National formulary should be integrated into electronic prescribing, paediatric bodies say

The British National Formulary for Children (BNFC) should be integrated into all electronic prescribing and medicines administration (ePMA) systems, the Neonatal and Paediatric Pharmacy Group (NPPG) and the Royal College of Paediatrics and Child Health (RCPCH) have said.

The recommendation was made in a position statement published on 20 April 2026, by the joint RCPCH and NPPG Medicines Committee.

The statement highlighted a report published by the Healthcare Services Safety Investigation Branch (HSSIB) in 2022 that warned that although ePMA use was growing, inaccurate dosing calculations and unsuitable electronic system configurations were still contributing to medication errors and severe harm in children.

It added that progress made since that 2022 report “remains uneven and several critical paediatric-specific needs remain unmet”.

The statement also noted that electronic systems can sometimes contribute to the prescription of incorrect doses for children, rather than preventing medication errors.

“From a human factors perspective, the medicines committee is concerned that as ePMA systems are more widely implemented, dosing errors are likely to increase without tailored safeguards for paediatrics,” it said.

The committee also recommended that BNFC-based dosing should be used within ePMA systems, UK-wide to calculate paediatric dosages and set safety dose limits. At the moment, it pointed out that the BNFC is not integrated on a wide scale.

According to the position statement, any local guidelines used to supplement the BNFC should be limited to genuinely necessary cases, as well as clearly marked to distinguish them from national standards.

It also warned that failure of ePMA systems to filter out adult dosing content can lead to severe medication errors, adding that “age-based, weight-based, and body surface area-based dosing should be integrated as a baseline for calculating paediatric dosages”.

In a review of electronic patient record (EPR) investigation reports, published on 27 November 2025, the HSSIB said that EPRs can contribute to risks of patient care being missed, delayed or incorrect. Patient safety risks were “persistent despite national recommendations and actions seeking to mitigate them”, it added.

Read more: ‘Support systems: how the Royal Pharmaceutical Society is investing in the future of safe prescribing‘.