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Exclusive: A Freedom of Information response has revealed that the National Formulary Committee, due to provide advice on the already-in-train Single National Formulary (SNF), is yet to be established. Leela Barham argues that a community pharmacy representative should be on the committee

The idea of a single national formulary for England was set out in July 2025 as part of The Labour government briefing Fit for the Future: 10 Year Health Plan for England.

The plan said that the NHS would “move to a single national formulary for medicines within the next 2 years.” The aim is to drive rapid and equitable adoption of the most clinically and cost-effective innovations. The government said it would work with industry throughout implementation.

The SNF matters for community pharmacy. The SNF could help by reducing variation in prescribing between areas where that’s driven by differences in local formularies. That could help with managing stocks; yet as ever, the devil is in the detail.

If the SNF is too restrictive, it could make shortages worse. Plus, let’s not forget that independent prescribers in community pharmacy will also be an audience for the SNF.

Some in the sector are concerned about the SNF. One community pharmacist posted on LinkedIn that the idea of the SNF “sends shivers down my spine. The supply chain and drug pricing are both volatile; I can’t easily see how it can be successful in this environment.”

Could having community pharmacy as part of a new formulary oversight board, as it was called in the plan, but now known as national formulary committee, help make the most of the SNF for the community pharmacy sector?

Progress to date

In July 2026, NHS England (NHSE) published a blog on delivering the SNF. That blog set out a list of thirteen ICBs who are first to implement a new standardised categorisation system for local formularies as part of the move towards the SNF. These ICBs are due to transition to the new categories by the end of 2026.

The SNF early adopter sites are:

• North West and North 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 ICB and Staffordshire and Stoke-on-Trent

• Coventry and Warwickshire and Herefordshire and Worcestershire.

Neil Hardy, chief pharmacist at NHS Hampshire and Isle of Wight ICB, told P3pharmacy that there is still much to work through to make the SNF a reality, but there’s a chance to shape it. “Lots of detail hasn’t been worked through; that’s really the whole point of having early adopters,” he said.

The NHSE blog also identified four therapy areas to be incorporated into the SNF as part of Phase I: chronic heart failure, type 2 diabetes (adult), ophthalmology and asthma. These were chosen because they share large patient populations, significant public health and service burdens plus have pathways with complex or inconsistent access to innovation, according to NHSE.

National Formulary Committee

The 10-year plan said that the committee would be “responsible for sequencing products included in the formulary based on clinical and cost-effectiveness, supported by NICE.” NHSE says the committee will provide clinical and professional oversight of SNF decisions.

The committee would work with NICE to translate national evidence into clear, clinically led formulary recommendations. That sounds like doing the granular work of listing what’s on, and what’s not, on the formulary. Hardy explained, “From day one, the SNF won’t have every single drug on it.”

The opposing view has also been put forward; the SNF could just avoid tough decisions, according to a pharmacist posting on the topic on LinkedIn.

They wrote: “No difficult decisions will be made, as this would result in legal challenges (as NICE did in the earlier days when they did robust independent evaluations) so the new national formulary will include all medicines and so not of practical use.”

Nuances will also apply to hospital medicines versus those prescribed and dispensed in the community, according to Hardy. “Hospital formularies are often closely linked to what organisations keep in stock. In primary care, formularies are guidance in a similar way to outputs from NICE,” he noted.

Missing so far is the detail of when and who would be on the committee. That prompted a freedom of information request to NHSE, which replied: “The Single National Formulary programme is currently in a development and design phase. It is being developed using an iterative “test and learn” approach, meaning that key elements remain subject to ongoing development and governance.”

The response also noted: “The National Formulary Committee has not yet been established. We aim that this will be established and begin to meet from early-mid 2027; there have been no meetings to date, and the frequency of meetings from 2027-2030 has not yet been agreed. The Terms of Reference will also be developed over the coming months and be ready early-mid 2027.”

That means that there is a window of opportunity to shape who is on the committee and its terms of reference since they’ve yet to be written.

Who should be on the committee?

Hardy thinks that the committee will likely draw on the model used when developing NICE clinical guidelines, explaining to P3pharmacy, “I assume the committee will act like a NICE guidelines group with good clinical input.”  Those committees are multidisciplinary and include practitioners, professionals, providers, commissioners and researchers (NICE’s words). They also typically include lay members.

Given the driver of the SNF is to speed up access to NICE-approved medicines, Hardy also suspects that the pharmaceutical industry body, the ABPI, could be represented on the committee.

The ABPI has set out its views on the SNF, calling for a collaborative approach. The ABPI are working on the SNF in an industry task and finish group but has called for more connectivity to others working on it. NICE is expected to be represented on the committee too, according to Hardy.

Community pharmacy could be represented on the committee too, not least so that the implications of stock holding are considered. Hardy noted, “nothing will happen overnight, but we all need to know how we can access the SNF, presumably it’ll be on a website somewhere, and how to ensure that there is stock, whether that’s in the hospital or from a community pharmacy.”

The SNF is in CPE’s sights. Dr. James Davies, director of research and insights at Community Pharmacy England, told P3pharmacy: “The SNF is intended to reduce unwarranted variation in prescribing, but the extent to which it can achieve this ambition in practice remains uncertain.

“Community Pharmacy England will continue to engage closely with the development of the SNF, working to ensure that the implications for community pharmacy owners are fully understood and appropriately considered as the programme evolves.”

Let’s see if that engagement translates into a place on the committee.