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REMEDY : BNSSG referral pathways & Joint Formulary

BNSSG Paediatric Joint Formulary
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Formulary Process

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

The Terms of Reference for the Joint Formulary Group (JFG) are available here.

We welcome any suggestions that may benefit Joint Formulary development, please contact us using the email address:

The Joint Formulary is co-ordinated by a group of representatives from primary care, secondary care, mental health, public health and community services including GPs, hospital consultants, and pharmacists.  

To support education, reduction of errors and stock control the formulary will not include all licensed products in a class.  When choosing a medicine 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.  


New Medicines

If a medicine 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. 

All formulary options should be considered before choosing to prescribe a non-formulary medicine.

If a prescriber wishes to prescribe a medicine which is not included in the formulary for a cohort of patients or a new patient cohort is identified, then they should fill out a New Drug Request application form.  It is expected that applicants liaise with peers in other organisations to obtain a system-wide BNSSG approach to the application as well as patient numbers.  If applications are submitted by clinicians based in Secondary Care / Mental Health or Community Services, applications should be sent to the relevant Pharmacist within their organisation first.  Further details are included in the new drug request application form. New drug request applications should then be sent to  and will be considered at the next JFG, after an appraisal of the available evidence has been completed.  Applicants are invited to present their application at JFG and it is the expectation that the applicant or a deputy attends, this is to facilitate more meaningful discussions.  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

  • Environmental impact

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


Keeping up to date - Formulary Chapter Review Process

The BNSSG Formulary Team co-ordinate the review of each chapter in the Adult and Paediatric Joint Formulary to ensure that clinicians have the opportunity to check content remains accurate, evidence-based and reflective of current practice.  The review process will often identify future pieces of work including the need for new drug request applications, traffic light status change requests and additional guidance.


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

Please contact:

Primary care: the BNSSG Formulary Pharmacists at

Secondary care / Mental Health / Community Services: the Pharmacy Department, Medicines Optimisation Team or your specialist pharmacist.