New insights into NHS prescribing for care home patients aged 65 and over released

27 November 2025

• An estimated 331,000 care home patients aged 65+ received NHS prescriptions on average each month in 2024/25 - an increase from 323,000 in 2023/24. They received an estimated 42 million prescription items at a drug cost of £410 million.

• Care home patients aged 65+ received higher rates of prescribing than non-care home patients, including more medicines associated with a risk of falling and anti-cholinergic burden.
• The total annual paracetamol drug cost for care home patients aged 65 and over has doubled in the last five years to £22.4 million.

The number of care home patients aged 65 and over in England receiving NHS prescriptions has increased, according to new 2024/25 estimates published by the NHS Business Services Authority (NHSBSA).

The NHSBSA’s primary care prescribing patterns report for patients aged 65 and over shows that an estimated monthly average of 331,000 care home patients received NHS prescriptions, up from 323,000 in 2023/24.

These patients received an estimated 42 million prescription items at a drug cost of £410 million in 2024/25, compared to 40 million items costing £396 million the previous year.

The report reveals that care home patients aged 65 and over received a higher rate of prescribing than non-care home patients. This includes medicines associated with a risk of falling and anti-cholinergic burden - the combined side‑effect risk from drugs that interfere with memory, alertness, and movement. However, they received less prescribing of medicines associated with kidney injury.

Other key findings include:

• Care home patients aged 65 and over were more likely to receive vitamin D and pain relief medications, whilst non-care home patients were more likely to receive Atorvastatin - a medicine that lowers cholesterol in your blood to help prevent heart problems like heart attacks and strokes.
• The total drug cost for paracetamol has doubled over the last five years to an estimated £22.4 million for care home patients aged 65 and over.
• Almost two-thirds of care home patients aged 65 and over who received prescriptions were female, with just over four in 10 of all care home patients being females aged 85 and over.

This year's report includes new features such as:

• geographical breakdown of overall prescribing
• new anticoagulant prescribing metric
• comparison of prescribing metrics by estimated care home length of stay

The NHSBSA estimates provide insights at both national and local level, showing trends over time and variation for key prescribing metrics.

The full report is available at: https://nhsbsa-data-analytics.shinyapps.io/estimated-prescribing-patterns-for-care-home-patients/

Notes to Editor:

The NHS Business Services Authority is an Arm’s Length Body of the Department of Health and Social Care. We manage over £100 billion of NHS spend annually and are responsible for providing platforms and delivering services that support the priorities of the NHS, Government and local health economies. Our purpose is to deliver business service excellence to the NHS to help people live longer, healthier lives.

For more information, please visit www.nhsbsa.nhs.uk.

Points to note:

• Prescribing estimates are based on an experimental methodology which includes linking primary care prescription address data to care home addresses in AddressBase Plus and CQC data .

• Patient count estimates are of care home residents aged 65 years and over receiving prescriptions. A care home resident that received no prescriptions would not appear in this data, meaning care home patient count estimates will be lower than the monthly actual care home population. These monthly estimates will be higher than 2021 Census estimates which are based on occupancy on Census Day.
• Values in this report are indicative.
• Since care home prescribing is identified through address matching, some non-care home prescriptions may be allocated to a care home and vice versa. Accuracy of identified care home matches is estimated to be 99.7%.
• Around 0.4% of prescription items for patients aged 65+ do not have a postcode, or have a non-English postcode, and are excluded from the analysis.
• Prescribing patterns are impacted by the COVID-19 pandemic and beyond. The pandemic started in March 2020 and included a series of national lockdowns during 2020/21.
• There are numerous published sources of data on Adult Social Care home resident numbers that have differing coverage and scope. The data in this publication relate to residents receiving prescriptions and therefore will differ from other estimates. 

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