Nine SSPs issued for Quetiapine tablets

In response to significant ongoing disruption to the supply of some Quetiapine tablets, the Department of Health and Social Care (DHSC) has issued nine new Serious Shortage Protocols (SSPs). The nine new SSPs, introduced with immediate effect, allow community pharmacists to consider different options to enable continued supply of quetiapine tablets to mitigate the ongoing supply disruptions affecting certain quetiapine tablet strengths.

Depending on the prescribed quantity of the affected quetiapine tablet, the protocols allow pharmacists to either supply a reduced quantity of the same quetiapine tablet, or substitute with a alternative strength, or provide a reduced quantity of a specific alternative product. For each SSP, DHSC has included specific patients counselling points which must be taken into account when deciding whether supply in accordance with an SSP is suitable for a patient. Pharmacists will need to call on their clinical expertise to determine which SSP is the most appropriate to use in each scenario and to counsel patients on any changes made to their treatment and what it means for their medicine regimen.

Pharmacy teams are advised to read the documentation in full for all SSPs published on the NHSBSA’s website and implement the protocols with immediate effect. DHSC have confirmed that the endorsement guidance for the new SSPs is currently being developed and will be added to the NHSBSA’s website shortly.

Quetiapine SSPs

For three strengths of quetiapine tablets affected by ongoing supply disruptions, a total of 9 individual SSPs have been issued by DHSC which allow either:

Restriction of the quantity supplied – where a prescription has a duration of more than one month and supplies are available, an equivalent of one 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 one month and supplies are unavailable, the SSPs will allow pharmacists to provide one months’ supply of specific alternative product.

A summary breakdown of SSPs available for each strength of quetiapine tablets is listed below.

Drug name
SSP

Substitution with a specific alternative quetiapine strengths 
Restriction of the quantity supplied 
Substitution with a specific alternative product AND restriction of the quantity supplied 

Quetiapine 150mg tablets
SSP062
SSP063
SSP064

Quetiapine 200mg tablets
SSP065
SSP066
SSP067

Quetiapine 300mg tablets
SSP068
SSP069
SSP070

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 quetiapine tablets listed above.

Support on implementation

Only one SSP can be used against an individual prescription. Therefore, in each scenario, the pharmacist will need to consider both the pharmacy’s stock levels of different quetiapine tablets strengths and the patient’s circumstances and before determining which of the SSPs is most appropriate to use. Depending on the SSP used, the change in supply may require additional counselling to ensure that the patient is confident to take their medication.

Endorsement Guidance

Due to the number of different quetiapine tablet SSPs available for each affected quetiapine tablet strengths, pharmacists must ensure that they follow the correct endorsements requirements as per the supporting guidance published for each SSP on the dedicated page of the NHSBSA’s website. Incorrect endorsements will affect pharmacy payments.

Reimbursement

Reimbursement is for the medicine supplied in accordance with the SSP and not the originally prescribed medicine i.e. in this instance contractors will be reimbursed for the quetiapine tablets supplied. The reimbursement price will account for VAT payment. Supply in accordance with the SSP will result in the following fees being paid to the contractor:

One Single Activity fee (currently £1.27)
One SSP fee (£5.35)

Useful resources

PSNC Briefing 023/19: Serious Shortage Protocols – A guide for community pharmacy teams

Serious Shortage Protocols (SSPs) webpage

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