Group items tagged

To help the pharmacists understand the Serious Shortage Protocols (SSPs) for three Hormone Replacement Therapy (HRT) products that was recently announced by the Department of Health and Social Care (DHSC)'s, the Pharmaceutical Services Negotiating Committee has shared top tips on the correct SSP endorsement and submission requirements. Top Tips by PSNC for pharmacists on HRT SSPs: Always double check that endorsements reflect the requirements outlined in the supporting guidance published for each SSP on the dedicated page of the NHSBSA's website. When endorsing using EPS, contractors are reminded to select the SSP endorsement and input the correct three-digit reference number leaving a space in between 'SSP' and the three-digit reference number for example, SSP 019. Remember to insert the leading zero in the three digit reference number. Each of the affected HRT medicines has its own SSP reference number. Check that the correct SSP number is endorsed for e.g. for Oestrogel® Pump-Pack 0.06% gel the SSP endorsement should be 'SSP 019'. Please note the 'NCSO' endorsement is no longer accepted for SSPs. Endorse the SSP product dispensed including the quantity. Ensure your endorsements are accurate and clear - NHSBSA processing staff must be able to determine what has been supplied. Contractors should note that SSP claims submitted using EPS tokens are no longer permitted.

The Pharmaceutical Services Negotiating Committee (PSNC) has advised the pharmacy contractors to check that their PMR systems supports correct and complete SSP endorsements. Several tips has been shared by the PSNC with pharmacy contractors after NHSBSA received several electronic EPS SSP claims which did not meet the requirements for a valid SSP between 1 April 2022 and 31 May 2022. PSNC has been working with NHS Business Services Authority (NHSBSA) to understand whether claims for HRT SSPs are being submitted correctly and in accordance with the specific supporting guidance for each SSP. "For any invalid SSP claims, contractors will continue to receive the usual dispensing fee but will not receive any SSP fee (£5.35). Reimbursement for invalid SSP claims will also be in accordance with the prescribed product rather than the alternative product or quantity supplied in accordance with an SSP," said PSNC.

The Department of Health and Social Care (DHSC) has suggested Estradiol patch as an alternative for patients who use 1 pump of Oestrogel daily. DHSC has updated Annex A of SSP022 and SSP023 for Oestrogel Pump-Pack 0.06 per cent gel to include a dose conversion to a specific alternative Estradiol patch. Previously, only dose conversions for patients using 2 to 4 pumps daily were included in Annex A of SSP022 and SSP023. Separately, the supporting guidance for three SSPs which allow quantity restriction have been updated to reflect the requirement to endorse the reduced quantity supplied in accordance with these SSPs. SSP019 - Oestrogel pump-pack 0.06% gel SSP020 - Ovestin 1mg cream SSP021 - Premique low dose 0.3mg/1.5mg modified release tablets "When endorsing an SSP for a reduced quantity, contractors must ensure that the correct SSP number is endorsed along with the product name and the reduced quantity supplied in accordance with the SSP," said PSNC.

Pharmacists can dispense Paracetamol 120mg suppositories in accordance with the prescription, as the Department of Health and Social Care (DHSC) has confirmed that sufficient stocks are available to meet normal demand. This means the Serious Shortage Protocol - SSP033 - for Paracetamol 120mg suppositories has now expired since 26 August 2022. Top tips for SSP claims NHSBSA advise that contractors must follow the specific endorsement guidance issued with each SSP and endorsements should be clear and unambiguous - NHSBSA processing staff must be able to determine what has been supplied. NHSBSA have published information on common SSP endorsing errors they see when processing claims. Any paper prescriptions with SSP claims need to be placed in the red separator provided by the NHSBSA. Although an SSP cannot be used outside its period of validity, claims can be submitted up to three calendar months after expiry or withdrawal of the SSP to help manage any owings for other items issued on the same prescription form. For example, for SSP033 Paracetamol 120mg suppositories, which expires at 23.59pm on Friday 26 August 2022, the NHSBSA would continue to look for the "SSP" endorsement on prescriptions for Paracetamol 120mg suppositories that are submitted with the August batch (submitted by 5 September), September batch (submitted by 5 October) and October batch (submitted by 5 November).

To help manage the ongoing supply disruptions, the health regulators have extended to 28 October 2022, serious shortage protocols (SSPs) for 12 of the 13 hormone replacement therapies (HRT). "The only HRT SSP set to expire on 29 July 2022 is for SSP021 Premique low dose 0.3mg/1.5mg modified-release tablets. After 29 July, there will be no need to restrict quantities of Premique tablets as its supply situation has now stabilised," said PSNC. In addition, the dose equivalence advice and endorsement guidance for SSP024 and SSP025 have been updated. SSP024 and SSP025 have been updated by DHSC to provide greater clarity to pharmacists on the dose equivalences to determine the appropriate quantity to supply. Pharmacists are asked to refer to the latest SSP versions and endorsement guidance published on NHSBSA's website.

The Department of Health and Social Care (DHSC) has extended the Serious Shortage Protocols (SSPs) for Fluoxetine 10mg tablets (SSP005) and Lipitor 10mg chewable tablets (SSP032) to Wednesday, 7 December 2022. SSP005 for Fluoxetine 10mg tablets was due to expire on 12 August 2022. DHSC has also updated that SSP032 for Lipitor 10mg chewable tablets was due to expire on 12 August 2022 but the end date has been further extended to Friday 26 August 2022. SSP005 provides that for every Fluoxetine 10mg tablet originally prescribed, one Fluoxetine 10mg capsule must be supplied: "Expiry dates of an SSP may be brought forward or extended, and the content may be amended at any time during the life of an SSP. Pharmacists should ensure they are using the latest version of an SSP before considering the supply of an alternative product," said DHSC.

The Department of Health and Social Care (DHSC) has issued two new Serious Shortage Protocols (SSPs) for Estraderm MX 25mcg and 100mcg patches. Effective from 8 September 2022, SSP035 and SSP036 provide that for every Estraderm MX 25mcg or 100mcg patch originally prescribed, one Evorel 25mcg patch or 100mcg patch must be supplied, respectively. Both SSPs are currently set to expire on 16 September 2022. Both SSPs, authorised by the secretary of state for health, have been developed by clinicians and provides pharmacists with procedures to follow in providing either of these suitable alternative products to help reduce the number of patients having to return to their prescriber for a replacement prescription. DHSC informed that there are no SSPs in place for Estraderm MX 50mcg patches and 75mcg patches - these strengths are not affected by supply disruptions and should continue to be dispensed in accordance with the prescriptions "The SSP035 and SSP036 only allow substitution of Estraderm MX 25 or 100 patches with Evorel 25 or 100 patches, respectively."

The Department of Health and Social Care (DHSC) has issued a further five new Serious Shortage Protocols (SSPs) for Phenoxymethylpenicillin (Pen V) to enable the continued supply of antibiotics to patients. "The new SSPs, introduced with immediate effect, allow community pharmacists to consider different oral antibiotic preparations, to enable the continued supply of antibiotics to patients and mitigate the ongoing supply disruptions affecting Phenoxymethylpenicillin," said DHSC. On Friday (16 December) SSP043-SSP047 has been authorised by the Secretary of State to provide pharmacists with procedures to follow in providing suitable alternative oral antibiotics to substitute Phenoxymethylpenicillin. "For each SSP, DHSC has included specific patient counselling points which must be taken into account when deciding whether supply in accordance with an SSP is suitable for a patient."

To curb the supply issue of HRT medicine, the government has taken a further action by issuing SSPs for Oestrogel, Ovestin cream, Lenzetto transdermal spray and Sandrena gel sachets - with appropriate alternatives. The move aims to allow community pharmacists to supply specified alternatives to the prescribed HRT products without needing to seek authorisation from the clinician who has prescribed the medicine. The regulator said that the availability of Premique Low Dose has impoved 'thanks to SSPs issued on 29 April to restrict dispensing for Oestrogel, Ovestin and Premique Low Dose to three months' supply'. "Since these measures were implemented, further deliveries of all three products have been made, with Premique Low Dose returning to good availability this week. The manufacturers of Oestrogel and Ovestin, as well as suppliers of alternative HRT products, are taking action to increase UK supply." It added, "SSPs restricting prescriptions to a maximum of three months' supply will also be issued for substitute products, as a precautionary measure to ensure the supply of those substitutes is maintained."

The Serious Shortage Protocol (SSP), for Estradot 50mcg patches will expire at 23.59pm on Friday 24 February 2023. Department of Health and Social Care (DHSC) has confirmed that sufficient stock of Estradot 50mcg patches are now available to meet normal demand. "After 24th February, any prescriptions for Estradot 50mcg patches must be dispensed in accordance with the prescription, and SSP048 will no longer be valid for use," said DHSC. Top tips for SSP claims by PSNC: Where available, use the claim amend facility on the PMR system to rectify any incorrect EPS claims already submitted this month. For any supplies made in accordance with SSPs, check that the correct number of patient charges are collected and declared on the end of month FP34C submission. NHSBSA advise that contractors must follow the specific endorsement guidance issued with each SSP and endorsements should be clear and unambiguous - NHSBSA processing staff must be able to determine what has been supplied. NHSBSA have published information on common SSP endorsing errors they see when processing claims.

The Scottish government has issued a circular to inform community pharmacy contractors that the Serious Shortage Protocol (SSP) for Clarithromycin 125mg/5ml oral suspension, an antibiotic product, due to expire on 15 December 2023, has been extended until Friday 12 January 2024. The extension is applicable to SSP053 which allows community pharmacists to substitute this product with Clarithromycin 250mg/5ml oral suspension for patients presenting with an NHS or private prescription. Scotland's chief pharmaceutical officer, Alison Strath, has advised health boards to spread this information to community pharmacy contractors on their pharmaceutical lists and area pharmaceutical committees, as well as general practices. Community pharmacists have been advised to review and familiarise themselves with the new end date for the noted SSP.

The Department of Health and Social Care has issued a Serious Shortage Protocol (SSP) in response to a significant ongoing disruption to the supply of Paracetamol 120mg and 240mg suppositories. Effective from Tuesday (Jan 25), SSP015 provides that for every Paracetamol 120mg or 240mg suppository originally prescribed, one Paracetamol 125mg or 250mg suppository must be supplied. SSP015, authorised by the Secretary of State, has been developed by clinicians and provides pharmacists with procedures to follow in providing either of these suitable alternative products to help reduce the number of patients having to return to their prescriber for a replacement prescription. The SSP may be amended or revoked at any time but currently expires on 18 February 2022 - PSNC will update contractors on any changes.

The Department of Health and Social Care (DHSC) has announced that sufficient stock of Lipitor 10mg chewable tablets is now available to meet normal demand. Therefore, the Serious Shortage Protocol, SSP032 Lipitor 10mg chewable tablets expired at 23.59pm on Friday (9 September). "After this date, any prescriptions for Lipitor 10mg chewable tablets must be dispensed in accordance with the prescription, and the SSP032 will no longer be valid for use," said DHSC.

The Department of Health and Social Care (DHSC) has allowed pharmacists to supply alternative penicillin to treat Strep A. It has issued Serious Shortage Protocols (SSPs) for three penicillin medicines. "The SSPs will help mitigate local supply issues of oral penicillin and allow pharmacists to supply alternative forms of the medicine if they do not have the specific formulation stated on the prescription," said DHSC. SSPs have been issued across the UK for 3 penicillin medicines on Thursday (December 15. "Issuing an SSP allows pharmacists to legally supply a specified alternative medicine, removing the need for the patient to return to the prescriber - which saves time in GP practices and inconvenience for patients." "Demand for penicillin has risen recently as it is used to treat strep A and scarlet fever, and the increased demand means that some pharmacists are experiencing temporary and localised supply issues and may not have the specific formulation listed on the prescription."

The Department of Health and Social Care (DHSC) has issued Serious Shortage Protocols (SSPs) on three HRT medicines to limit dispensing supply to three months. To ensure women across the UK will be able to more reliably access HRT products SSPs has been issued on the supply of Oestrogel, Ovestin cream and Premique Low Dose. DHSC stated, "Women who have a prescription for more than three months but are only able to access three months' supply will not have to pay an additional prescription charge." "This means women will not incur any additional costs. Imposing a three month limit will mean more women are able to access the medication they want. Any woman who is worried about access to HRT or is unable to access HRT should speak to her GP." Recently, Vaccine Taskforce Director General Madelaine McTernan has been appointed to spearhead a new HRT Supply Taskforce, applying lessons learned from the successful procurement seen during the Covid vaccination programme to identify ways to support the HRT supply chain ensuring it can meet both short and long term demand. The move will save time for patients as well as pharmacists and prescribers who are working tirelessly to tackle the covid backlog.

In a recent meeting with the head of the government's HRT Taskforce, Madelaine McTernan, the National Pharmacy Association (NPA) board members gave a gist on the ongoing medicines supply issues in community pharmacy. The meeting, which explored possible solutions to end the nationwide shortage of some Hormone Replacement Therapies, took place on Friday (May 20). Independent contractors Reena Barai and Olivier Picard gave the so-called 'HRT tsar' an overview of the medicines supply issues in community pharmacy and discussed the new Serious Shortage Protocols (SSPs) which the government introduced in response to the on-going HRT disruption. Earlier this month, the NPA attended an HRT summit organised by the Department of Health and Social Care, alongside other pharmacy bodies, wholesalers and manufacturers. Health secretary Sajid Javid and pharmacy minister Maria Caulfield said they would be working collaboratively with manufacturers to meet demand and boost supply.

A total of 14 Serious Shortage Protocols (SSP) will expire today (12 May) as the Department of Health and Social Care has confirmed availability of the products to meet normal demand. The products include Sandrena 0.5mg and 1mg gel sachets, Lipitor 10mg chewable tablets, Phenoxymethylpenicillin 125mg/5ml and 250mg/5ml oral solution, sugar free variant of both doses and 250mg tablets, and Paracetamol 120mg and 240mg suppositories. The expiring SSPs include three related to Sandrena gel sachets, one for Lipitor, eight concerning Phenoxymethylpenicillin and two for Paracetamol. These will expire at 23.59pm on Friday 12 May and any prescriptions for these products must be dispensed in accordance with the prescription after that.

The Department of Health and Social Care (DHSC) has redetermined the December 2023 concessionary prices for four medicines following requests made by Community Pharmacy England (CPE) on behalf of community pharmacy owners. For Ezetimibe 10mg tablets (pack size 28), the price has been fixed at £17.78, up from £9.44. Other drugs included in the list are Aripiprazole 5mg (£8.52), Digoxin 125microgram (£3.70) and Digoxin 250micrgram (£3.70) tablets. Contractors would be reimbursed at the new prices only for prescriptions submitted for payment for the dispensing month of December 2023. CPE said they are still working with DHSC to agree price concessions for January. Check the final the December 2023 price concessionary here. Additionally, DHSC on Friday confirmed that there's now sufficient stock of Clarithromycin 125mg/5ml oral suspension to meet normal demand, and the Serious Shortage Protocol (SSP), SSP053 for the antibiotic expires on 12 January 2024.

The Royal Pharmaceutical Society (RPS) has urged the government to amend medicines legislation to allow pharmacists to make minor amendments to a prescription without any protocol being needed. RPS wants to see a change in the law that makes the whole process of supply of medicines easier and quicker, enabling pharmacists to use their knowledge and expertise in medicines to better support patients. "At present a prescription can only be changed by a prescriber, which causes unnecessary workload for GPs and delays for patients," said RPS. RPS President Professor Claire Anderson said: "We want to see all pharmacists across the UK able to supply a different quantity, strength or formulation of a medicine (for example changing capsules to tablets) when required, to avoid unnecessary bureaucracy and the need for an SSP to be developed, signed and authorised by a Minister. In effect it would mean that pharmacists can help patients straight away - it would future proof the problem to some degree.

Carolyn Harris, Labour MP for Swansea East and co-chair of the Menopause Taskforce, has raised concerns over overcharging of HRT medicines by some online pharmacies, The Telegraph reports. Carolyn, according to the newspaper, has claimed that some HRT products are being sold online for up to "three times as much as they're worth". She has also accused the companies of "profiteering" from HRT shortage. Carolyn has vowed to raise this issue in parliament and will also ensure that health secretary Sajid Javid is aware. She also intends to write to Javid to make sure he is up to date with the alleged "profiteering" taking place. "Get your act together, this is just exploitation. Anybody who thought it was a good idea to hike the price up because there was a shortage… it's awful, it's just complete profiteering, and making a profit off the back of somebody's desperation is never a good look," she told The Telegraph.