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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 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.

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.

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 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.

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.

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 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 PSNC on Friday said it has warned the DHSC about the "very serious impact" of the limited supply of certain antibiotics on pharmacies who are "having to chase stock, purchase without sight of any concession prices, and cope with increasing patient questions and abuse." With higher than usual number of cases of scarlet fever, caused by invasive Group A Streptococci (iGAS) infections, being reported in children across the country, supplies of antibiotics for Group A Strep treatment have seen a surge in demand, leading to limited supply at certain wholesalers and pharmacies. PSNC has urged the DHSC to adopt measures that could help to manage the current crisis, such as allowing pharmacists more freedom to change strengths or formulations without prescriber approval, outside of Serious Shortage Protocols. It has also raised concerns on the significant rise in wholesale prices of many oral antibiotics as a result of the surge in demand and the ongoing supply disruptions. PSNC also said they have received reports of some suppliers putting up their prices for any oral antibiotics they do have in stock.

Community Pharmacy England (CPE) has explained MPs on instability that puts operational pressures on pharmacies, financial pressures on businesses at a Parliamentary drop-in event held on Monday (10 July). The association has been in Parliament today alongside patient representatives and others to highlight our ongoing concerns about medicines supply to MPs. It said: "Medicines supply remains a critical issue for community pharmacies with disruption causing problems both accessing medicines and procuring them cost effectively." In CPE's recent sector polling, community pharmacy owners rated medicines supply instability as being the most severe pressure facing their businesses. This echoed the results of CPE's Pressures Survey which found 97% of pharmacy owners survey are facing significant increases in wholesaler and medicine supply issues, with 71% saying this was leading to delays in prescriptions being issued. During the Parliamentary drop-in event, CPE talked MPs through the issues and set out what it believe needs to happen to resolve them, calling for- Reform of Serious Shortage Protocols; Allowing generic substitution; An overhaul of the concessions system; and a strategic Government review of medicine supply and pricing with a shift to focusing on how to improve the functioning of the supply chain rather than solely on the drive to depress prices and margins.

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 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 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 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."

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.