Update 28/10/22 – The Department of Health and Social Care (DHSC) has provided an update on the Serious Shortage Protocols (SSPs) for 12 HRT SSPs. All 12 SSPs were due to expire 28 October 2022 but have been further extended.  The table below reflects the new SSP expiry dates for all 12 SSPs:

SSP
Expiry Date
Supporting Information
SSP019 Oestrogel® Pump-Pack 0.06% gel – restriction
30 November 2022
SSP019 guide
SSP020 Ovestin® 1mg cream – restriction
30 November 2022
SSP020 guide
SSP022 Oestrogel® Pump-Pack 0.06% gel (750microgram per actuation) – substitution
30 November 2022
SSP022 guide
SSP023 Oestrogel® Pump-Pack 0.06% gel (750microgram per actuation) – substitution and restriction
30 November 2022
SSP023 guide
SSP024 Ovestin® 1mg cream – substitution
30 November 2022
SSP024 guide
SSP025 Ovestin® 1mg cream – substitution and restriction
30 November 2022
SSP025 guide
SSP026 Lenzetto® 1.53mg/dose transdermal spray –  restriction
13 January 2023
SSP026 guide
SSP027 Lenzetto® 1.53mg/dose transdermal spray –  substitution
13 January 2023
SSP027 guide
SSP028 Lenzetto® 1.53mg/dose transdermal spray – substitution and restriction
13 January 2023
SSP028 guide
SSP029 Sandrena®  0.5mg and 1mg gel sachets – restriction
30 November 2022
SSP029 guide
SSP030 Sandrena®  0.5mg and 1mg gel sachets –  substitution
30 November 2022
SSP030 guide
SSP031 Sandrena® 0.5mg and 1mg gel sachets –  substitution and restriction
30 November 2022
SSP031 guide

Twelve of the thirteen Hormone Replacement Therapy (HRT) Serious Shortage Protocols (SSPs) was extended to 28 October 2022. This is to help manage the ongoing supply disruptions affecting the availability of certain HRT medicines. The HRT SSPs which have been extended include SSP019, SSP020 and SSPs 022 – 031 (see table below).

In addition, the dose equivalence advice and endorsement guidance for SSP024 and SSP025 was updated.  SSP024 and SSP025 was updated by DHSC to provide greater clarity to pharmacists on the dose equivalences to determine the appropriate quantity to supply.  Please refer to the latest SSP versions and endorsement guidance published on NHSBSA’s website.

The table below shows all HRT SSPs with an extended expiry date.

Drug name
SSP
Restriction of the quantity supplied (for prescriptions ordering > 3 months)
Substitution with a specific alternative product (for prescriptions ordering < 3 months)
Substitution with a specific alternative product AND restriction of the quantity supplied (for prescriptions ordering > 3 months)
Ovestin® 1mg cream
SSP 020
SSP 024 (update to dose equivalence advice and endorsing guide – see latest versions)
SSP 025 (update to dose equivalence advice and endorsing guide – see latest versions)
Oestrogel® Pump-Pack 0.06% gel
SSP 019
SSP 022
SSP 023
Lenzetto® 1.53mg/dose transdermal spray
SSP 026
SSP 027
SSP 028
Sandrena® 0.5mg and 1mg gel sachets
SSP 029
SSP 030
SSP 031

Pharmacists are required to read and comply with the requirements outlined within the individual SSPs and supporting guidance as published on the NHSBSA website for the HRT products listed above.

HRT SSPs

For four HRT medicines affected by ongoing supply disruptions, a total of 12 individual SSPs remain valid for use which allow either:

Restriction of the quantity supplied – where a prescription has a duration of more than three months and supplies are available, an equivalent of three months’ supply will be permitted in accordance with the SSP for the prescribed medicine; or
Substitution with a specific alternative product – where the prescribed duration of treatment is three months or less and supplies are unavailable, a pharmacist can supply a specific alternative product sufficient to provide a reasonable estimate of the prescribed duration of treatment, if deemed clinically appropriate; or
Substitution with a specific alternative product AND restriction of the quantity supplied – where a prescription has a duration of more than three months and supplies are unavailable, the SSPs will allow pharmacists to provide three months’ supply of specific alternative product.

Additional Resources

Endorsement guidance and FAQs for HRT SSPs now live – update

Serious Shortage Protocols (SSPs) – PSNC website

Serious shortage protocols (SSPs) – NHSBSA website

PSNC Briefing 011/21: Serious Shortage Protocols (SSPs) updated endorsing guidance

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