Thank you for your request for information about the following:

‘I am writing to make a request under the freedom of information act. Please could you tell me the number of unique patients in England under the age of 18 who have been prescribed medications under the following categories between January 2019 and including July 2022 or the most recent date available, broken down both by month, by the drug category, AND by the age of the patients according to the following age categories: 0-6, 7-11, 12-17? Please include information for prescriptions issued in England but dispensed elsewhere.

Category of medication:

1. Benzodiazepines (specific drugs as follows: Alprazolam (0401020A0) Bromazepam (0401020G0) Chlordiazepoxide hydrochloride (0401020E0) Clobazam (040801060) Clonazepam (0408010F0) Clonazepam (0408020D0) Diazepam (0401020K0) Flunitrazepam (0401010I0) Flurazepam hydrochloride (0401010L0) Loprazolam mesilate (0401010N0) Lorazepam (0401020P0) Lormetazepam (0401010P0) Midazolam hydrochloride (0408020W0) Midazolam hydrochloride (1501041T0) Midazolam maleate (0408020V0) Nitrazepam (0401010R0) Oxazepam (0401020T0) Temazepam (0401010T0)

2. Anti-psychotics ( BNF 040201)

3. Medications licensed for the treatment of ADHD ( BNF 0404)

4. Barbiturates (BNF 040103) If the information exceeds the cost-threshold for a single FOI request, please would you work down from the top of the list of medicines as far as the cost threshold will allow. Please would you send me the information in an Excel or Google spreadsheet format. Many thanks

[On 13 September 2022 you clarified your request as follows] ''The accumulation of the 18 substances please’

Your request was received on 22 August 2022 and has been dealt with under the terms of the Freedom of Information Act 2000.

Response

A copy of the information is attached.

NHSBSA

NHS Prescription Services process prescriptions for Pharmacy Contractors, Appliance Contractors, Dispensing Doctors and Personal Administration with information then used to make payments to pharmacists and appliance contractors in England for prescriptions dispensed in primary care settings (other arrangements are in place for making payments to Dispensing Doctors and Personal Administration). This involves processing over 1 billion prescription items and payments totalling over £9 billion each year. The information gathered from this process is then used to provide information on costs and trends in prescribing in England and Wales to over 25,000 registered NHS and Department of Health and Social Care users.

Data Source: ePACT2

Data in ePACT2 is sourced from the NHSBSA Data Warehouse and is derived from products prescribed on prescriptions and dispensed in the Community. The data captured from prescription processing is used to calculate reimbursement and remuneration. It includes items prescribed in England, Wales, Scotland, Northern Ireland, Guernsey / Alderney, Jersey and Isle of Man which have been dispensed in the community in England. English prescribing that has been dispensed in Wales, Scotland, Guernsey / Alderney, Jersey and Isle of Man is also included. The Data excludes:

• Items not dispensed, disallowed and those returned to the contractor for further clarification.

• Prescriptions prescribed and dispensed in Prisons, Hospitals and Private prescriptions.

• Items prescribed but not presented for dispensing or not submitted to NHS Prescription Services by the dispenser.

Time Period

January 2019 – July 2022 (monthly data)

Organisation Data

The data provided is for prescriptions prescribed in England regardless of where they were dispensed.

Data

The data provided is limited to the unique identified patients for the below grouped drugs with the following age bandings applied:

0-6 years old

7-11 years old

12-17 years old

Drug groups

Benzodiazepines includes the following BNF Chemical substances accumulated:

Alprazolam (0401020A0)

Bromazepam (0401020G0)

Chlordiazepoxide hydrochloride (0401020E0)

Clobazam (040801060)

Clonazepam (0408010F0)

Clonazepam (0408020D0)

Diazepam (0401020K0)

Flunitrazepam (0401010I0)

Flurazepam hydrochloride (0401010L0)

Loprazolam mesilate (0401010N0)

Lorazepam (0401020P0)

Lormetazepam (0401010P0)

Midazolam hydrochloride (0408020W0)

Midazolam hydrochloride (1501041T0)

Midazolam maleate (0408020V0)

Nitrazepam (0401010R0)

Oxazepam (0401020T0)

Temazepam (0401010T0)

Antipsychotic drugs (BNF Paragraph 040201)

CNS stimulants and drugs used for ADHD (BNF Section 0404)

Please note:

There is no data for the age ranges and the time period specified for Barbiturates (BNF Paragraph 040103)

Please note:

NHSBSA do not capture the clinical reason as to why a medicine is prescribed.

Patient Identification:

Where patient identifiable figures have been reported they are based on the information captured during the prescription processing activities. Please note, patient details cannot be captured from every prescription form and based on the criteria used for this analysis, patient information (0-17 age and NHS number) was captured for 99.17% of prescription items for 0-17 year olds.

The patient count figures are based on a distinct count of NHS number as captured from the prescription image.

Patient ages are based on the age as captured from the prescription image and relates to the patient's age at the time of prescribing/dispensing. Results have been restricted to only show results for patients aged 17 and under with results presented by age band (0-6, 7-11, 12-17). Please note it is possible that a single patient may be included in the results for more than one age band where a patient has received prescribing at different ages during the time period (Jan 2019 - July 2022). The figures for the number of identifiable patients should not be combined and reported at any other level than provided as this may result in the double-counting of patients. For example, a single patient could appear in the results for multiple age bands, drug groupings and/or time periods,

Please note:

Data Quality

NHS Prescription Services have a variety of validation streams throughout prescription processing to support accurate capture of the data. In addition, a retrospective sample is completed in the month following reimbursement to identify the accuracy of prescription processing information. The check includes the accuracy of prescriber, practice and drug information, but does not include the personal details of the patient. The information is used to populate a number of Key Performance Indicators, the results of which are published on a monthly basis on the NHSBSA website at: https://www.nhsbsa.nhs.uk/pharmacies-gp-practices-and-appliance-contractors/payments-and-pricing/how-we-process-prescriptions

NHSBSA stores information on the age of the recipient of each prescription as it was read by computer from images of paper prescriptions or as attached to messages sent through the electronic prescription system.

The NHSBSA does not validate, verify or manually check the resulting information as part of the routine prescription processing. However an additional check is carried out on a yearly basis to check the capture rate and accuracy of the stored patient information. The results of this check for the most recent time period available (January 2020 to December 2020) show that for both paper and electronic prescriptions patient age was captured from 94.88% of prescription forms and the accuracy of age data captured was 99.95%.

When considering the accuracy of age data it is expected that a small number of prescriptions may be allocated against any given patient age incorrectly.

If you have any queries regarding the data provided, or if you plan on publishing the data, please contact nhsbsa.foirequests@nhsbsa.nhs.uk ensuring you quote the above reference. This is important to ensure that the figures are not misunderstood or misrepresented.

If you plan on producing a press or broadcast story based upon the data please contact nhsbsa.communicationsteam@nhs.net. This is important to ensure that the figures are not misunderstood or misrepresented.

The information supplied to you continues to be protected by the Copyright, Designs and Patents Act 1988 and is subject to NHSBSA copyright. This information is licenced under the terms of the Open Government Licence detailed at: http://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/

Should you wish to re-use the information you must include the following statement: “ePACT2, NHSBSA Copyright 2022” This information is licenced under the terms of the Open Government Licence:

http://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/

Failure to do so is a breach of the terms of the licence.

Information you receive which is not subject to NHSBSA Copyright continues to be protected by the copyright of the person, or organisation, from which the information originated.

Please obtain their permission before reproducing any third party (non NHSBSA Copyright) information.