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The proportion of older care home residents in England prescribed ten or more medications has increased from 2020/2021 to 2024/2025, NHS data show.
An analysis of estimated prescribing patterns, shared by the NHS Business Services Authority (NHSBSA) on 10 June 2026, showed that 22% of care home residents aged over 65 years who received a prescription in 2024/2025 were on 10 or more unique medications, compared with 19% in 2020/2021, while 61% were on six or more medications in 2024/2025, compared with 57% in 2020/2021.
The average care home resident was prescribed 6.8 medications per month in 2024/2025, compared with 6.4 in 2020/2021, the data revealed.
However, between 2020/2021 and 2024/2025, the proportion of patients receiving three or more medicines that increased their risk of falls remained unchanged, at 24% — as did those receiving two or more medications that should be stopped in case of dehydration (e.g. diuretics, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, metformin and non-steroidal anti-inflammatory drugs) at 12%, the data showed.
The data also highlighted that in the same time period, the average percentage of care home patients receiving two or more medicines with anticholinergic activity reduced from 11% to 10%.
Analysis of integrated care boards (ICBs) data show that between 2020/2021 and 2024/2025, Shropshire, Telford and Wrekin Solihull ICB, and Cornwall and the Isles of Scilly ICB, had the biggest increase in prescribing of unique medicines per patient per month over the same time period, at 14%. NHSBSA noted that Cornwall and the Isles of Scilly ICB had a high number of care homes.
Coventry and Warwickshire ICB saw a 12% increase, while Birmingham and Solihull, Black Country, and Nottingham and Nottinghamshire ICBs all saw an 11% increase, the data showed.
Commenting on the data, Laura Buckley, primary care network pharmacist with a special interest in care homes at Eastgate Medical Group, Hornsea, said: “While the growing medical complexity of our ageing population is apparent thanks to growing advancements in healthcare, there is a clear growth in prescribing for elderly patients.
“A focus on reviewing potentially problematic polypharmacy in this patient cohort is key, since the risk of admissions and adverse drug events can positively correlate with the increase in prescribing.
“Pharmacy teams are central to patient review and shared decision-making, and should lead the way for safe and effective prescribing and deprescribing for care home residents.”
Caroline Abrahams, charity director at Age UK, said: “Getting the medicines right for older people who live in care homes is especially challenging but also all the more crucial, because many residents are coping with multiple health problems, frailty and dementia, meaning they are especially likely to be on multiple treatments that in turn increase the risk of adverse reactions.
“These medications can be life-saving and can help people to live well with their health conditions. However, if not properly managed, many older people can find they are taking far too many prescriptions at once, in some cases taking multiple medicines with the same or similar active ingredient. This can severely impact things like cognitive function and mobility and can even lead to avoidable admissions to hospital, ultimately doing more harm to the person than good.
“Older people should be offered structured medicine reviews to make sure that what they are taking is actually helping and that any side effects are not outweighing the benefit of the treatment.”
