This free article is sponsored by Drug Tariff Pro, which provides accessible dental and nurse formulary information alongside other Drug Tariff tools.
A prescription arrives from a dentist for an unfamiliar medicine. Another is signed by a nurse, but the medicine is missing from the Nurse Prescribers’ Formulary. Can either be dispensed?
The answer depends on the prescriber’s legal authority, the applicable NHS arrangements, and whether the treatment is clinically appropriate. These are related questions, but they are not interchangeable.
What are the formularies?
The dental and nurse prescribers’ formularies identify preparations that specified prescribers may order under the relevant NHS arrangements.
However, they have different legal effects:
- The NHS dental formulary restricts NHS dental prescribing. It does not define the full extent of a dentist’s underlying authority to prescribe medicines.
- The community practitioner nurse formulary applies to a particular category of nurse prescriber. For prescription-only medicines, these nurses also have a separate statutory restriction on their prescribing authority.
The distinction follows from regulation 214 of the Human Medicines Regulations 2012, which recognises dentists and nurse independent prescribers as appropriate practitioners for POMs generally, while limiting community practitioner nurse prescribers to the POMs specified in Schedule 13.
Which formulary applies in each UK country?
The general medicines-law framework must be considered alongside the relevant national NHS rules.
| NHS prescribing arrangements | Dental formulary | Community practitioner nurse formulary |
|---|---|---|
| England | England and Wales Drug Tariff, Part XVIIA | England and Wales Drug Tariff, Part XVIIB(i) |
| Wales | England and Wales Drug Tariff, Part XVIIA | England and Wales Drug Tariff, Part XVIIB(i) |
| Scotland | Scottish Drug Tariff, Part 8A | Scottish Drug Tariff, Part 8B |
| Northern Ireland | Northern Ireland Drug Tariff, Part IX | Northern Ireland Drug Tariff, Part IX |
The England and Wales lists identify preparations approved by the Secretary of State for England and Welsh Ministers for Wales. Scotland publishes its own dental and nurse prescribing provisions, while Northern Ireland’s tariff contains a separate section covering dental, nurse and independent prescribing. Use the latest applicable version.
For a pharmacy professional, this means establishing both where the prescription was issued and where it is being dispensed. The prescriber’s NHS authority and the dispensing pharmacy’s national contractual and reimbursement requirements both matter.
A Welsh dental prescription dispensed in England
Check Part XVIIA of the England and Wales Drug Tariff. It is the published dental prescribing list for both countries, so this example does not involve choosing between two different national dental lists. The prescription’s Welsh origin does not remove the formulary restriction when it is presented in England.
The English pharmacy must also comply with its own dispensing terms of service. These are set out in Schedule 4 of the NHS Pharmaceutical and Local Pharmaceutical Services Regulations 2013; they should not be described as UK-wide pharmacy terms.
For prescriptions involving Scotland or Northern Ireland, check the originating NHS prescribing restrictions alongside the requirements applying to the dispensing pharmacy. Do not assume that an item’s inclusion in one national tariff establishes permission and reimbursement throughout the UK.
For example, the Scottish tariff expressly links reimbursement for general dental prescriptions to the dental formulary promulgated by Scottish Ministers. Its nurse prescribing provisions similarly distinguish limited-formulary, independent and supplementary prescribing.
Does the dental formulary define everything a dentist can legally prescribe?
No. A dentist’s underlying prescribing authority is broader than the NHS dental formulary.
Regulation 214(3)(b) recognises a dentist as an appropriate practitioner in relation to POMs without restricting that recognition to the NHS dental list.
Separate NHS rules govern what may be ordered for NHS patients. For example, Schedule 3, Part 3 of the General Dental Services Contracts Regulations 2005 governs prescribing under general dental services contracts in England.
A medicine’s absence from the NHS dental formulary therefore does not, by itself, prevent a dentist from issuing an otherwise lawful private prescription.
Professional restrictions still apply. The GDC’s prescribing guidance requires dentists to prescribe within their competence and only to meet their patients’ identified dental needs. An unusual private dental prescription still requires appropriate clinical scrutiny.
What if an NHS dental prescription contains a non-formulary item?
Refer the item back for resolution before ordinary NHS dispensing.
NHSBSA confirms that FP10D prescriptions are restricted to Part XVIIA. Its published guidance also identifies non-formulary items ordered by dentists and community nurse prescribers as a cause of disallowed payments. A genuine prescription and genuine clinical need do not establish NHS eligibility.
However, describing every such prescription simply as “illegal” obscures the distinction between NHS prescribing restrictions and underlying medicines-law authority.
The prescriber may need to select a permitted alternative or issue an appropriate private prescription. The pharmacy should clarify the intended route and explain the outcome to the patient.
These formulary provisions principally concern the NHS prescribing arrangements identified in the relevant tariff. Avoid assuming that every prescription signed by a dentist, including prescriptions issued through other services, necessarily falls within the same arrangements.
Which nurses are restricted to the Nurse Prescribers’ Formulary?
The limited formulary concerns community practitioner nurse prescribers—not every nurse who prescribes.
The NMC distinguishes the following prescribing categories:
| Category | Main restriction |
|---|---|
| Community practitioner nurse prescriber, commonly associated with V100 or V150 | Limited to the community practitioner formulary |
| Nurse independent prescriber, commonly associated with V200 or V300 | Broad prescribing authority within professional scope and competence, subject to relevant legal restrictions |
| Nurse supplementary prescriber | Prescribes under an agreed patient-specific clinical management plan |
A nurse must have the appropriate prescribing qualification recorded on the NMC register. Their workplace or job title does not establish their prescribing powers: a nurse working in the community may hold an independent prescribing qualification.
Community practitioner nurse prescribers
The applicable national formulary governs what these prescribers may order under the relevant NHS arrangements.
There is also a separate legal limit for POMs. Under regulation 214(4), a community practitioner nurse prescriber is an appropriate practitioner only for POMs specified in Schedule 13.
Writing a private prescription does not remove that statutory restriction. This differs from a dentist prescribing privately outside the NHS dental formulary.
Independent and supplementary prescribers
Nurse independent prescribers are not confined to the community practitioner list. The NMC describes their authority as covering medicines appropriate to their scope of practice, subject to exceptions concerning certain controlled drugs.
Supplementary prescribing operates through an agreed clinical management plan. Establish the capacity in which the nurse is prescribing where this affects the prescription.
Does the prescription form determine the nurse’s prescribing powers?
The form and its annotations help identify the prescriber, but the stationery does not confer prescribing authority.
In England, community practitioner and independent or supplementary nurse prescribers can use computer-generated FP10SS prescriptions. NHSBSA’s overprint specification provides different headings and identifiers for these categories. Consequently, an FP10SS is not automatically a doctor’s prescription or an unrestricted nurse prescription.
Likewise, NHSBSA’s stationery guidance identifies FP10PN forms as being used by nurses with different prescribing qualifications. A lilac nurse prescription does not, by colour alone, establish that the limited formulary applies.
National form references also differ:
- The England and Wales nurse formulary refers to FP10(P), and WP10(CN) and WP10(PN) in Wales.
- The Scottish limited nurse formulary refers to GP10(N); its dental provisions refer to GP14.
Read the prescriber description and applicable form rules together, and verify the qualification where necessary. A change of stationery cannot expand a community practitioner nurse prescriber’s legal authority.
Does a non-formulary item make the prescription “invalid”?
It is more useful to identify the precise problem:
- NHS eligibility: the item is outside the applicable prescribing formulary.
- Prescribing authority: the prescriber lacks legal authority to prescribe that POM.
- Prescription requirements: required particulars are missing or the prescription has expired.
- Clinical appropriateness: the proposed supply is unsafe or inappropriate.
The general prescription requirements appear in regulation 217 of the Human Medicines Regulations 2012, subject to provisions including those for electronic prescriptions. Formulary inclusion does not replace those checks.
For NHS pharmacists in England, Schedule 4, paragraph 9(2) requires refusal where an order is for a POM the prescriber was not entitled to prescribe. Paragraph 9(1)(b) also addresses errors and supplies contrary to clinical judgement. These are English terms of service; pharmacies elsewhere must apply their corresponding national requirements.
A serious shortage protocol (SSP) provides a separate legal route for supplying an authorised alternative. It does not give pharmacists general permission to substitute any unavailable medicine.
For POMs, regulation 226A of the Human Medicines Regulations 2012 disapplies the ordinary prescription requirement in regulation 214(1) when its conditions are met. These include compliance with the SSP and the pharmacist’s assessment that the specified substitution is reasonable and appropriate.
The protocol must specify where in the UK, and for what period, it has effect. Its scope, exclusions and conditions must be checked for the individual patient.
Must the SSP alternative also be in the original prescriber’s formulary?
On the wording of regulation 226A, the alternative does not need to fall within the original prescriber’s POM prescribing authority merely because that prescriber issued the original prescription. The pharmacist’s authority for the alternative supply comes from the SSP exemption.
This is an interpretation of the statutory structure: regulation 226A does not impose an additional condition requiring the substitute to appear in the original prescriber’s formulary. It does require every applicable SSP condition to be satisfied.
For NHS supply, the national contractual and payment provisions must also be satisfied. In England, Schedule 4, paragraph 5A expressly permits an appropriate alternative supply under an SSP. Paragraph 5A(4)(a) provides for the endorsed prescription to support reimbursement even though the supply is made under the SSP rather than pursuant to that prescription. These provisions were introduced by regulation 4 of the 2019 SSP amendments.
Accordingly, an authorised SSP substitution should not be treated as though the dentist or nurse had themselves prescribed the substitute outside their formulary.
However:
- Check that the original prescription and patient fall within the SSP.
- Do not assume that an SSP resolves an unauthorised or otherwise defective original prescription.
- Follow the protocol’s consent, recording, notification and endorsement requirements.
- Check the NHS arrangements applying where the pharmacy supplies the medicine.
The English reimbursement provision is not a UK-wide payment rule. Scotland, Wales and Northern Ireland have their own SSP service arrangements.
Check the exact preparation
A formulary entry may specify a strength, formulation, quantity or other condition.
For example, the October 2026 England and Wales dental formulary lists fluconazole 50 mg capsules. That does not establish NHS dental permission for every fluconazole strength. The nurse formulary also contains quantity restrictions, named preparations and qualifications affecting particular indications or doses.
Controlled-drug requirements remain separate. Where relevant, check the applicable controlled-drug legislation as well as the formulary and general prescription requirements.
A practical approach for pharmacy teams
Before supply:
- Identify the prescriber’s category and authority.
- Establish the prescription’s originating NHS arrangements and the dispensing country.
- Check the applicable formulary, including the exact preparation and conditions.
- Complete the usual legal and clinical checks.
- If considering an SSP, check its separate authority and national supply requirements.
- Resolve discrepancies and record the outcome.
Drug Tariff Pro provides convenient access to dental and nurse formulary information alongside other reimbursement tools.