PFD report

Darren James CARRINGTON · Prevention of Future Deaths report

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Issued 15 Jun 2018•Brighton and Hove

Report record

Published report and response evidence

This page connects the concerns raised in this report with statements found in recipients’ published responses. A link shows a clear evidence connection; it does not assign responsibility.

View original report
Concerns
2

Raised in this report

Recipients
3

Named on the report

Responses found
3

Of 3 recipients

Stated actions
29

Described in responses

Recipients and published responses

Source document

Full report text

This is the full text from the original published report.

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Concerns and recipient responses

Select any concern, action or position to view the source wording.

Concerns raised2

  1. Failure to apply adequate safeguards when prescribing potentially dependence-forming or misused medication
    Part of recurring concern: Failure to identify clinically significant medication risksPart of recurring concern: Inadequate safeguards against misuse of medicines with abuse potentialPart of recurring concern: Unsafe medication prescribing
  2. Failure of prescribing-system warnings to prevent inappropriate override
    Part of recurring concern: Inadequate safeguards for medication-safety software overrides
Responses linked to these concerns

Each statement is shown once, even when linked to more than one concern.

Actions described in response An action is something a recipient says it has done, is doing, or plans to do in response to a concern raised.19

  1. Action

    Discuss discharge-information requirements with Emergency Department medical staff through regular governance meetings.

    Stated by University Hospitals Sussex NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 8 July 2018.
  2. Action

    Discuss sharing the high-risk medication review protocol with a linked practice.

    Stated by NHS Surrey and Sussex Integrated Care BoardStated in progressThe respondent said that this action was in progress when they made their response on 8 July 2018.
  3. Action

    Lower computer-alert thresholds for early prescription ordering and increase awareness of relevant alerts.

    Stated by NHS Surrey and Sussex Integrated Care BoardStated completedThe respondent said that this action was complete when they made their response on 8 July 2018.

Source evidence

How this individual concern was interpreted

PFD Monitor created a concise, searchable interpretation from the report wording shown below. Response links show a clear evidence connection; they do not assign responsibility.

PFD Monitor interpretation

Failure to apply adequate safeguards when prescribing potentially dependence-forming or misused medication

Wider context from the report

“The method of prescribing medication such as Zopiclone (in this case), Codeine, Morphine, Benzodiazepines etc. to patients which suggests that they either are or are very likely to be becoming dependent upon such medications or are misusing them. Examples of both the above would be too frequent requests for repeat prescriptions and information concerning a history of overdoses. The Inquest discussed whether circumstances, including those outlined above should trigger an automatic/mandatory medication review conducted with the patient; consideration of a different prescribing period and very careful monitoring of the online requests for repeat prescriptions. Alternatively, there could be a ban on the requests for repeat prescriptions with the repeats simply being issued for an appropriate period of time “automatically”. In this case as you will see from ████████ report, over twice the appropriate amount of Zopiclone was issued over a period of 57 days. The patient in question had Zopiclone present at a fatal level in his blood at the time of his collapse from which he never recovered. I remain very worried about these prescribing issues and about the fact that apparently receptionists and clinicians can override the warnings in the surgery’s computer system. I should like this to be carefully investigated and look forward to hearing with a response within the relevant time period. I realise that the situation may be exacerbated by GPs working part time and many part time practitioners being involved in the prescribing procedure as well as many receptionists being involved in it but if this is the trend then it seems to me the safeguards must be extended not made easier to override. The other ‘failsafe device’ is the dispensing pharmacist. When repeats are requested online there is a designated pharmacy. They receive emailed scripts. Their own systems should flag up cases of over or too frequent prescribing as well as other matters. ”

Is this part of a recurring concern?

Yes — Failure to identify clinically significant medication risks; Inadequate safeguards against misuse of medicines with abuse potential; Unsafe medication prescribing.

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Source evidence

How this individual concern was interpreted

PFD Monitor created a concise, searchable interpretation from the report wording shown below. Response links show a clear evidence connection; they do not assign responsibility.

PFD Monitor interpretation

Failure of prescribing-system warnings to prevent inappropriate override

Wider context from the report

“The method of prescribing medication such as Zopiclone (in this case), Codeine, Morphine, Benzodiazepines etc. to patients which suggests that they either are or are very likely to be becoming dependent upon such medications or are misusing them. Examples of both the above would be too frequent requests for repeat prescriptions and information concerning a history of overdoses. The Inquest discussed whether circumstances, including those outlined above should trigger an automatic/mandatory medication review conducted with the patient; consideration of a different prescribing period and very careful monitoring of the online requests for repeat prescriptions. Alternatively, there could be a ban on the requests for repeat prescriptions with the repeats simply being issued for an appropriate period of time “automatically”. In this case as you will see from ████████ report, over twice the appropriate amount of Zopiclone was issued over a period of 57 days. The patient in question had Zopiclone present at a fatal level in his blood at the time of his collapse from which he never recovered. I remain very worried about these prescribing issues and about the fact that apparently receptionists and clinicians can override the warnings in the surgery’s computer system. I should like this to be carefully investigated and look forward to hearing with a response within the relevant time period. I realise that the situation may be exacerbated by GPs working part time and many part time practitioners being involved in the prescribing procedure as well as many receptionists being involved in it but if this is the trend then it seems to me the safeguards must be extended not made easier to override. The other ‘failsafe device’ is the dispensing pharmacist. When repeats are requested online there is a designated pharmacy. They receive emailed scripts. Their own systems should flag up cases of over or too frequent prescribing as well as other matters. ”

Is this part of a recurring concern?

Yes — Inadequate safeguards for medication-safety software overrides.

Open source report

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Discuss discharge-information requirements with Emergency Department medical staff through regular governance meetings.

Verbatim wording from the response

“I am very sorry that Mr Carrington's GP, Sussex Partnership NHS Foundation Trust and Pavilions did not receive adequate information concerning the details of Mr Carrington’s mixed overdose and accept that this does not reflect good continuity of care. I can confirm that this has been fed back to ████████, Clinical Director for Emergency and Acute Medicine and to ████████, Consultant and Governance Lead for Emergency Medicine. ████████ have discussed these issues with all medical staff as part of the Emergency Department regular governance meetings to highlight the issues that arose from Mr Carrington’s attendances and the importance of ensuring that discharge letters contain sufficient detail.”

Source location

2018-0181-Response-from-Brighton-and-Sussex-University-Hospitals
Page 1 · response
Published 8 July 2018

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Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Discuss sharing the high-risk medication review protocol with a linked practice.

Verbatim wording from the response

“• Ongoing discussions with linked Practice around sharing high risk medication review protocol.”

Source location

2018-0181-Response-from-Commission-Alliance-
Page 2 · response
Published 8 July 2018

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Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Lower computer-alert thresholds for early prescription ordering and increase awareness of relevant alerts.

Verbatim wording from the response

“• Computer settings changed with a view to lower thresholds for flagging up early ordering of scripts and increased awareness around the potential significance of these and other alerts.”

Source location

2018-0181-Response-from-Commission-Alliance-
Page 2 · response
Published 8 July 2018

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Embed the high-risk drug review protocol with support from the Medication Management team.

Verbatim wording from the response

“Our Medication Management team are providing ongoing support. In particular, around embedding The High Risk Drug review protocol mentioned above, as well as ensuring that the new Practice Repeat Prescribing Policy covers current best practice.”

Source location

2018-0181-Response-from-Commission-Alliance-
Page 2 · response
Published 8 July 2018

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Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Provide protected administrative and clinical staff time to manage prescription requests.

Verbatim wording from the response

“• Arrangements have been made to ensure administrative and clinical staff have adequate, protected time to manage prescription requests.”

Source location

2018-0181-Response-from-Commission-Alliance-
Page 2 · response
Published 8 July 2018

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Ensure the new Practice Repeat Prescribing Policy covers current best practice.

Verbatim wording from the response

“Our Medication Management team are providing ongoing support. In particular, around embedding The High Risk Drug review protocol mentioned above, as well as ensuring that the new Practice Repeat Prescribing Policy covers current best practice.”

Source location

2018-0181-Response-from-Commission-Alliance-
Page 2 · response
Published 8 July 2018

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Review high-risk prescribing records and remove online prescription-request access for weekly, controlled, dependency-forming and potentially abusive medicines.

Verbatim wording from the response

“• Records of all patients receiving weekly prescriptions have been reviewed and access to on-line requests have been removed.”

Source location

2018-0181-Response-from-Commission-Alliance-
Page 2 · response
Published 8 July 2018

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Increase staff awareness of frequent requests for small medication quantities as potential risk indicators.

Verbatim wording from the response

“I can confirm that the following changes have been implemented at North Laine Surgery via a Practice Meeting attended by all staff:-”

Source location

2018-0181-Response-from-Commission-Alliance-
Page 2 · response
Published 8 July 2018

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Audit records of patients receiving Zopiclone and review their prescribed quantities.

Verbatim wording from the response

“I can confirm that the following changes have been implemented at North Laine Surgery via a Practice Meeting attended by all staff:-”

Source location

2018-0181-Response-from-Commission-Alliance-
Page 2 · response
Published 8 July 2018

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Code all overdoses and suicide attempts in the practice system.

Verbatim wording from the response

“Action plan following meeting held on 22nd May which have been implemented by the practice.”

Source location

2018-0181-Response-from-North-Laine-Medical-Centre
Page 3 · response
Published 8 July 2018

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Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Develop a computer-generated warning identifying patients with overdoses or suicide attempts when high-risk medicines are requested.

Verbatim wording from the response

“10. A further meeting is planned with the practice IT coordinator to highlight automatically patients who have taken an overdose when certain high-risk drugs are requested. We hope to have this in place shortly.”

Source location

2018-0181-Response-from-North-Laine-Medical-Centre
Page 2 · response
Published 8 July 2018

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Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Add patients who overdose to the weekly prescription list.

Verbatim wording from the response

“5. Patients who overdose will be added to the weekly script list.”

Source location

2018-0181-Response-from-North-Laine-Medical-Centre
Page 2 · response
Published 8 July 2018

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Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Review patients receiving controlled drugs and agree medication-reduction or cessation plans with them.

Verbatim wording from the response

“9. A whole practice meeting took place on 24th July to discuss the updated practice prescribing policy. Ongoing review of patients on controlled drugs ████████ ████████ will occur and a plan to reduce and/or stop agreed with the patient. This will complement what the practice already has put in place over the past 2 years in terms of reduction programmes for patients.”

Source location

2018-0181-Response-from-North-Laine-Medical-Centre
Page 2 · response
Published 8 July 2018

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Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Revise the practice prescribing policy using CCG pharmaceutical advice and discuss the updated policy in a whole-practice meeting.

Verbatim wording from the response

“6. There has been an extensive revision of the practice prescribing policy incorporating suggestions from the CCG pharmaceutical adviser and we are having a practice meeting on 24th July to discuss further. We look forward to working with her again over the next year to improve further our systems.”

Source location

2018-0181-Response-from-North-Laine-Medical-Centre
Page 2 · response
Published 8 July 2018

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Change computer-system thresholds so early-order warnings appear one day before due dates and online ordering closes three days before due dates.

Verbatim wording from the response

“4. An investigation into online ordering and script generation by the computer system was conducted in conjunction with the practice IT co-ordinator. As a result, the timings were changed within the system so that warnings about scripts being ordered too early were changed from 7 to 1 day and ordering online from 10 to 3 days.”

Source location

2018-0181-Response-from-North-Laine-Medical-Centre
Page 2 · response
Published 8 July 2018

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Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Raise receptionist and GP awareness of patients ordering prescriptions too early, including when requested amounts appear small.

Verbatim wording from the response

“7. There has been a raised awareness of the potential of any patient to over-order medication, whether by accident or design.”

Source location

2018-0181-Response-from-North-Laine-Medical-Centre
Page 2 · response
Published 8 July 2018

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Remove online prescription requests for controlled drugs and drugs of potential abuse or dependence, following patient assessment.

Verbatim wording from the response

“3. Access to online requests for controlled drugs has been removed for all patients. Following discussion with the patient and their doctor, this may be restored if the patient is considered “low-risk”.”

Source location

2018-0181-Response-from-North-Laine-Medical-Centre
Page 2 · response
Published 8 July 2018

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Copy all GPs into reports of overdoses and other suicide attempts.

Verbatim wording from the response

“Action plan following meeting held on 22nd May which have been implemented by the practice.”

Source location

2018-0181-Response-from-North-Laine-Medical-Centre
Page 3 · response
Published 8 July 2018

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Audit Zopiclone prescribing to verify repeat-template intervals, doses and limits, and reduce some prescription amounts.

Verbatim wording from the response

“2. An audit of all patients on Zopiclone was carried out to ensure that limits and doses were correctly entered on the system. There was no evidence that any other patients had over-ordered or done so too early.”

Source location

2018-0181-Response-from-North-Laine-Medical-Centre
Page 2 · response
Published 8 July 2018

Open published response

Other statements in published responses

These actions and other statements could not be clearly connected to one concern in this report.

Recipient-stated actions An action is something a recipient says it has done, is doing, or plans to do in response to a concern raised.10

  1. 1

    Use the Task and Finish Group to highlight community pharmacists’ safety role and promote a joint approach.

    Stated by NHS Surrey and Sussex Integrated Care BoardStated plannedThe respondent said that this action was planned when they made their response on 8 July 2018.
  2. 2

    Circulate all patient self-harm reports to clinical staff.

    Stated by NHS Surrey and Sussex Integrated Care BoardStated completedThe respondent said that this action was complete when they made their response on 8 July 2018.
  3. 3

    Establish the Task and Finish Group to share learning across the city, including community pharmacy, digital, practice management and primary care representatives.

    Stated by NHS Surrey and Sussex Integrated Care BoardStated plannedThe respondent said that this action was planned when they made their response on 8 July 2018.
  4. 4

    Review best-practice coding for self-harm.

    Stated by NHS Surrey and Sussex Integrated Care BoardStated completedThe respondent said that this action was complete when they made their response on 8 July 2018.
  5. 5

    Continue liaison with the CCG, other groups and the task-and-finish group on safer prescribing systems.

    Stated by North Laine Medical CentreStated in progressThe respondent said that this action was in progress when they made their response on 8 July 2018.
  6. 6

    Self-refer the practice to the GMC regarding the prescribing concerns.

    Stated by North Laine Medical CentreStated completedThe respondent said that this action was complete when they made their response on 8 July 2018.
  7. 7

    Allocate protected processing time to the receptionist handling repeat prescriptions and the doctor authorising them.

    Stated by North Laine Medical CentreStated plannedThe respondent said that this action was planned when they made their response on 8 July 2018.
  8. 8

    Conduct a whole-practice significant event analysis and implement its signed prescribing action plan.

    Stated by North Laine Medical CentreStated completedThe respondent said that this action was complete when they made their response on 8 July 2018.
  9. 9

    Continue liaison with NHS England and the CQC about the prescribing concerns.

    Stated by North Laine Medical CentreStated in progressThe respondent said that this action was in progress when they made their response on 8 July 2018.
  10. 10

    Discuss St Peter’s Medical Centre’s high-risk medication protocol and potential use in medication reviews.

    Stated by North Laine Medical CentreStated plannedThe respondent said that this action was planned when they made their response on 8 July 2018.

Recipient positions A position is what a recipient says about a concern when they do not describe a specific action.1

  1. 1

    Same-day electronic discharge summaries cannot yet be implemented because process, system testing and Medway rollout work remain necessary.

    Stated by University Hospitals Sussex NHS Foundation TrustUnable to actThe respondent said that a constraint prevented them from taking the relevant action.

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Use the Task and Finish Group to highlight community pharmacists’ safety role and promote a joint approach.

Verbatim wording from the response

“You raise the important issue to what extent Community Pharmacists provide an additional level of safety. Representatives of the Local Pharmaceutical Committee have agreed to attend the Task and Finish Group during which we will highlight this role and the importance of a joint approach.”

Source location

2018-0181-Response-from-Commission-Alliance-
Page 2 · response
Published 8 July 2018

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Circulate all patient self-harm reports to clinical staff.

Verbatim wording from the response

“I can confirm that the following changes have been implemented at North Laine Surgery via a Practice Meeting attended by all staff:-”

Source location

2018-0181-Response-from-Commission-Alliance-
Page 2 · response
Published 8 July 2018

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Establish the Task and Finish Group to share learning across the city, including community pharmacy, digital, practice management and primary care representatives.

Verbatim wording from the response

“I am confident that the measures outlined will significantly reduce the chance of future related patient harm at North Laine Surgery. It is however, essential that the learning is shared across the city. The Task and Finish Group’s membership will include Community Pharmacy Representatives, CCG digital staff, Practice Managers as well as Primary care Clinicians with a view to ensuring maximal learning from this case is embedded across the city.”

Source location

2018-0181-Response-from-Commission-Alliance-
Page 2 · response
Published 8 July 2018

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Review best-practice coding for self-harm.

Verbatim wording from the response

“I can confirm that the following changes have been implemented at North Laine Surgery via a Practice Meeting attended by all staff:-”

Source location

2018-0181-Response-from-Commission-Alliance-
Page 2 · response
Published 8 July 2018

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Continue liaison with the CCG, other groups and the task-and-finish group on safer prescribing systems.

Verbatim wording from the response

“8. ████████ will continue to liaise with the CCG and other groups and will be a member of the T and F group looking into these issues. As part of this, he had a meeting with ████████, the chair of the CCG, on 23rd July where the issues involved were discussed and he seemed supportive of the practice’s efforts to address the problem. ████████ has seen a draft of the report to be submitted by ████████ and feels it accurately reflects the actions and changes made by the practice.”

Source location

2018-0181-Response-from-North-Laine-Medical-Centre
Page 2 · response
Published 8 July 2018

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Self-refer the practice to the GMC regarding the prescribing concerns.

Verbatim wording from the response

“11. We have self-referred as a practice to the GMC and are also liaising with NHS England and the CQC. We will be submitting a full report to NHS England at some point in the future.”

Source location

2018-0181-Response-from-North-Laine-Medical-Centre
Page 2 · response
Published 8 July 2018

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Allocate protected processing time to the receptionist handling repeat prescriptions and the doctor authorising them.

Verbatim wording from the response

“8. The receptionist processing repeat prescriptions for the day is to be given allocated and protected time to process the scripts and the same will apply to the doctor signing them off. Receptionists have been reminded that the turnaround for prescriptions is two working days and not to feel pressurised to take less time.”

Source location

2018-0181-Response-from-North-Laine-Medical-Centre
Page 3 · response
Published 8 July 2018

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Conduct a whole-practice significant event analysis and implement its signed prescribing action plan.

Verbatim wording from the response

“1. A significant event analysis attended by the whole practice was held on 22nd May, 2018 to discuss the issues raised by the case. An action plan of 10 items was drawn up which has been read and signed by all participants in the prescribing/repeat prescribing process.”

Source location

2018-0181-Response-from-North-Laine-Medical-Centre
Page 2 · response
Published 8 July 2018

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Continue liaison with NHS England and the CQC about the prescribing concerns.

Verbatim wording from the response

“11. We have self-referred as a practice to the GMC and are also liaising with NHS England and the CQC. We will be submitting a full report to NHS England at some point in the future.”

Source location

2018-0181-Response-from-North-Laine-Medical-Centre
Page 2 · response
Published 8 July 2018

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Discuss St Peter’s Medical Centre’s high-risk medication protocol and potential use in medication reviews.

Verbatim wording from the response

“9. We will discuss St Peter’s Medical Centre’s protocol for high risk medication and how we might use this in the practice, particularly around medication reviews.”

Source location

2018-0181-Response-from-North-Laine-Medical-Centre
Page 3 · response
Published 8 July 2018

Open published response

Source evidence

How this respondent position was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Same-day electronic discharge summaries cannot yet be implemented because process, system testing and Medway rollout work remain necessary.

Verbatim wording from the response

“With regard to sending discharge summaries I agree that these should ideally be sent by e-mail on the same day of the patient's discharge. However, this is a major project for the Trust and there is a considerable amount of work to be done on process and system testing before this can be implemented. We are currently focused on roll-out of the new Medway Patient Administration System and our hope is to implement systems within the next 12 months to allow discharge letters and summaries to be sent electronically to GPs and other partner organisations as required.”

Source location

2018-0181-Response-from-Brighton-and-Sussex-University-Hospitals
Page 1 · response
Published 8 July 2018

Open published response
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Information checked against the published report and official responses · Data reviewed 7 Sep 2026 · About data quality and limitations

Data last updated 7 September 2026