You can use "list size" which tells you how many patients a practice covers, but this can be problematic, because different practices will have different kinds of patients, some with lots of older people, and so on.
-To account for this the NHS uses imperfect but useful "adjusted" denominators called STAR-PUs, which try to account for the age and sex structure of the practice's population. These STAR-PUs are specific to specific disease areas, because they try to account for different rates of usage -- in different age bands of the population - for specific treatment. So for the STAR-PU for cardiovascular disease prevention prescribing, for example, gives you extra points for every man aged 40-50, even more for men aged 50-60, and so on; but less for women in the same bands, and very little for younger people.
- -Generating these STAR-PUs for each practice, each disease area, and each month, takes coder time, so we currently only have the STAR-PU for antibiotics.
-When using the data ourselves we tend to use more thoughtful approaches to try to "bake in" population prevalence or need for a particular condition, or to explore different prescribing patterns. For example, we often use whole classes of drug as the denominator in our analyses, as in the video walkthroughs; or we compare the use of one drug against the use of another. When looking at whether a practice is using a lot of Nexium (an expensive "proton pump inhibitor" pill for treating ulcers) we might look at "Nexium prescribing" versus "all proton pump inhibitor prescribing" (example).
+We have removed STAR-PUs as a denominator option on our analysis page and from several of our pre-built antibiotic measures. This decision was made following user consultation, due to concerns about the appropriateness of the STAR-PU weightings, which have not been reviewed since 2013. You can read more about this in our blog.
+Play around and let us know if you find anything interesting, or develop any interesting methods.