Shaping better health
REMEDY : BNSSG referral pathways & Joint Formulary

BNSSG Paediatric Joint Formulary

Formulary Process

The BNSSG Joint Formulary has been built in the spirit of cooperative collaboration between Bristol, North Somerset and South Gloucestershire to aid good prescribing practices and reduce variability in prescribing, providing good evidence based decisions which have been agreed between clinicians, pharmacists and formulary leads across the area. 

If there are any suggestions that would benefit the project please contact us using the email address:


The Joint Formulary is co-ordinated by a small group of primary and secondary care representatives including GPs, consultants and pharmacists. The Joint Formulary Group, in collaboration with relevant specialists, develops the chapters. Once the draft chapter is complete, over 2000 individuals are invited to comment. Chapters are reviewed regularly. Once again we consult widely, seeking feedback and comment as before.

To support education, reduction of errors and stock control the formulary will not include all licensed products in a class. When choosing a drug for inclusion in the formulary, the agent with the widest range of therapeutic indications and best quality published evidence showing clinically beneficial outcomes will be chosen. In most cases a maximum of 2-3 drugs of the same class will be sufficient to cover 90% of prescribing.


New Drugs

If a drug is not included on this website, it is considered non-formulary within BNSSG, and therefore not appropriate for routine prescribing.  The formulary is intended to cover 90% of all prescribing, so it is recognised that there are some occasions where it is clinically necessary to deviate from the formulary.  It is hoped that that all of the formulary options are considered first. 

If a prescriber wishes to prescribe a drug which is not included in the formulary in a cohort of patients, then they should fill out a New Drug application Form, and submit it to the BNSSG Joint Formulary Pharmacist.  It will be considered at the next Joint Formulary Group (JFG), after an appraisal of the available evidence has been completed.  The JFG will consider the application on the basis of:


  • Patient safety
  • Clinical effectiveness
  • Cost effectiveness or resource impact
  • Strength of evidence
  • Place in therapy relative to available treatments
  • National guidance and priorities
  • Local health priorities
  • Equity of access


 Please note we will only accept New Drug Applications from clinicians who work within BNSSG, this can be a doctor, nurse or pharmacist. We will not accept applications directly from the pharmaceutical industry. 


Keeping up to date

Each chapter, with the exception of Chapter 5 Infections, is scheduled for review every two years, but reviews may be more frequent if compelling NEW evidence becomes available. The review process follows a similar pattern of wide consultation as the initial chapter production.

Changes to a chapter may occasionally become necessary between reviews, for example, when the Joint Formulary Group (JFG) approve new therapies, or a drug is withdrawn from supply. These changes will be made on the website within 2 months of the JFG meeting.


If you would like help implementing the Joint Formulary...

Please contact:

  • Primary care: the CCG Medicines Optimisation Team on
  • Secondary care: the Pharmacy or your directorate pharmacist.