Single National Formulary: What the NHS Rollout Means for Prescribing

20 July, 2026

The Single National Formulary is set to change how prescribing guidance works across the NHS in England. NHS England has now confirmed the first therapy areas, the early adopter sites and the timeline through to 2030. Here is what healthcare teams need to know.

Introduction

The Single National Formulary (SNF) is a new NHS England initiative designed to reduce variation caused by local formularies and remove barriers that can delay access to clinically and cost-effective treatments. Set out in the 10 Year Health Plan for England, it aims to ensure every NHS patient in England can access the right medicine, at the right time, wherever they live.

The scale of the challenge is significant. For common conditions such as diabetes, variation in the uptake of treatments across the NHS is reported to be more than 50 per cent. There is also an economic case, with the pharmaceutical industry estimating that increased uptake of innovative medicines could deliver £17.9 billion in additional productivity gains for the UK economy.

What is the Single National Formulary?

The Single National Formulary will be a single, evidence-based source of prescribing guidance, delivered as a digital product integrated into clinical workflows.

Its purpose is to drive rapid and equitable adoption of clinically and cost-effective innovations while securing value for taxpayers. Success will be measured by whether patients benefit from fairer access, faster uptake and better outcomes.

The SNF forms part of a wider package of policies under the Life Sciences Sector Plan, which aims to reduce friction in the system so that the most clinically and cost-effective medicines can reach patients faster.

Why change is needed

Securing access to and uptake of medicines is a complex process. Once a medicine with a NICE technology appraisal is recommended, responsibility passes to the 26 NHS commissioners, the Integrated Care Boards (ICBs), to ensure the treatment is funded for eligible patients within three months.

All local formularies use categorisation to guide prescribing. A colour, for example, may indicate that a medicine should only be prescribed by a specialist. However, data found at least 51 different categories in use across England. The result is a system that is both complicated and inconsistent depending on where a patient lives.

The first therapy areas

With more than 70,000 medicines used in the UK, the SNF must be functional and practical in its design. Phase 1 will cover four therapy areas:

Chronic heart failure
Type 2 diabetes (adult)
Ophthalmology
Asthma

These conditions share large patient populations, significant public health and service burdens, and pathways with complex or inconsistent access to innovation.

The starting areas were chosen because they align with national strategies, have high-potential patient populations, show existing prescribing variation, are major causes of morbidity and mortality, align with NICE’s workplan, and include pathway innovation such as genomic testing and upcoming disruptive technologies.

Clinicians will have consistent, accessible information in one place, embedded into prescribing systems and decision support tools. Clinical autonomy for individual prescribing decisions will be maintained.

Early adopter sites and rollout timeline

Early adopter sites will be the first to implement a new standardised categorisation system, and their experience will directly shape the national rollout.

Half of all 26 ICBs, including those operating under clustering arrangements, will transition to the new categories by December 2026. These include areas such as North Central and Northwest London, Greater Manchester, Essex, West Yorkshire, Hampshire and Isle of Wight, and Thames Valley, among others.

The remaining ICBs will adopt the new categorisation by July 2027.

What happens next

The next group of therapy areas will be considered before the end of 2026. This second group 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 first SNF digital product is planned for launch by July 2027 and will include 8 to 12 therapy areas. 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.

From late 2027 to mid-2030, the SNF will expand to cover additional therapeutic areas, evolving into a comprehensive, single-source prescribing and decision-making tool. Feedback from patients, clinicians, local systems and industry will continue to be encouraged throughout this period.

Measuring success

Success will ultimately be measured by whether patients benefit from fairer access to, faster uptake of, and better outcomes from medicines. NHS England will also track whether the SNF supports wider strategic changes, including the transfer of care from hospital to community settings.

The SNF will be developed alongside existing commitments for rapid uptake of new biosimilar and generic medicines, and the government commitment for medicines investment to reach 0.6 per cent of GDP over the next decade.

Conclusion

The Single National Formulary represents a substantial shift in how prescribing guidance is organised across the NHS in England. For healthcare teams, the immediate changes begin with the standardised categorisation system in early adopter areas from December 2026, with full adoption by July 2027 and the first digital product covering 8 to 12 therapy areas launching the same year. Staying informed on local ICB timelines will help teams prepare for the transition.