The Single National Formulary (SNF) is a planned national list of recommended medicines for the NHS in England, led by NHS England, designed to replace variation between local formularies. The 10 Year Health Plan committed in July 2025 to moving to an SNF within two years, and NHS England aims to launch the first version by July 2027.
Medicines are currently categorised and recommended through local formularies run by Integrated Care Boards (ICBs) and their area prescribing committees, which NHS England says use at least 51 different categorisation schemes. The result is that patients in different areas can have different access to the same NICE-approved medicine. The SNF aims to give faster and fairer access by setting one national position, while the existing duty on ICBs to fund NICE-approved medicines within three months continues.
NHS England plans to deliver the SNF as a digital product built into clinical systems and prescribing workflows. A national formulary committee will provide clinical and professional oversight, working with NICE to turn national evidence into formulary recommendations. Prescribers will keep clinical autonomy over individual decisions.
The Medium Term Planning Framework separately prioritises savings in 2026/27 from best-value direct oral anticoagulants, SGLT-2 inhibitors and the wet age-related macular degeneration pathway. Whether local ICB formularies will remain alongside the SNF has not yet been decided.
The SNF moves the main formulary decision from local committees towards a single national process, so a product's position in the national categories could shape uptake across England. Market access teams will need to engage with the national formulary committee and NICE evidence, while local medicines optimisation work adjusts to standardised categories.
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