¹ January to September. Notes: 1. The PACT system covers prescriptions prescribed by general practitioners (GPs), nurses, pharmacists and others in England and dispensed in the community in the United Kingdom. For data at PCT level, prescriptions written by a prescriber located in a particular PCT but dispensed outside that PCT will be included in the PCT in which the prescriber is based. Prescriptions written in England but dispensed outside England are included. Prescriptions written in hospitals/clinics that are dispensed in the community, prescriptions dispensed in hospitals, dental prescribing and private prescriptions are not included in PACT data. It is important to note this as some British National Formulary (BNF) sections have a high proportion of prescriptions written in hospitals that are dispensed in the community. For example, BNF chapter 4, “Central Nervous System” has a fair proportion of items written in mental health clinics that are dispensed in the community—these prescriptions are not included in PACT data. 2. Data are held for 60 months and so at the moment the only complete years available are 2006, 2007, 2008 and 2009. Complete data for 2009 cannot be released until after the publication of the associated National Statistic in April 2010 and so only data for January to September is presented here. 3. Prescriptions are written on a prescription form known as a FP10. Each single item written on the form is counted as a prescription item. 4. The term “asthma-related conditions” has been taken to mean asthma and chronic obstructive pulmonary disease since they are treated with the same medications, namely those classified under sections 3.1, 3.2 and 3.3 of the BNF. Source: Prescribing Analysis and CosT (PACT) system.

Notes: 1. A finished consultant episode (FCE) is defined as a continuous period of admitted patient care under one consultant within one health care provider. FCEs are counted against the year in which they end. Please note that the figures do not represent the number of different patients, as a person may have more than one episode of care within the same stay in hospital or in different stays in the same year. 2. Episode duration/bed days: episode duration is calculated as the difference in days between the episode start date and the episode end date, where both are given. Episode duration is based on FCEs and applies only to ordinary admissions, i.e. day cases are excluded (unless otherwise stated). 3. The primary diagnosis is the first of up to 20 (14 from 2002-03 to 2006-07 and seven prior to 2002-03) diagnosis fields in the HES data set and provides the main reason why the patient was admitted to hospital. 4. PCT Changes: In July 2006, the NHS reorganised strategic health authorities (SHA) and PCTs in England from 28 SHAs into 10, and from 303 PCTs into 152. As a result, data from 2006-07 onwards is not directly comparable with previous years. In particular, it is noted that there was a change in the number of PCTs that constituted the London boroughs around 2003-04: Walthamstow, Leyton and Leytonstone PCT became Waltham Forest PCT; Chingford, Wanstead and Woodford PCT and Redbridge PCT became Redbridge PCT; and Bexley PCT became Bexley Care Trust. 5. Assessing growth through time: HES figures are available from 1989-90 onwards. The quality and coverage of the data have improved over time. These improvements in information submitted by the NHS have been particularly marked in the earlier years and need to be borne in mind when analysing time series. Some of the increase in figures for later years (particularly 2006-07 onwards) may be due to the improvement in the coverage of independent sector activity. Changes in NHS practice also need to be borne in mind when analysing time series. For example, a number of procedures may now be undertaken in out-patient settings and may no longer be accounted for in the HES data. This may account for any reductions in activity over time. 6. Data quality: HES are compiled from data sent by more than 300 NHS trusts and PCTs in England. Data is also received from a number of independent sector organisations for activity commissioned by the English NHS. The NHS Information Centre for health and social care liaises closely with these organisations to encourage submission of complete and valid data and seeks to minimise inaccuracies and the effect of missing and invalid data via HES processes. While this brings about improvement over time, some shortcomings remain. Source: Hospital Episode Statistics (HES), The NHS Information Centre for health and social care.