{
  "abstract": "Aim The local Integrated Care Board (ICB) has developed a digital dashboard which aims to identify all patients prescribed valproate products in primary care to support compliance with MHRA safety requirements. 1 2 This project aimed to evaluate the accuracy of this dashboard by comparing the paediatric patients prescribed sodium valproate or valproic acid identified by the dashboard and comparing them with hospital records from a specialist children’s hospital.Method A list of patients prescribed valproate was downloaded from the ICB dashboard into a secure NHS digital environment. Filters applied were: Age 0–21 years, Medication dates from 01/01/2025 to 01/05/2025, Valproate prescriptions.Additional filtering was applied:Responsible organisation = Specialist children’s hospital and/or GP practice. Latest outpatient organisation = Specialist children’s hospitalThis cohort was cross-checked against local Neurology and General Paediatrics records to identify discrepancies and assess alignment with MHRA Annual Risk Acknowledgement Form (ARAF) requirements.2 ResultsFemales:28/48 females were correctly flagged in the dashboard as our patients. 20 (42%) should have been under the care of local secondary care trustsMales:124 males were flagged. Of these: 23 (18.5%) were incorrectly included (due to stopping valproate, transition to adult services, or residence outside the ICB); 9 (7.3%) had started valproate post-2024 under our care. One of these was misaligned to GP care; 92 (74.2%) had started valproate pre-2024 but were not identified as this, in the dashboard, despite not requiring ARAF forms under MHRA guidance.1 Two patients from the local data were missing from the dashboard. Both started valproate in late 2024, potentially explaining their absence from Primary Care data.Following this audit, several actions were agreed: Dashboard developers will explore adding flags for pre-2024 initiations. Filters will be reviewed to exclude out-of-area patients. The local epilepsy network will discuss referral pathways when responsibility is misattributed between the specialist children’s hospitals and local trusts.Importantly, the audit identified two patients needing ARAF forms, prompting appropriate escalation. This underscores the importance of cross-sector collaboration and precise data sharing in large-scale safety initiatives. Accurate digital tools are crucial to ensure safe prescribing, timely referrals, and compliance with MHRA guidance.Conclusion This audit shows the ICB Valproate Dashboard is a valuable regional tool, but has significant limitations: It does not reliably differentiate patients started on valproate pre-2024 from new initiations, complicating the identification of those requiring ARAF forms. Misattribution of patient responsibility can lead to inappropriate referrals, missed specialist oversight, and delays in care. This is critical given the ICB’s planned policy requiring secondary care reviews within three weeks of GP referral.References Medicines and Healthcare products Regulatory Agency. Valproate use by women and girls. Updated safety information. MHRA 2023. Available at: https://www.gov.uk/drug-safety-update/valproate-licensing-changes-and-new-safety-measures {accessed 01.09.2025}National Institute for Health and Care Excellence. Epilepsies in children, young people and adults. NICE guideline NG217. London: NICE; 2022. Available from: https://www.nice.org.uk/guidance/ng217 {accessed 01.09.2025}",
  "authors": [
    {
      "affiliations": [
        "Alder Hey Children’s NHS Foundation Trust, UK"
      ],
      "name": "Andrew Taylor"
    }
  ],
  "title": "P53 Validation of an integrated care board valproate dashboard",
  "uid": "091067e6-1990-558b-933c-a072ac299063"
}