Changes in primary care prescribing in the northern region UK: 1989–1992

Prescribing rates for the Family Health Service Authorities (FHSAs) of the Northern region were studied for the period June 1989–September 1992. Over three years the total number of items prescribed in the region rose by 13 per cent, and costs rose by 39 per cent. Trends within individual leading British National Formulary (BNF) chapters were different. The number of endocrine items increased substantially faster than average (45 per cent, over three years); gastro‐intestinal (GI) items also showed an above average rise; central nervous system (CNS) and infections items rose by only 6–8 per cent. In terms of cost, there were major rises for both endocrine (89 per cent) and CNS (62 per cent) drugs, but musculoskeletal (MS) prescribing costs were nearly static (+5 per cent). These trends were similar across the nine FHSAs in the Northern region. Significant upturns in the prescribing trends for CNS and endocrine drugs occurred in early 1992 leading to the high overall increases already noted. Despite the pressure for conformity associated with changes in the funding of general practitioners' prescribing budgets, the differences between FHSAs in their absolute prescribing rates have largely remained. Within each therapeutic group the rankings of FHSAs have also shown surprising consistency. Whether these observations are attributable to fundamental differences in patient populations, or merely the consequence of inertia with respect to historic rates, is debatable. The reasons can only be properly determined by focused investigation of data linking prescribing and patient demographics.