Jeffrey Aronson: 6/60 Vision: Celebrating the BNF and BNFC

Thursday 18 November. To BMA House to celebrate the publication of the 60th issue of the British National Formulary (BNF) and the 6th issue of its paediatric counterpart, the BNF for Children (BNFC).

 The word “formulary” was first used to describe Charles Thomas Haden’s translation of François Magendie’s Formulaire pour la préparation et l’emploi de plusieurs nouveaux médicamentes, tels que la noix vomique, la morphine, l’acide prussique, la strychnine, la vératrine, les alcalis des quinquinas, l’iode etc, published in 1823 as “Formulary, for the preparation and mode of employing several new remedies.” However, nowadays when UK prescribers say “look it up in the formulary” they mean the BNF or the BNFC.

 In 1948, after the success of the National War Formulary, the then Ministry of Health asked the BMA and the Royal Pharmaceutical Society to prepare a more extensive peacetime formulary for use by the newly formed NHS. However, when the issue dated 1976–8 was published it was no longer fit for purpose, and a new formulary was therefore commissioned by the then Department of Health and Social Security. Issue 1 of the new British National Formulary was published in March 1981 and updated issues have been published every 6 months ever since [1]. It was an instant success and has grown in size and stature ever since; The figure shows its growth rate over the last 30 years.

BNFC was first published in 2005, taking over from “Medicines for Children” and continuing its success. It is published annually.

 Martin Kendall, Professor Emeritus of Clinical Pharmacology in Birmingham, opened the celebratory proceedings by reviewing the history of the BNF and paying tribute to his two predecessors as Chairmen of the Joint Formulary Committee of the BNF, the late Professor Owen Wade (also his predecessor in Birmingham) and Professor Sir Charles George, previously Professor of Clinical Pharmacology in Southampton, who was in the audience. Professor Kendall then introduced the other speakers.

Professor Terence Stephenson, President of the Royal College of Paediatrics and Child Health, reviewed the history of BNFC and stressed its importance to paediatricians, given the huge range of variability across the population of patients that they have to manage. Professor Sir Michael Rawlins, Chairman of NICE, then stressed the importance of the formularies for health care in general and complimented Professor Kendall on his contribution. Professor Nick Barber, Professor of the Practice of Pharmacy at the London School of Pharmacy, reviewed the importance of pharmacists in the production of the BNF and BNFC and suggested that it is time that a patients’ BNF was produced.  Dr Jamie Coleman, Consultant Clinical Pharmacologist in Birmingham and an expert in e-communication in medicine, then offered us a view of the future.

Finally, Fiona Godlee, Editor of the BMJ, told us how much she had relied on the BNF during all phases of her medical education and career and invited us to drink a virtual toast to the future of the BNF and BNFC, in the temporary absence of a suitable beverage. That deficiency then being repaired, we all toasted it for real.

1. Wade OL. British National Formulary: its birth, death, and rebirth. BMJ 1993; 306(6884): 1051-4.

Jeffrey Aronson is the president emeritus of the British Pharmacological Society.