, methods and results in public so that others - such as SystmOne - can take your analysis, check it, build on it and fix problems for the NHS.

We know that other teams have noticed Ghost Branded Generics and are working on it. Please get in touch, if you haven’t already, and share what you have learnt! or @openprescribing on Twitter.