Quality prescribing for respiratory illness 2024 to 2027 - draft guidance: consultation

We are consulting on this draft guide which aims to optimise treatment outcomes in the management of respiratory illness. Produced by Scottish Government, NHS Scotland and Experts by Experience, it builds on the 2018 to 2021 strategy. It promotes person-centred care, the 7-Steps process for medicine reviews and shared decision-making.


Appendix 4 - Data tables from indicator charts

Table 7: People prescribed six or more short-acting beta-agonists ( SABA) per annum (Chart 1)
NHS Board January to December 2020 January to December 2021 January to December 2022
NHS Ayrshire & Arran 32.5% 31.6% 29.4%
NHS Borders 31.7% 31.2% 30.0%
NHS Dumfries & Galloway 33.2% 32.5% 30.8%
NHS Fife 33.1% 32.3% 31.5%
NHS Forth Valley 29.9% 28.8% 27.8%
NHS Grampian 28.0% 27.7% 26.3%
NHS Greater Glasgow & Clyde 36.5% 35.5% 33.3%
NHS Highland 30.6% 30.2% 28.2%
NHS Lanarkshire 35.3% 33.9% 32.2%
NHS Lothian 33.1% 31.7% 29.6%
NHS Orkney 26.5% 25.6% 21.4%
NHS Shetland 26.6% 25.8% 23.6%
NHS Tayside 32.4% 31.3% 29.8%
NHS Western Isles 34.4% 33.2% 32.0%
Scotland 33.4% 32.5% 30.7%
Table 8: People prescribed three or more short-acting beta-agonists ( SABA) per annum (Chart 2)
NHS Board January to December 2020 January to December 2021 January to December 2022
NHS Ayrshire & Arran 56.0% 54.5% 52.4%
NHS Borders 54.8% 53.6% 52.1%
NHS Dumfries & Galloway 55.4% 53.5% 52.9%
NHS Fife 56.2% 54.5% 54.1%
NHS Forth Valley 53.8% 52.4% 51.7%
NHS Grampian 51.4% 50.8% 49.8%
NHS Greater Glasgow & Clyde 57.9% 56.7% 54.5%
NHS Highland 53.2% 52.3% 50.5%
NHS Lanarkshire 58.8% 56.7% 55.0%
NHS Lothian 55.4% 54.0% 52.2%
NHS Orkney 48.5% 47.9% 44.4%
NHS Shetland 48.7% 48.1% 47.4%
NHS Tayside 54.7% 53.6% 52.6%
NHS Western Isles 54.2% 53.7% 53.8%
Scotland 56.1% 54.7% 53.2%
Table 9: Number of SABA pMDIs prescribed per 1,000 list size (Chart 3)
NHS Board October to December 2020 October to December 2021 October to December 2022
NHS Ayrshire & Arran 125.51 131.80 132.41
NHS Borders 132.30 138.03 144.44
NHS Dumfries & Galloway 157.59 162.97 163.49
NHS Fife 128.05 136.59 139.45
NHS Forth Valley 102.49 110.86 111.40
NHS Grampian 95.94 101.91 101.50
NHS Greater Glasgow & Clyde 128.47 136.91 134.39
NHS Highland 119.92 125.11 117.82
NHS Lanarkshire 137.88 145.24 149.68
NHS Lothian 107.95 111.23 106.06
NHS Orkney 99.65 99.42 105.71
NHS Shetland 112.59 116.89 112.12
NHS Tayside 126.29 134.21 132.35
NHS Western Isles 135.14 141.18 151.99
Scotland 121.16 127.76 126.55
Table 10: High dose corticosteroid inhalers as a percentage of all corticosteroid inhaler items (using 2019 SIGN/ BTS classification of high dose) (Chart 4)
NHS Board October to December 2020 October to December 2021 October to December 2022
NHS Ayrshire & Arran 15.9% 14.8% 14.3%
NHS Borders 13.1% 14.4% 15.4%
NHS Dumfries & Galloway 14.9% 14.7% 14.7%
NHS Fife 19.7% 20.4% 21.4%
NHS Forth Valley 14.9% 15.5% 16.3%
NHS Grampian 15.7% 15.8% 15.7%
NHS Greater Glasgow & Clyde 17.1% 17.2% 18.0%
NHS Highland 22.4% 21.9% 21.9%
NHS Lanarkshire 15.8% 16.3% 17.0%
NHS Lothian 17.3% 17.8% 18.6%
NHS Orkney 18.4% 18.0% 18.7%
NHS Shetland 19.4% 18.0% 15.8%
NHS Tayside 11.8% 12.6% 12.5%
NHS Western Isles 21.3% 18.7% 17.7%
Scotland 16.6% 16.8% 17.2%
Table 11: People prescribed a LABA without ICS per 1000 patient size (Chart 5)
NHS Board October to December 2020 October to December 2021 October to December 2022
NHS Ayrshire & Arran 0.69 0.65 0.61
NHS Borders 0.53 0.46 0.36
NHS Dumfries & Galloway 0.90 0.74 0.60
NHS Fife 0.54 0.44 0.40
NHS Forth Valley 0.22 0.20 0.18
NHS Grampian 0.13 0.11 0.10
NHS Greater Glasgow & Clyde 0.83 0.72 0.56
NHS Highland 0.54 0.45 0.37
NHS Lanarkshire 0.17 0.13 0.14
NHS Lothian 0.21 0.20 0.17
NHS Orkney 0.36 0.36 0.13
NHS Shetland 0.35 0.13 0.30
NHS Tayside 0.35 0.27 0.21
NHS Western Isles 1.31 1.04 0.81
Scotland 0.45 0.39 0.33
Table 12: Prescribing of SABA only (in absence of other inhalers) (Chart 6)
NHS Board October to December 2020 October to December 2021 October to December 2022
NHS Ayrshire & Arran 20.0% 22.2% 22.8%
NHS Borders 19.4% 22.5% 22.5%
NHS Dumfries & Galloway 20.8% 23.3% 23.4%
NHS Fife 20.4% 23.8% 24.0%
NHS Forth Valley 20.5% 23.0% 22.6%
NHS Grampian 19.8% 23.0% 22.5%
NHS Greater Glasgow & Clyde 20.5% 23.9% 24.2%
NHS Highland 20.3% 24.3% 24.9%
NHS Lanarkshire 19.2% 22.8% 23.6%
NHS Lothian 20.8% 24.1% 24.2%
NHS Orkney 20.4% 22.0% 23.7%
NHS Shetland 19.0% 19.6% 22.9%
NHS Tayside 18.8% 21.4% 21.0%
NHS Western Isles 21.0% 22.4% 22.7%
Scotland 20.0% 23.2% 23.4%
Table 13: Number of Montelukast doses prescribed per 1000 list size of population (Chart 7)
NHS Board October to December 2020 October to December 2021 October to December 2022
NHS Ayrshire & Arran 724.13 733.51 757.25
NHS Borders 630.80 624.85 664.66
NHS Dumfries & Galloway 672.49 715.90 766.32
NHS Fife 727.52 744.48 753.05
NHS Forth Valley 609.54 649.16 675.26
NHS Grampian 535.77 559.98 568.78
NHS Greater Glasgow & Clyde 426.23 438.71 454.68
NHS Highland 533.83 548.13 544.58
NHS Lanarkshire 739.05 756.37 800.09
NHS Lothian 411.99 414.31 423.09
NHS Orkney 492.73 639.41 690.21
NHS Shetland 842.94 842.10 880.14
NHS Tayside 633.39 641.95 639.02
NHS Western Isles 408.71 440.38 566.52
Scotland 519.78 533.60 548.94
Table 14: Number of people with severe asthma receiving biologics as a proportion of the estimated severe asthma population (Chart 8)
NHS Board Total number of patients on biologics for severe asthma Total weighted patient list size* Patients on treatment / weighted 100,000 patients Potential population with severe asthma (est 4% of asthma population)
NHS Ayrshire & Arran 58 386625 15.00 773
NHS Borders 21 120675 17.40 241
NHS Dumfries & Galloway 26 144499 17.99 289
NHS Fife 30 392751 7.64 786
NHS Forth Valley 62 323774 19.15 648
NHS Grampian 397 1334720 29.74 2669
NHS Greater Glasgow & Clyde 151 600359 25.15 1201
NHS Highland 64 338204 18.92 676
NHS Lanarkshire 140 693596 20.18 1387
NHS Lothian 201 1002978 20.04 2006
NHS Tayside 180 434197 41.46 868
Scotland 1330 5772378 23.04 11545
Table 15: Mucolytic Prescribing (Chart 9)
NHS Board October to December 2020 October to December 2021 October to December 2022
NHS Ayrshire & Arran 2.11 2.04 1.90
NHS Borders 1.18 1.39 1.33
NHS Dumfries & Galloway 1.98 1.78 1.62
NHS Fife 0.76 0.76 0.64
NHS Forth Valley 1.59 1.59 1.31
NHS Grampian 0.78 0.83 0.78
NHS Greater Glasgow & Clyde 2.25 2.13 1.80
NHS Highland 1.09 1.07 0.99
NHS Lanarkshire 2.03 1.94 1.75
NHS Lothian 0.36 0.38 0.35
NHS Orkney 1.32 1.68 1.42
NHS Shetland 0.53 0.48 0.58
NHS Tayside 0.88 0.79 0.61
NHS Western Isles 1.89 2.22 2.21
Scotland 1.47 1.42 1.24
Table 16: Number of people receiving triple therapy (either as separate or single inhalers) (Chart 10)
NHS Board October to December 2020 October to December 2021 October to December 2022
NHS Ayrshire & Arran 14.58 14.60 15.42
NHS Borders 11.50 11.55 12.11
NHS Dumfries & Galloway 14.70 15.05 15.93
NHS Fife 9.61 9.98 11.25
NHS Forth Valley 11.58 11.93 12.05
NHS Grampian 8.56 8.81 9.16
NHS Greater Glasgow & Clyde 11.68 11.93 12.31
NHS Highland 9.25 9.44 9.31
NHS Lanarkshire 13.37 13.64 13.99
NHS Lothian 8.30 8.23 8.40
NHS Orkney 8.04 9.75 9.67
NHS Shetland 7.36 7.61 7.90
NHS Tayside 11.34 12.31 13.23
NHS Western Isles 6.42 6.92 6.23
Scotland 10.88 11.12 11.54
Table 17: Number of people prescribed triple therapy as a single device as a proportion of all patients prescribed triple therapy (Chart 11)
NHS Board October to December 2020 October to December 2021 October to December 2022
NHS Ayrshire & Arran 50.9% 54.8% 61.5%
NHS Borders 42.2% 50.9% 58.2%
NHS Dumfries & Galloway 42.3% 50.2% 57.6%
NHS Fife 51.7% 57.5% 62.9%
NHS Forth Valley 49.5% 69.7% 74.0%
NHS Grampian 60.3% 64.5% 71.1%
NHS Greater Glasgow & Clyde 51.5% 55.6% 60.2%
NHS Highland 47.4% 57.7% 65.3%
NHS Lanarkshire 44.8% 52.5% 59.2%
NHS Lothian 54.2% 59.3% 62.6%
NHS Orkney 44.6% 54.2% 59.1%
NHS Shetland 50.9% 57.1% 64.3%
NHS Tayside 62.0% 64.7% 66.0%
NHS Western Isles 25.0% 33.7% 47.9%
Scotland 51.4% 57.7% 62.9%
Table 18: Respiratory Costs per treated patient (Chart 12)
NHS Board January to December 2020 January to December 2021 January to December 2022
NHS Ayrshire & Arran £177 £171 £162
NHS Borders £170 £167 £161
NHS Dumfries & Galloway £167 £163 £152
NHS Fife £172 £168 £162
NHS Forth Valley £178 £174 £167
NHS Grampian £165 £164 £158
NHS Greater Glasgow & Clyde £176 £172 £165
NHS Highland £171 £169 £160
NHS Lanarkshire £181 £174 £163
NHS Lothian £163 £159 £151
NHS Orkney £156 £157 £140
NHS Shetland £143 £144 £132
NHS Tayside £172 £178 £175
NHS Western Isles £154 £146 £135
Scotland £174 £171 £163
Table 19: Proportion of generically prescribed inhalers as a proportion of all inhaler (excluding salbutamol) (Chart 13)
NHS Board October to December 2020 October to December 2021 October to December 2022
NHS Ayrshire & Arran 8.3% 7.1% 5.9%
NHS Borders 7.9% 7.2% 6.7%
NHS Dumfries & Galloway 15.6% 13.5% 12.4%
NHS Fife 6.6% 6.3% 6.0%
NHS Forth Valley 5.2% 4.4% 4.2%
NHS Grampian 7.2% 6.8% 6.5%
NHS Greater Glasgow & Clyde 9.3% 8.0% 7.0%
NHS Highland 7.8% 6.8% 6.3%
NHS Lanarkshire 6.7% 6.1% 5.6%
NHS Lothian 9.3% 8.0% 6.3%
NHS Orkney 9.0% 6.8% 6.0%
NHS Shetland 11.1% 10.3% 8.7%
NHS Tayside 4.9% 4.8% 4.4%
NHS Western Isles 19.2% 18.9% 17.6%
Scotland 8.1% 7.2% 6.4%
Table 20: CO2 Emissions (kg) per 1000 patients on list size (including targets)(Chart 14)
NHS Board January to December 2020 January to December 2021 January to December 2022
NHS Ayrshire & Arran 14,405 13,686 14,262
NHS Borders 15,571 14,181 15,511
NHS Dumfries & Galloway 19,192 18,263 18,508
NHS Fife 14,395 13,237 14,318
NHS Forth Valley 12,055 12,307 12,940
NHS Grampian 12,091 11,611 11,118
NHS Greater Glasgow & Clyde 13,918 13,518 13,837
NHS Highland 13,089 11,888 11,429
NHS Lanarkshire 14,241 13,830 14,836
NHS Lothian 12,294 11,322 11,468
NHS Orkney 14,223 12,824 13,607
NHS Shetland 16,076 14,514 15,223
NHS Tayside 14,951 14,485 14,729
NHS Western Isles 15,550 14,725 15,510
Scotland 13,666 13,032 13,347
Table 21: Proportion of pMDIs versus all inhalers (dry powder and soft mist inhalers) (Chart 15)
NHS Board October to December 2020 October to December 2021 October to December 2022
NHS Ayrshire & Arran 60.6% 63.4% 64.5%
NHS Borders 66.7% 68.6% 69.4%
NHS Dumfries & Galloway 69.8% 72.0% 72.7%
NHS Fife 63.9% 66.1% 67.6%
NHS Forth Valley 61.2% 65.5% 66.6%
NHS Grampian 67.5% 69.7% 71.0%
NHS Greater Glasgow & Clyde 65.3% 67.6% 68.1%
NHS Highland 61.0% 62.9% 62.3%
NHS Lanarkshire 60.8% 64.1% 66.5%
NHS Lothian 68.8% 70.9% 71.1%
NHS Orkney 70.2% 71.1% 71.2%
NHS Shetland 72.9% 74.6% 74.8%
NHS Tayside 73.2% 74.3% 74.6%
NHS Western Isles 64.9% 66.7% 68.2%
Scotland 65.1% 67.6% 68.5%
Table 22: Salbutamol DPI as a proportion of all salbutamol (items)(Chart 16)
NHS Board October to December 2020 October to December 2021 October to December 2022
NHS Ayrshire & Arran 13.1% 12.1% 11.7%
NHS Borders 6.0% 5.5% 5.6%
NHS Dumfries & Galloway 6.5% 6.1% 6.2%
NHS Fife 12.1% 11.1% 10.1%
NHS Forth Valley 15.8% 13.9% 13.8%
NHS Grampian 3.0% 2.9% 2.7%
NHS Greater Glasgow & Clyde 7.7% 7.3% 8.0%
NHS Highland 3.3% 3.4% 5.2%
NHS Lanarkshire 7.3% 6.6% 6.2%
NHS Lothian 5.2% 4.8% 5.6%
NHS Orkney 1.2% 2.3% 2.9%
NHS Shetland 2.2% 2.3% 2.3%
NHS Tayside 3.0% 2.7% 2.8%
NHS Western Isles 3.3% 3.1% 4.1%
Scotland 7.4% 6.8% 7.0%
Table 23: People prescribed both pMDI and DPI in consecutive quarters as a proportion of all people prescribed a DPI (Chart 17)
NHS Board July to December 2020 July to December 2021 July to December 2022
NHS Ayrshire & Arran 30.3% 29.2% 28.6%
NHS Borders 34.3% 32.6% 32.3%
NHS Dumfries & Galloway 38.2% 36.8% 35.6%
NHS Fife 28.3% 27.7% 27.1%
NHS Forth Valley 27.4% 26.0% 25.6%
NHS Grampian 34.5% 33.9% 33.6%
NHS Greater Glasgow & Clyde 38.4% 37.1% 36.0%
NHS Highland 34.8% 33.3% 32.8%
NHS Lanarkshire 39.2% 37.3% 36.4%
NHS Lothian 34.0% 33.3% 32.2%
NHS Orkney 30.3% 30.0% 32.2%
NHS Shetland 36.6% 34.4% 34.5%
NHS Tayside 38.3% 37.5% 37.9%
NHS Western Isles 32.6% 33.9% 36.0%
Scotland 35.3% 34.1% 33.4%
Table 24: People prescribed inhalers as separate devices as a proportion of people prescribed any inhaler for which a combination inhaler may be appropriate (Chart 18)
NHS Board October to December 2020 October to December 2021 October to December 2022
NHS Ayrshire & Arran 16.7% 15.0% 12.9%
NHS Borders 15.8% 13.4% 11.6%
NHS Dumfries & Galloway 18.3% 15.7% 13.6%
NHS Fife 10.8% 9.9% 9.2%
NHS Forth Valley 15.7% 9.6% 8.3%
NHS Grampian 9.9% 8.9% 7.5%
NHS Greater Glasgow & Clyde 16.0% 14.8% 13.1%
NHS Highland 13.0% 10.6% 8.9%
NHS Lanarkshire 15.6% 13.4% 11.5%
NHS Lothian 11.6% 10.2% 9.5%
NHS Orkney 14.6% 13.3% 10.8%
NHS Shetland 10.7% 9.3% 7.2%
NHS Tayside 10.8% 10.4% 10.4%
NHS Western Isles 15.7% 14.4% 10.6%
Scotland 13.9% 12.1% 10.8%

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