Informing and supporting prescribing behaviour, decision making and research with medicines dispensed in primary care,Electronic Prescribing and Medicines Administration in Secondary Care and NHS hospital activity

Synapsys IQ requires access to NHS England data for the purpose of delivering the following services to NHS and non-NHS users:

• Online Interactive Dashboards and Services: Access information to monitor trends and patterns in community prescribing, aligned with trends and patterns in NHS hospital activity.

• Tailored/Advised Analytics: Given the varied needs within the NHS and health and social care sector, not all information warrants dashboard creation. This service enables the delivery of analytical requests that do not require consistent updating or need delivery within tighter timeframes to maximise their benefit.

• Research for Publication: Contribute to thought leadership in healthcare data analytics, aiming to improve the planning, delivery, and outcome of health and social care.

The aim of the initial dashboards and bespoke reports is to highlight prescribing variations across Sub-Integrated Care Board Locations (SICBLs) in England. This data will enable SICBLs and local health economies to determine whether these variations are warranted or unwarranted and to decide how they may wish to address them. Synapsys IQ believe that by aligning their analysis priorities with NHS priorities, they can develop a unique offering tailored to the real-time requirements of the NHS.

The inclusion of the Electronic Prescribing and Medicines Administration (EPMA) dataset will strengthen these services by providing clinically rich, inpatient-level medicines data. This complements Synapsys IQ's existing use of community prescribing and hospital activity datasets, enabling clearer interpretation of therapy pathways, care transitions, and cross-setting prescribing behaviours.

Synapsys IQ Ltd will collaborate with non-NHS organisations that benefit the health and social care sector. These entities will only be provided with aggregate, small number suppressed analyses where a clear benefit to the health and social care sector can be identified. This restriction is ensured by the exclusive use of the SDE for querying all datasets included in this Data Sharing Agreement (DSA).

Each non-NHS organisation seeking access to Synapsys IQ’s aggregate, small number suppressed analyses will undergo an assessment by their internal ethical review board. This review ensures that the projects align with Synapsys IQ’s internal ethics and values policies, as well as their commitment to benefiting the health and social care sector. The requesting non-NHS organisation will enter into an agreement that the insights provided will be used in projects aligned with Synapsys IQ’s commitment to benefiting the health and social care sector and will not be used for commercial promotion.

Methods of service:

• Dashboard Provision for Trend Analysis: To monitor and analyse trends effectively.

• Annual Therapy Area Summaries: To provide locality specific information for high interest therapy areas.

• Bespoke Requests: To provide quicker, top-level detail for one-off queries.

The data will be utilised through the previously mentioned service types to achieve the following:

• Improve Patient Safety: Contributing to safer and more effective prescribing by reviewing medicines dispensed in the community alone and in the context of NHS hospital activity.

• Inform Planning and National Priorities: Benchmarking performance against other hospital providers or ICBs and understanding the context of these performances in relation to either community prescribing or hospital activity.

• Provide Tailored Solutions: Supporting commissioning, analytical support, and outcomes analytics for the NHS.

• Improve Services: Measuring the uptake and effectiveness of new medicines, focusing primarily on community prescribing patterns and evaluating effectiveness by reviewing concomitant prescribing and subsequent NHS hospital activity.

EPMA data enhances these objectives by allowing Synapsys IQ to examine the timing, dosing, and appropriateness of inpatient-administered medicines. When linked with community prescribing and hospital activity data, EPMA supports deeper understanding of adherence, transitions of care, and reasons behind variation in outcomes or medicines optimisation opportunities. This enables the identification of unwarranted variation more accurately by clarifying whether variation arises in primary care, secondary care, or at their intersection.

Other Areas of Enablement:

• Health Inequalities and Needs Analysis: Reviewing prescribing and hospital activity concurrently.

• Isolation of Changes in Clinical Practice and Prescribing.

• Practice-Level Performance Monitoring.

• Capacity and Utilisation Management Requirements.

The addition of EPMA further enhances these areas by enabling analysis of inpatient prescribing patterns across demographic groups, supporting improved understanding of inequalities in treatment initiation, escalation and monitoring.

Only employees of Synapsys IQ will access the Data. Synapsys IQ will use the Data to provide Online Interactive Dashboards, tailored/advised analytics services and research for publication services to clients and will charge the clients for provision of the services (NHS clients will not be charged).

The following types of clients can request access to an online Interactive Dashboards, tailored/advised analytics service and research for publication service from Synapsys IQ:

• Integrated Care Systems (ICS)

• Integrated Care Boards (ICB)

• Primary Care Networks (PCN)

• Provider Organisations

• NHS Therapy Area specific analysts

• Health Charity Organisations

• National Institute of Health and Care Excellence

• Pharmaceutical companies

• Medical Device companies

The main users are anticipated to be members of NHS medicines optimisation teams through ICBs and therapy-specific analysts from ICBs. These professionals will introduce the information to other relevant NHS users. It is anticipated that the user base will consist of 75% NHS users and 25% non-NHS users.

The Data can be used for the purposes of medicines optimisation, research aligned with NHS priorities, and projects that provide demonstrable benefit to health and social care.

This may be in the form of:

• Online Interactive Dashboards and Services – helping NHS organisations better understand the therapy area of review. For non-NHS organisations, dashboards will be used to gain a better understanding of NHS priorities, burdens, and successes.

• Tailored/Advised Analytics – bespoke one-off requests that may not require the creation of dashboards.

• Research for Publication – requests must align with the purposes stated above and demonstrate a benefit to the NHS. For example: linking medicine over-use to hospital admissions or examining patient adherence to treatment protocols and associated outcomes.

The Data cannot be used:

• For promotional or commercial activities by pharmaceutical companies.

• To support product marketing or comparative advertising.

Requests for services from clients are reviewed and approved unanimously by a panel of individuals at Synapsys IQ which includes (but is not limited to) a data lead, a pharmaceutical representative, a clinician and the head of medicines management.

The panel consults with external medicines management individuals and a private forum of optimisation professionals to inform decisions and ensure alignment with NHS priorities.

The panel assess requests for services against the following criteria:

1. The requested service aligns to one of the three service types listed above.

2. The requesting organisation has articulated a valid use of the requested output.

3. Requests for medicines optimisation/research are aligned with NHS priorities and/or projects provide demonstrable benefit to health and social care.

4. The requested service is feasible.

All requests to use the data will proceed according to the following process:

1. A potential client contacts Synapsys to request a service.

2. The panel meet to discuss and assess the request against the criteria above.

3. If the panel is supportive of the requested service being delivered, Synapsys will draw up a contract between Synapsys and the client and, once signed, Synapsys will begin the work.

On an annual basis Synapsys IQ will report back to NHS England on outputs achieved and update their website to demonstrate use cases.

Commercial purpose:

All outputs processed by Synapsys IQ Limited in line with this agreement will be accessed by approved personnel, apart from those outputs deemed beneficial for public viewing. Non-NHS organisations must agree that they will not use the service to market or promote their products. Their involvement must be aligned with better understanding the therapy area of review to either better align with NHS priorities or collaboratively promote benefits for the patients within this area.

Through the website, any visiting member of the public will have direct access to Synapsys IQ's privacy policies and initial ethical review meeting minutes.

Each project utilizing outputs from this application will undergo an internal ethical review process to ensure alignment with the directive of providing benefit to the health and social care sector.

Synapsys IQ Limited will charge all non-NHS organisations requesting access to the outputs, with relevant contractual agreements in place. A sustainable percentage of the profits from these sales will be allocated to further development of the dashboard, providing analysis pertaining to direct requests received from NHS users.

Non-NHS organisations will benefit by gaining a better understanding of NHS priorities, burdens, and successes, allowing them to collaborate with the NHS to improve services and care. They may use insights to review the clinical positioning of new products or explore hypothetical indications that might benefit the NHS and its patients.

All non-NHS organisation requests for access will be kept in a register alongside ethical review minutes for the given project. Details of the bi-annual reviews of these projects will also be documented.

It is possible that commercial companies may derive indirect benefit from enhanced understanding of the NHS environment. However, all projects undertaken are subject to rigorous ethical review, with a core focus on delivering meaningful benefit to the health and social care sector. Any indirect benefit to commercial entities is incidental, arising only from improved alignment with NHS priorities and patient needs.

Synapsys IQ remain committed to ensuring that all research is conducted transparently, ethically, and in alignment with public sector values.

Synapsys IQ Limited will commercially benefit from this agreement by having the opportunity to be seen as a leader in healthcare analytics. This exposure will allow Synapsys IQ to profit from non-NHS organisations paying for access to the outputs.

No data will flow to NHS England for the purposes of this Data Sharing Agreement (DSA).

NHS England will grant access to the Data via the Secure Data Environment (SDE). The SDE is a secure data and research analysis platform. It allows approved researchers with approved projects access to pseudonymised data and industry-leading analytics tools.

NHS England will provide access to the relevant records from the HES, ECDS, NHSBSA and ePMA data to Synapsys IQ via NHS England Secure Data Environment (SDE). The Data will contain no direct identifying data items. The Data will be pseudonymised and individuals cannot be reidentified.

SDE users can request exportation of aggregated analysis results (suppressed and summarised according to the NHSE SDE Disclosure Control rules) subject to review and approval by the NHS England SDE Output Checking team. The SDE Output Checking team will ensure that no output contains information which could be used either on its own or in conjunction with other data to breach an individual's privacy.

Users must identify themselves via a multi-factor authentication mechanism and are only able to access the datasets detailed within this DSA. The access and use of the system is fully auditable, and all users must comply with the use of the Data as specified in this DSA.

Users are only authorised to access the Data specified in this DSA and can utilise a variety of analytical tools available within the SDE platform. Users are not permitted to export record-level data from the SDE.

The Data will not be transferred to any other location.

The Data will be stored on servers at NHS England.

The Data will be accessed by authorised personnel via remote access.

The Controller must confirm and provide evidence upon audit by NHS England that access via any remote device complies with the data security obligations within this DSA and the Data Sharing Framework Contract.

For remote access:

- Remote access will only be from secure locations situated within the territory of use (as further restricted elsewhere within the DSA if so done) stated within this DSA;

- Access controls granting users the minimum level of access required are in place;

- Remote access is only via secure connections (e.g., VPNs or secure protocols) to protect data;

- Multifactor authentication (MFA) is required for remote access;

- Device security, including up-to-date software and operating systems, antivirus software, and enabled firewalls are utilised for the remote access;

- All remote access is undertaken within the scope of the organisation’s DSPT (or other security arrangements as per this DSA) and complies with the organisation’s remote access policy.

The above applies in addition to any condition set out elsewhere within the DSA (e.g. who may carry out processing, and for what purpose).

The Data will not be linked with any other data outside of this agreement.

The expected outputs of the processing will be:

• Monthly Updated Dashboards: Accessible by the NHS, selected charities, and approved non-NHS healthcare sector employees. (HES elements to be updated quarterly).

• Annualized Therapy Area Reports: Showcasing headlines from the developed dashboards in locality specific reports.

• Aggregated Data Tabulation Provision: In combination with retrospective studies.

• Posters; to be displayed at events including, but not limited to, ISPOR Europe.

The outputs will not contain NHS England Data and will only contain aggregated information with small numbers suppressed as appropriate in line with the relevant disclosure rules for the dataset(s) from which the information was derived.

The outputs will be communicated to relevant recipients through the following dissemination channels:

• Outputs will be communicated to approved recipients via Synapsys IQ Limited's secure portal, developed solely for this purpose. Clients will be provided access to a secure online portal containing the dashboards and reports produced by this data processing.

• Webinar style NHS attendee quarterly presentation meetings: To further promote engagement with other services whilst discussing current healthcare priority analysis.

• For its initial and subsequent launches, Synapsys IQ Limited will hold webinars to showcase the initial outputs and the potential for future outputs.

• Posters

• Social media (LinkedIn)

• Synapsys IQ website updates: the Synapsys IQ Limited website focuses on sharing the awareness of the outputs with NHS personnel, and showcasing publicly digestible outputs, with a minor section related to services for non-NHS organisations.

• Synapsys IQ Limited holds numerous established relationships with potential users and will directly share awareness of the available services with them.

All services linked to this Agreement will be made freely available to NHS personnel with a relevant need to access the data. This will remove all barriers to maximize potential access and therefore achieve the following benefits:

Accessible and Digestible Information: Unique measures will be taken to align the presentation and terminologies used within the NHS to make the information as easily digestible as possible. The main users are expected to be members of NHS medicines optimization teams through ICBs and therapy-specific analysts from ICBs, who will then introduce the information to other relevant NHS users. Given the focus on prescribing, these individuals have the potential to generate the largest scale benefit from access to the outputs.

With the addition of EPMA data, users will also be able to interpret medicines information in a richer clinical context, as EPMA captures not only prescribing decisions but the actual administration activity within hospital settings. This will make outputs more intuitive, allowing NHS users to understand where variations arise across primary care, outpatient clinics, and inpatient wards.

Relevant and Actionable Analysis: By involving these individuals in scoping the broad requirements and having Synapsys IQ Limited finalize the outputs, Synapsys IQ can confirm the relevance of all analysis undertaken. All outputs will have the potential to inform actionable plans, contributing to safer and more effective prescribing, improving services, and providing resources to measure these actions. Combining the Hospital Episode Statistics datasets will provide further context for planning purposes and enable direct measurement of patient benefits post prescribing changes.

EPMA further enhances the actionability of these insights by identifying how medicines are administered in real world inpatient settings, including timing, dose adjustments, and any missed or delayed doses. This supports more precise root cause identification and enables teams to address variation that might otherwise be hidden when reviewing prescribing data alone.

Publication and Sharing of Insights: Insights will be published via dashboards, Synapsys IQ website, business social media, and poster publications. These findings will add to the body of evidence considered by organizations and individual care practitioners making policy decisions for, or within, the NHS or making treatment decisions for specific patients. Selected elements of the outputs will also be available to the public to raise awareness of issues and successes, promoting motivation to seek better treatment if required.

EPMA enabled insights will also make publication outputs more clinically meaningful, as they can include inpatient medication administration patterns and provide a fuller picture of pathway effects. This supports more impactful communication with clinicians, commissioners, and patient groups.

Geographically Comparable Data: By providing geographically comparable data, users will be able to review the impact of other ICBs’ prescribing habits and resulting outcomes. This will lead to evidence-based decision making for their own regions where variations are observed, helping to reduce geographical variation.

EPMA strengthens this by revealing unwarranted variation in inpatient therapy delivery that cannot be seen in primary care data alone. This includes escalation patterns, acute care pathways, and administration reliability across regions.

Actionable Information for NHS: The NHS will need to take action based on the information provided to realize the potential improvement opportunities. For instance, members of a medicines optimization team may review their region in a dashboard, identify a prescribing profile they wish to change, and propose this change to a healthcare professional. Upon review, the healthcare professional could address the prescribing habits in their practice, ultimately benefiting their patients by starting them on or reviewing them for the perceived optimal treatment.

EPMA introduces additional intervention points by identifying issues such as delayed or omitted doses, variation in acute treatment regimens, or mismatches between inpatient and discharge prescribing. This makes the actions proposed by medicines optimisation teams even more targeted and effective.

Non-NHS organisations are expected to benefit from this analysis and the service by gaining a better understanding of NHS priorities, resource limitations, and successes, enabling them to collaborate with the NHS to improve services and care. They can better support the NHS when reviewing the clinical positioning of a new product or researching a hypothetical product or indications that might benefit the NHS and its patients. In addition, if a company manufactures a product for a specific patient group, NHS organisations may recognize the potential of the product if it is not being utilized safely or effectively. Aligning their understanding with NHS priorities will make non-NHS organisations more beneficial in their interactions with the NHS. Non-NHS users of the service must agree not to use it for marketing or promoting their products.

The addition of EPMA gives non NHS users (under strict governance and suppression) a more realistic understanding of the inpatient environment—how therapies are administered, escalated, or adjusted in practice. This leads to more NHS aligned and clinically relevant collaborations.

The use of the data could:

• Advance Understanding of Prescribing Behaviours: Identify potential reductions in patient safety and compare these across different geographies, further enhanced by providing context through hospital activity outcomes.

• Inform Health Services Planning: Improve equity of access to preferred treatment pathways.

• Advance NHS National Priorities: Increase patient safety and the effectiveness of prescribing.

• Identify or Improve Treatments: Enhance health and care outcomes or experiences.

• Quality of Care Mechanism: Check the quality of care regarding patient safety and prescribing effectiveness, identifying areas of good and poor practice to learn from or address.

• Support Insight Generation: Aid NHS or Charity patient safety or medicine effectiveness requests, especially when they lack sufficient capacity.

• Advance Preventative Health Measures: Understand the need for or effectiveness of preventative health and care measures for particular populations or conditions.

• Enable NHS Medicines Optimisation Teams: Measure, compare, and benchmark key quality indicator trends, focusing on risk-adjusted measures of admissions, readmissions, and length of hospital stay in the context of primary care prescribing.

• Provide Evidence for Clinical Audits: Instigate clinical audits and investigations related to quality of care, highlighting potential poor clinical coding or quality/efficiency concerns.

• Improve Efficiency of Health Services: Use performance information to identify, quantify, and act on opportunities for efficiency improvements.

• Facilitate Best Practice Interactions: Support quality and efficiency improvements by understanding best practices and interacting with other localities performing less well.

• Provide Independent Analysis: Offer authoritative analysis of prescribing and hospital outcome variations, making the information meaningful and understandable for the NHS.

It is understood that changes in policy and the implementation of these changes will take time after gaining awareness of the insights. However, it is hoped that the resulting patient benefits will be realized shortly after annual planning cycles are concluded by the personnel accessing the dashboard insights.

Awareness of the services will be raised through direct communication with NHS individuals and groups. Synapsys IQ’s internal website and LinkedIn activity will further increase awareness. Initial users of the dashboard will be encouraged to share their experiences with other potential NHS users and will be proactively urged to do so through data update communications.

Synapsys IQ Limited personnel have experience working with charities and patient groups. Synapsys IQ intend to share relevant information with these groups, allowing them to disseminate it to their audiences. This approach will amplify the awareness benefits by concentrating the provision of information to those most affected by the therapy areas in question.

EPMA enabled insights, because they include real world inpatient activity, will resonate particularly strongly with patient groups seeking better understanding of treatment pathways, especially where hospital care plays a central role.

In the first six months of operating under this Agreement, Synapsys IQ has delivered a wide range of tangible benefits to NHS organisations, academic partners, and patient focused charities. These benefits demonstrate clear alignment with NHS England national priorities, including respiratory care improvement, medicines optimisation, the Women’s Health Strategy, health inequalities reduction, and the NHS Long Term Plan’s emphasis on data driven improvement.

Synapsys IQ's PES–HES dashboards have rapidly gained widespread adoption across NHS teams. On average, ICB coverage now exceeds 50% for the therapy areas Synapsys IQ support, with particularly strong engagement in respiratory therapy areas. Users include ICB medicines optimisation teams, therapy specific analysts, PCN clinical leads, consultants within NHS Trusts, hospital analysts, GPs, and charity analysts. This breadth of usage demonstrates that the outputs are becoming part of the routine evidence base used across multiple layers of the health and care system.

A key indicator of value has been the increasing number of bespoke data requests, directly reflecting alignment with NHS needs. One example involved an ICB request for an age stratified review of SABA over use, which enabled the medicines optimisation lead to identify youth over use patterns and target support to surgeries with high risk young patients. This analysis directly informed the decision to investigate whether youth over use was linked to increased hospital utilisation — a relationship Synapsys IQ were subsequently able to demonstrate. This work formed a core rationale for the ISPOR Europe 2026 poster entitled “Impact of Short Acting Beta Agonist (SABA) Overuse on Asthma Related Hospital Utilisation in England”. Although Synapsys IQ are not responsible for the final programme interventions, Synapsys IQ’s outputs were a critical enabling step in the identification and pursuit of this high priority area of focus.

A second bespoke request from an ICB sought to review the success of recent inhaler therapy reviews for asthma and COPD. Synapsys IQ's analysis supported their planning for subsequent pathway work, helping them identify whether particular patient types were responding differently to the intervention and informing their approach to similar programmes in the coming year. While the final project outcomes sit with the ICB, Synapsys IQ's data was explicitly used as part of the planning cycle and early evaluation.

Further requests have included analysis of pMDI to DPI inhaler switches, HRT user vs non user comparisons, and assessments of MART and AIR inhaler utilisation. These topics map directly to NHS national priorities, including the Net Zero agenda (inhaler transition), the NHS England Respiratory Clinical Programme, and the Women’s Health Strategy (HRT equity and access).

The value of Synapsys IQ's service also extends beyond dashboards. Synapsys IQ has provided a bespoke aggregated dataset for an HRT specific study conducted by King’s College London. This supports academic investigation into prescribing behaviour, inequalities, and women’s health — contributing directly to a key area of Government and NHS strategic focus.

Synapsys IQ's work with charities has continued to expand as well. Much of this engagement has come via direct referrals from NHS Medicines Management teams, indicating confidence in Synapsys IQ's service as a trusted source of real world evidence. Charities in respiratory care, and women’s health have used the outputs to inform their internal priorities, patient education materials, and advocacy activities. Synapsys IQ are also actively co developing a dedicated dashboard with a national asthma charity, ensuring they can direct their resources towards patients most at risk, based on robust NHS data.

These contributions collectively demonstrate that Synapsys IQ’s work is already influencing NHS service planning, clinical priority setting, academic research, charity intervention design, and public facing health conversations. Because users are accessing data directly aligned with NHS priorities and local improvement pathways, the insights Synapsys IQ provide naturally shape their approach to high impact projects across multiple therapy areas.

As EPMA data is implemented in the future, these benefits will expand further by adding precise inpatient administration context, enabling deeper understanding of transitions of care, acute treatment variation, timing related patient safety issues, and the true drivers of variation across therapy pathways. This will reinforce the value already demonstrated in Synapsys IQ's first six months and further strengthen the contribution Synapsys IQ makes to NHS improvement, research, patient focused charities, and real world clinical insight.