NHS England confirms first 13 ICBs to pilot single national formulary
The first ICBs that will pilot the new single national formulary (SNF) have been confirmed.
In a blog post, NHS England said the 13 early adopter sites will be the first to implement a new standardised medicine categorisation system.
The proposal for a SNF had been outlined in the 10-year health plan, with GPs and other prescribers expected to be ‘encouraged’ to use products ranked highly in the SNF.
The pilot areas will transition over to the new categories by December, while the remaining ICBs will adopt the new system by July next year, NHSE added.
The blog, by NHS England’s deputy chief pharmaceutical officer Richard Cattell and its director of medicines policy and strategy Claire Foreman, also said that the first SNF digital product is planned to be launched by July 2027.
This will include eight to 12 therapy areas, with chronic heart failure, type 2 diabetes in adults, ophthalmology, and asthma to be the first four to be incorporated into the SNF as part of phase one.
Mr Cattell and Ms Foreman said these conditions share large patient populations, ‘significant public health and service burdens’, and pathways with complex or inconsistent access to innovation.
They added: ‘The SNF will give clinicians consistent, accessible information in one place, embedded into prescribing systems and decision support tools, while maintaining clinical autonomy for individual prescribing decisions.’
The next group of therapy areas will be considered before the end of 2026 and will include more complex areas ‘where the SNF can act as a strategic enabler particularly around innovation, genomics, pathway transformation, service readiness and variation in access’, the blog said.
The authors added: ‘We plan to launch the first SNF digital product by July 2027, which will include eight to 12 therapy areas.
‘To support this, a national formulary committee will provide clinical and professional oversight of SNF decisions, working with NICE to translate national evidence into clear, clinically led formulary recommendations.’
A SNF is a nationally approved list of medications and medical products, and the 10-year health plan committed to moving to one ‘within the next two years’.
NHS England’s blog said the SNF aims to reduce variation caused by local formularies and remove barriers that can delay access to clinically and cost-effective treatments.
Currently, formularies are locally maintained documents that list medicines deemed suitable for prescribing within the local area – usually drawn up by groups of clinicians from secondary and primary care.
NHS England said that local formularies currently use categorisation to guide prescribing but data showed that at least 51 categories were being used across England.
It said this had created a system that is ‘complicated’ and ‘inconsistent’ depending on where patients live.
The blog, published on 9 July, said the SNF will be delivered as a digital product which will be integrated into clinical workflows.
It added that through late 2027 to mid-2030 it will expand the SNF to cover additional therapeutic areas, ‘evolving it into a comprehensive, single-source prescribing and decision-making tool’.
Mr Cottell and Ms Foreman added: ‘The success of the SNF will ultimately be measured by whether patients benefit from fairer access to, faster uptake of, and better outcomes from medicines.
‘We will also be tracking whether the SNF supports wider strategic changes in the NHS, including the transfer of care from hospital to community settings.’
The first 13 early adopter ICBs – including those operating under clustering arrangements – are:
- North Central and Northwest London
- Northeast London
- Southeast London and Southwest London
- Greater Manchester
- Essex
- Norfolk and Suffolk
- Central East
- West Yorkshire
- Hampshire and Isle of Wight
- Humber and North Yorkshire
- Thames Valley
- Shropshire/Telford and Wrekin/Staffordshire and Stoke on Trent
- Coventry and Warwickshire/Herefordshire and Worcestershire
However, speaking at the Community Pharmacy and General Practice conference in Birmingham last month, National Pharmacy Association (NPA) chair Olivier Picard questioned whether an SNF would be workable given ongoing medicines shortages.
He said: ‘A national formulary will bring equality, I get that.’
But he added: ‘It’s going to make matters worse. It’s also going to stop innovation, whether we like it or not, a national formulary will restrict entry into the market.’
Mr Picard argued that, rather than tighter prescribing restrictions, pharmacists needed legislative change to allow them to practise more independently.
‘If I’m going to be prescribing, if I’m going to be able to help my GP colleagues in titrating patients, in monitoring patients, in adjusting treatment, I want to be able to have a legislation that supports that,’ he said.
‘I don’t want a restriction of a formulary that gives me four walls and I can’t get out.’
And the Royal College of Pharmacy warned in May that while a SNF could reduce variation in prescribing across England, it must not come at the expense of individualised patient care.
A version of this story first appeared on Pulse’s sister title The Pharmacist
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