Understanding the Single National Formulary: A new era for medicine access

The announcement of a Single National Formulary (SNF) marks a shift in how medicines are provisioned across the NHS. First detailed in the government’s 10-year 'Fit for the Future' plan released in July 2025, the SNF is designed to replace the fragmented system of local decision-making that currently governs medicine availability.

While the initial announcement generated considerable headlines, the focus has now shifted to the practical implications for the NHS and the life sciences sector. The core objective of the SNF is to end the 'postcode lottery' of drug access, ensuring that clinical and cost-effective medicines are available to patients regardless of their location.

The roadmap for implementation

The transition to a Single National Formulary is expected to be completed within the next two years, going live sometime in 2027. During this period, the government intends to work collaboratively with key stakeholders, including the National Institute for Health and Care Excellence (NICE) and industry partners, to design and deliver the new framework.

A central component is the creation of a new formulary oversight board. This board will be responsible for sequencing products included in the SNF, with decisions underpinned by NICE’s assessments of clinical and cost-effectiveness. While the SNF will provide a national standard, local prescribers, including clinicians and pharmacists, will retain the autonomy to prescribe in line with NICE guidance, although they will be encouraged to use products ranked highly within the national formulary.

Implications for the pharmaceutical and medtech industries

For industry, the move to a single national system presents both opportunities and challenges:

• Streamlined market access: The SNF aims to simplify what is currently a bureaucratic and inconsistent local approval process. A single point of entry could significantly reduce the administrative burden for companies seeking to bring new treatments to the NHS.
• Rapid adoption of innovation: By centralising oversight, the SNF is intended to drive the rapid and equitable adoption of clinically effective innovations across the entire health service.
• Commercial predictability: A national standard provides a clearer landscape for commercial planning, though the role of the oversight board in 'sequencing' products will be a critical area for industry engagement.
• Expansion to medtech: The government also plans to expand NICE’s technology appraisal process to cover more devices, diagnostics, and digital products from April 2026, creating a more defined national pathway for healthtech.

Impact on the NHS and patient care

The SNF is a pillar of the broader effort to improve NHS productivity and quality of care:

• Equity of access: The primary benefit for the NHS is the removal of local barriers to medicine access, ensuring patients have a core standard of high-quality care nationwide.
• Efficiency gains: Centralising the formulary process is expected to reduce the duplication of effort currently found in local areas, where the same drugs are often assessed multiple times by different local bodies.
• Cost-effectiveness: The system will give NICE new powers to identify and remove outdated technologies and therapies, freeing up resources for investment in more effective, modern treatments.
• Digitally enabled prescribing: The SNF will be supported by the shift to a Single Patient Record and enhanced NHS App functionality, allowing for better tracking of medicine regimes and potential drug interactions.

Conclusion

The Single National Formulary marks a break from the past, moving away from a hospital-centric, fragmented model toward a more integrated and transparent national system. As implementation progresses over the next two years, there will be an important balancing act to achieve between national standards and the clinical autonomy HCPs need on the frontline.

For pharmaceutical and medtech professionals navigating these changes, quickly grasping the evolving regulatory and procurement landscape will be vital. At CHASE, we provide the expertise and insight to help you adapt to the new NHS operating model.

To discuss how these reforms affect your strategy, contact the CHASE team today.

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