The Safety Medication Dashboard (SMASH) is an award-winning IT system developed by the University of Manchester to prevent hazardous prescribing. It analyses patient record data against evidence-based harm indicators, such as acute kidney injury or gastrointestinal bleeds, to highlight cases where reviews are necessary. The SMASH dashboard uses live data by integrating with the Greater Manchester Care Record (GMCR) and is accessible to all primary care, pharmacy, and clinical staff across Greater Manchester.

The indicators included in the SMASH dashboard are selected based on a combination of:

• National patient safety priorities
• Robust, evidence-based research
• Feedback from local Greater Manchester safety groups and clinical forums

The SMASH dashboard was originally based on the PINCER indicator set, a well-established set of prescribing safety indicators developed by the University of Nottingham. These form the foundation for identifying at-risk patients and driving safer prescribing practices.

Over time, the SMASH dashboard has evolved to include additional indicators developed in response to local and national needs through the GM Medicines Safety Group. These are rigorously tested and reviewed before deployment.

To access the evidence and rationale behind each indicator, click on ‘References’ in the sidebar of the SMASH dashboard. This section provides concise clinical evidence summaries that support each alert.

The evidence summaries have been reviewed and signed off by the IPMO Medicines Safety Group, GMMMG and GM CEG groups prior to release.

The SMASH dashboard uses data from the Graphnet GMCR system, refreshed daily. This ensures that the indicators reflect real-time prescribing and monitoring activity.

You can see the exact date and time of when this was last updated by looking at the bottom of the dashboard in small, fine print: ‘Data last refreshed: DD/MM/YYYY hh:mm’

You may only have “Whole ICB” access, which shows aggregate data. To view patient-level data, your account must be granted “Patient List” access, assigned by the SMASH team. Please complete this form https://forms.office.com/e/VQqmKQz4Ef to update your permissions.

Once you have the correct permissions, ensure you are on “Patient List” view as below. You will not be able to see any patient lists within “Whole ICB View”.

This can happen due to how the SMASH dashboard logic works. Some indicators track prescriptions over the last 3 months, so patients may continue to flag for a short time after action is taken, whereas others may drop off straight away.

Refer to the SMASH Logic Table to understand when a patient will stop flagging based on the indicator.

Example: A patient prescribed an NSAID without a PPI will only stop flagging once a PPI is added OR 3 months have passed since the last NSAID prescription.

Yes. The updated dashboard includes a Comparison View. Navigate via the sidebar “Whole ICB View” → “Comparison View”

• Compare between 2 GP practices, PCNs or sub-ICBs
• View indicator performance over time

See SMASH User Guide for more detailed guidance.

This feature is currently in development. Once available, you’ll be able to:

• Leave notes against patient entries for each specific indicator
• Record review outcomes for colleagues to see

You should continue to document review notes in the patient’s clinical record or use your organisation’s communication tools to share information with colleagues. Please note that the SMASH notes functionality will not write directly into the patient’s GP Clinical Record and should be seen as an alternative entry into the patient record.

To use the Filter Feature effectively, please refer to the ‘How To Use’ section in the left-hand panel on the dashboard. Please also refer to the SMASH User Guide for detailed visual guidance.