The creation a Single National Formulary (SNF) for England was back as the agenda at the Healthcare Distribution Association (HDA UK) Supply Chain Resilience Group which Charles Joynson, WaveData MD, attended last week.
NHS England is now actively moving toward an SNF – a unified, national prescribing framework intended to replace the patchwork of local formularies that currently shape access to medicines. The proposals are well‑developed, formally embedded in the 10‑Year Health Plan for England and the Life Sciences Sector Plan, and NHS England began phased implementation this year.
The aim of the SNF is to eliminate unwarranted variation in prescribing across England by providing one evidence‑based, nationally consistent source of prescribing guidance. It’s designed to standardise prescribing, accelerate uptake of cost‑effective medicines, reduce post NICE bureaucratic delays and ensure fairer, faster access for patients across England.
Half of England’s 26 ICBs will adopt the new categorisation system by December 2026, including:
• North West
• North London
• Northeast, Southeast, Southwest London
• Greater Manchester
• Essex
• Norfolk & Suffolk
• West Yorkshire
• Hampshire & Isle of Wight
• Humber & North Yorkshire
The full rollout will take place by July 2027 in a phased transition, with the first wave focusing on:
• Chronic heart failure
• Type 2 diabetes (adult)
• Ophthalmology
• Asthma
Over time, the SNF will cover more therapeutic areas, include more medicines and indications, incorporate devices and become a core national prescribing decision‑support tool. The benefits include better value for the NHS from the £21bn annual medicines spend, improved supply resilience and stronger alignment with the Life Sciences Sector Plan.
However, this will mean that the SNF may contradict the way products are reimbursed by the Drug Tariff. If a generic were to be included in the guidance in place of another generic, should its Drug Tariff price be raised to encourage manufacturers and wholesalers, or reduced to encourage clinicians? Making products too cheap may make them unprofitable for the supply chain, causing an economic shortage, but increasing their Drug Tariff price may help manufacturers and wholesalers, but discourage clinicians.