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The safety of patients could be threatened by a government decision that will affect the quality of training of young doctors in the use of drugs, say leaders of the profession.
The Department of Health has decided to stop paying for a free copy of the British National Formulary (BNF) for all medical students in England. The move has been described as illogical, shortsighted, and against the current drive to reduce the number of prescribing errors.
The BNF provides up to date information on all drugs available on the NHS and is used daily by more than 200000 health professionals in the United Kingdom to help them select the correct treatment for patients.
The BNF also helps students develop their knowledge and skills before taking on clinical responsibility. It is published twice a year under the authority of a joint formulary committee comprising representatives of the medical and pharmaceutical professions and the UK health departments.
Dominic Vaughan, the BNF's publishing director, said, “The BNF is a critical tool for the safe use of drugs. It gives health professionals the information they need to make the best treatment decisions for their patients.”
A recent study of new doctors, published in the British Journal of Clinical Pharmacology (2007;64:363-72), found that training in pharmacology is insufficient to prepare medical students to prescribe safely and rationally.
Mr Vaughan added: “The fact that almost all (95%) of doctors in the study used the BNF before prescribing confirms just what a highly regarded and trusted resource it is. Withdrawing funding for this vital education tool is worrying indeed.”
In December last year students were told they would not receive the BNF, but this decision was overturned in March after pressure from the profession. This, however, proved to be a temporary reprieve, as the government has said it is withdrawing funding for good.
The BMA's medical students' committee also reacted angrily to the decision. Its chairman, Ian Noble, said he was appalled by the government's U-turn, which would have dire consequences.
“The BNF is an essential part of medical training, helping students to learn about safe and effective prescribing before taking on clinical responsibility,” he said.
“I think this decision is part of cost cutting and a further invasion on education budgets to relieve the stresses and strains on the NHS as a whole.
“If the government is serious about patient safety and newly qualified doctors' pharmacology knowledge, then they need to take this seriously. The BNF is a vital resource. This will have an impact on patient safety somewhere down the road.”
Martin Kendall, chairman of the joint formulary committee and a professor of clinical pharmacology at the University of Birmingham, said, “Providing medical students with the BNF must be one of the most cost effective ways of improving the quality of care in the NHS. It is sad that the Department of Health does not appreciate this and has decided not to make the BNF available to students. The potential savings will be trivial; the cost to patients and to the NHS could be very great.”
A Department of Health spokesman said, “The funding for the provision of the BNF has not been cut or deleted, it has been reallocated to the strategic health authorities, as we believe they are better placed to determine local education and training expenditure priorities.
“It is therefore up to the undergraduate medical deans and BMA medical student committee to approach all 10 health authorities to request funding of the BNF for medical students.”
Competing interest: The BMJ Publishing Group co-publishes the BNF with the Royal Pharmaceutical Society.