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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.

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 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.

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.

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 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 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."