Useful Links

COVID-19 Medicines Optimisation Guidelines	Clinical Guidelines	Shared Care Protocols
Antimicrobial Guidelines (Adults and Paediatrics)	Guidance for Care Homes	Wound Management Formulary
BOB Medicines Optimisation Bulletin	Clinical Commissioning Policies	Individual Funding Request (IFR)
BOB APC Information

How to use the formulary

• Use the search tool to find the drug or condition of interest or browse by BNF chapter using the 'Chapters' Menu at top of page.
• Formulary products may be found in one or more chapters.  Click on the entry in the appropriate chapter.
• First and second choices shown where possible to assist cost-effective prescribing.
• Non-formulary products are shaded in pink and labelled non-formulary.
• APCO decisions are dated within the individual product entry.
• Hyperlinks are available to BNF, BNFc and to the Summaries of Product Characteristics.

If you have any comments or queries please email bobicb.medicines@nhs.net.

Key to formulary recommendations

	Red: Drugs which should only be prescribed in secondary care by a specialist. Require specialist knowledge and/or equipment for patient selection and initiation Require long term on-going monitoring and dose adjustment to ensure efficacy and minimise toxicity by a specialist. Designated as “hospital only“ by product licence, NICE, DoH or BNF. May need further evaluation by a specialist. Are hospital initiated clinical trial materials.
	As for ‘red’ (above) with the addition of the following: Designated by NHS England to require initiation by or in prior agreement with a Specialist Centre. Continuation where appropriate by hospital (or other secondary care provider). Detailed requirements for Specialist Centre initiation to be described in the wording of the formulary restriction.
	Drugs which should be initiated in secondary care by the specialist with follow-on prescription and monitoring according to a drug specific Shared Care Protocol (SCP). Prescribing may be continued in primary care following the SCP. Require specialist knowledge and/or equipment for patient selection and initiation. Require short or medium term (eg. 3 to 6 months) specialist monitoring of efficacy or toxicity. The need for stabilisation will vary with different drugs and patients, but is usually a minimum of 2 months (see principles for shared care). Require significant long term monitoring. Require ongoing communication between the GP/primary care prescriber and the specialist. Have clearly defined consultant, GP/primary care prescriber and patient responsibilities documented in a shared care protocol.
	Drugs suitable for primary care prescribing following specialist initiation. Require specialist knowledge and/or equipment for patient selection. Monitoring does not require specialist knowledge or equipment. If the drug is one with which the GP/primary care prescriber is unfamiliar the specialist is expected to provide sufficient information on the drug indication, dose, duration, monitoring and any further necessary dose adjustments. Requires at least the first prescription to be written by the specialist.
	Drugs suitable for primary care prescribing following specialist recommendation As for amber initiation except that:- The first prescription may be written by the GP/primary care prescriber after specialist recommendation.
	Medicines which are suitable for initiation and ongoing prescribing within primary care. Primary care prescribers take full responsibility for prescribing and monitoring.
	Medicines which are not recommended for use because of lack of evidence of clinical effectiveness, cost effectiveness or safety.
Non-Formulary	Non-formulary drugs should not routinely be prescribed. Non-formulary drugs have not been included as formal choices within guidelines, or have not had a full review by the Area Prescribing Committee.

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