Single National Formulary: NHS England announces first early adopter sites and therapy areas

To support implementation of the Single National Formulary (SNF), NHS England has announced the first integrated care boards (ICBs) that will act as early adopters. It has also confirmed the first therapy areas to be incorporated into the SNF.

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

Half of all 26 ICBs – including those operating under clustering arrangements – will transition over to the new categories by December 2026. They are:

• North Central and Northwest 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/Staffordshire and Stoke on Trent
• Coventry and Warwickshire/Herefordshire and Worcestershire

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

Therapy areas
The first four therapy areas incorporated into the SNF as part of Phase 1 will be:

1. Chronic heart failure
2. Type 2 diabetes (adult)
3. Ophthalmology
4. Asthma

These areas were selected because they share large patient populations, significant public health and service burdens, and pathways with complex or inconsistent access to innovation.

What happens next?
The next group of therapy areas will be considered before the end of 2026.

This 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 expected to be ready by July 2027, and will include eight to 12 therapy areas. To support this, 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.

What is the SNF?
The SNF will be a single, evidence-based source of prescribing guidance, delivered as a digital product integrated into clinical workflows. It will drive the adoption of clinically and cost-effective innovations and will be measured by whether patients benefit from fairer access, faster uptake, and better outcomes.

The SNF is one of a package of policies set out in:

FIT FOR THE FUTURE 10 Year Health Plan for England (July 2025)

“We will therefore move to a Single National Formulary (SNF) for medicines within the next 2 years. We will create a new formulary oversight board, responsible for sequencing products included in the formulary based on clinical and cost effectiveness, supported by NICE.”

The Life Sciences Sector Plan (July 2025)

“Introducing a Single National Formulary to remove bureaucratic delays to patient access, reduce unwarranted variation in prescribing, and free-up healthcare staff administrative time to focus on caring for patients. We will work with industry throughout its implementation.”

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