NHSAAA Adult Medicines Formulary

NHS Ayrshire & Arran aim to promote high-quality, cost-effective prescribing in all areas of care. 

Good prescribing dictates that the choice of therapy should be made on the basis of sound clinical evidence of efficacy, safety and also takes into consideration patient acceptability and cost effectiveness. The NHS Ayrshire & Arran Adult Medicines Formulary takes the above into account when considering a medicine for inclusion and therefore prescribing from the Formulary is consistent with good clinical practice.

Structure of the Formulary

Update October 2026: Over the next 2 years the NHSAAA Medicines Formulary (link only active if accessing via NHS network) will be merged into the new West of Scotland Formulary (WoSF) on a chapter-by-chapter basis. The home page of the NHSAAA Medicines Formulary will keep users up-to-date as each chapter is transferred to WoSF content.

Please note that the new regional formulary presents recommendations using a condition-based pathway structure, moving away from the traditional BNF-style list format. 

In principle, all licensed medicines referred to in this Handbook should be included in either the NHSAAA Adult Medicines Formulary or the WoSF; however, there may be some discrepancies until the formulary merger is completed and all guidelines have been aligned to any changed formulary choices.

Non-Formulary prescribing and processes

The need for prescription of medicines from outwith the Formulary (non-Formulary prescribing) is recognised, but it is expected that:

  • Formal treatment guidelines / protocols will only include Formulary medicines.
  • Non-Formulary status will apply to new medicines until accepted for use by the Scottish Medicines Consortium (SMC) and the Area Drug and Therapeutics Committee (ADTC) or the WoSF Regional Formulary Committee. Further information regarding the SMC, including all previous decisions, can be found on their website: www.scottishmedicines.org.uk.
  • Non-Formulary prescribing may be necessary and approved for individual patients in accordance with local processes including the Peer Approved Clinical System Tier 2 (PACS 2), Individual Patient Treatment Request (IPTR) and case by case processes.
  • An overview of the main routes of access to medicines which are not recommended for use by the SMC or awaiting evaluation is available as a useful flowchart (link only active if accessing via NHS network) to help ascertain which process to follow. Further information, including the flowchart, is available on AthenA / Code of Practice for Medicines Governance.

Peer Approved Clinical System Tier 2 (PACS 2)

PACS 2 is intended to be used for requests for licensed medicines and indications where:

  • The SMC has evaluated the medicine and indication and issued 'Not Recommended' advice, or;
  • The request relates to the use of a medicine outwith the SMC restrictions, or;
  • The medicine and indication have been submitted to the SMC, but the SMC are yet to issue advice.

 Individual Patient Treatment Requests (IPTR)

The IPTR process is the route for requesting access to medicines in the following specific circumstances:

  • Where the SMC have issued 'Not Recommended' advice because the manufacturing company has not made a submission to SMC for this medicine or indication, or;
  • Where a company have yet to make a submission to SMC for this medicine and indication, or;
  • Where the intended use of the medicine is outwith the SMC restrictions where these are based solely on the company requesting a selective positioning or sub-population.

Case by Case Requests

Where there are funding or service implications, the medicine will be available on a case by case basis until a local protocol has been agreed.

Where to find Formulary information

The NHSAAA Medicines Formulary can be found on the AthenA homepage / Joint Formulary (link only active if accessing via NHS network). Alternatively, the Medicines Information Team (see Appendix 6 for contact details) are happy to answer any specific queries where the information is not readily available. This provides access to the remaining NHSAAA Formulary chapters as well as to the new WoSF website chapters. Until the merger is complete, users may need to search both formularies to identify formulary treatment choices.

 

Guideline reviewed October 2026
Page updated October 2026



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