Wednesday, October 20, 2010

What is a GP's local formulary?

What is a GP's local formulary?
A local formulary refers to the drugs selected by a local NHS Trust formulary committee, usually made up of doctors (usually mainly GPs) and pharmacists which is passed to doctors in that trust area only.
Generally these committees select the most cost effective drugs in each drug group. They also look at new drugs and new indications for drugs and recommend that doctors should or should not use them.
Their views are advisory and not binding, but if GPs blatantly ignore their recommendations they may be asked to justify this with scientific reasons. This appears to be prescribing by committee, which I suppose it is.
Some GPs object to and ignore this advice saying it interferes with their clinical freedom. The majority, like myself, understand that no individual GP actually has the ability to analyse the pros and cons of every drug and should make use of all sources of advice. We also realise that whether we like it or not it is a fact that NHS resources are finite and we have no choice but to live within them.
The whole thing breaks down a bit however because there are national guidelines, and these differ between for example England and Scotland, and also guidelines for different diseases issued be the Royal Colleges and guidelines and advice issued by different specialist groups. These guidelines are almost never identical!
Its a list of all medications available. with the dosages, prices, whether its available on NHS or private prescription etc;
it guides the doctor on selection of tablets or other forms of medicine they are permitted to subscribe perhaps under NHS rules// but it also has other implications but that is generally what your asking

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