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Within Calderdale and Kirklees Health Authority area there are two distinct groups of general practitioners (GPs) ‐Huddersfield and Halifax. Following a small pilot study, a modified X‐ray request form was developed for sole use by the Huddersfield GPs. This X‐ray request form encouraged the local GPs to specify their reasons for referral. During the year in which the modified X‐ray request form was circulating within Huddersfield, the GP community was 0.66 times as likely (less likely) to request lumbar spine X‐rays in comparison with the community in Halifax. The 95% confidence intervals were 0.57–0.77, indicating that this is a highly‐significant result.

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