Important changes to the BNF
The British National Formulary (BNF) is a joint publication of the British Medical Association and the Royal Pharmaceutical Society. The aim of the BNF is to provide prescribers, pharmacists and health care professionals with current information about medicines used in clinical practice. It is not intended to be a comprehensive guide and other information sources should also be considered when treating patients.
The BNF is available in print as a book which is published every six months in March and September. There is also a separate BNF for Children (BNFC) which is published annually in September. It is important to use the most recent version when making clinical decisions, as information is continually updated. An online version of the BNF is available via the MedicinesComplete website. The online BNF is available free of charge to any healthcare professional treating NHS patients who registers on this website.
The new format for the BNF
The layout and design of the BNF has remained consistent for the past 35 years, which has been one of its strengths, as it is generally used as a quick reference guide. However, the September 2015 version has been completely redesigned and clinical staff will need to familiarise themselves with this new format.
The size, colour palette, and structure of the information in the BNF have been changed. It is now larger and the colour palette has changed from blue to green. More significantly, although the chapters remain broadly the same, the order of the content has changed. There is a “more systematic approach” which is based on disease states, and then drug class, within these sections. However, the overriding organisation of the chapters is alphabetical, which will take clinicians time to become accustomed with.
The monographs for the drugs have changed from seven sections to twenty sections and new topics include ‘Monitoring Requirements’ which will be useful. The order has been improved by having the ‘Indication’ and ‘Dose’ together, which is more convenient.
However, the most significant change for many clinicians is that the numbering system has been revised. Previously, categories of drugs could be identified by the BNF section number. For instance, methadone for opioid dependence was in BNF section 4.10.3, and in the latest BNF it is now in section 8.3.
This will undoubtedly cause confusion. In particular, for patients being treated under the Mental Health Act, the Treatment Forms will have to be changed as soon as possible to reflect the new section numbering.
The main reason for the changes to the BNF was to make the format more digitally friendly, which should have long-term benefits.
The most obvious change is that the BNF has removed the numbering system which many healthcare establishments have embedded into their forms and into the day-to-day running of their hospitals.
CQC advice for writing MHA Treatment Forms
- All Mental Health Act (MHA) Treatment Forms (T2 or T3) written before the end of September 2015 will remain valid if they referenced old numeric BNF category codes from edition 69, or before, and do not need to be updated or replaced.
- From 1st October 2015, the MHA Treatment Forms must either specify the drug by its name or it must reference the electronic version of the BNF by stating eBNF not BNF. The eBNF will continue to use the numeric BNF categories in the original format.
- The numeric categories in the new edition of the BNF 70 are unsuitable for using on the MHA Treatment Forms.
- For further advice on this please discuss with your visiting pharmacist or contact the information pharmacist at Ashtons 08452 223350.