Medicine Shortages
Published on: 27th November 2024 | Updated on: 15th October 2026
Please note: This page is intended for community pharmacy teams. If you are a patient or member of the public and are having difficulty obtaining a medicine you have been prescribed, please speak to a member of your local pharmacy team.
Medicines supply issues continue to place significant pressure on community pharmacies and their patients. This page brings together practical information and resources to help pharmacy teams identify and manage medicine shortages, understand the options available, report supply and pricing problems, and support patients and other healthcare professionals.
Latest news on supply: Autumn brings renewed pressures on medicines supply.
Fulfilling the prescription
If your pharmacy is having difficulty obtaining a medicine, the steps below can help identify and manage the supply issue.
1. Is there a known supply issue?
Pharmacy teams should first check the Medicines Supply Tool if they suspect a medicine may be affected by a supply issue.
The tool provides up-to-date information from the Department of Health and Social Care (DHSC) and NHS England on known medicine supply issues, including anticipated resupply dates and recommended management options. It is hosted on the Specialist Pharmacy Service (SPS) website and pharmacy teams will need to register using an NHS-based work email address to access it.
Resupply dates can change, therefore it is important that pharmacy teams check the tool for the latest information and follow any recommended management advice.
DHSC may also issue a Medicine Supply Notification (MSN) where a medicine is affected by a supply problem. MSNs provide information on the expected duration and severity of the shortage and may include recommendations for managing affected patients. MSNs are categorised according to the severity and impact of the supply issue, ranging from Tier 1 (low impact) to Tier 4 (critical).
MSNs are cascaded across the NHS and are also available through the Medicines Supply Tool. Community Pharmacy England publishes brief summaries of MSNs, but these reflect the position when the MSN is first issued and are not updated following subsequent changes. Pharmacy teams should therefore always check the Medicines Supply Tool for the latest information.
In more complex shortages, where the relevant criteria are met, a National Patient Safety Alert (NatPSA) may also be issued through the MHRA Central Alerting System (CAS). See our Patient safety information page for current and previous NatPSAs and other safety notifications.
Medicine Supply Notifications (MSNs) or other supply alerts may recommend that prescribers consider an unlicensed medicine or import where a licensed medicine is unavailable.
Where an unlicensed medicine or import is required, the prescription must be written correctly for the unlicensed product before it can be supplied.
For EPS prescriptions, the prescriber should select the appropriate Actual Medicinal Product (AMP) on their prescribing system. Supplementary product information such as ‘Special Order’ entered only within the dosage or additional instructions field cannot be used by NHSBSA to determine reimbursement.
If the required product is not listed on dm+d or cannot be selected on the prescriber’s system, a paper FP10 prescription may be required.
See our Unlicensed specials and imports page for detailed guidance on prescribing, endorsement, reimbursement and submission requirements.
For prescriptions containing supplementary product information, see our Dealing with EPS product information within the dose area guidance and Funding & Reimbursement Short: Handling prescriptions with supplementary product information.
2. Check if an SSP has been issued
Serious Shortage Protocols (SSPs) can help community pharmacies manage serious shortages without needing to refer patients back to prescribers. An SSP will only be considered and issued where there is, or may be, a serious shortage of a specific medicine.
An SSP will specify the alternative product or quantity that may be supplied and any conditions that apply.
Pharmacy owners must consider the SSP. The supervising pharmacist must then use their professional judgement to decide whether the alternative product or quantity specified in the SSP is reasonable and appropriate for the patient. Any supply must be made in accordance with the terms of the SSP and with the patient’s agreement.
Before supplying against an SSP, pharmacy teams should:
- check that the SSP is active at the time of supply;
- check that the patient and prescription meet the relevant SSP criteria;
- ensure the supply is made in accordance with the conditions set out in the SSP; and
- endorse and submit the claim in accordance with the relevant SSP guidance.
Our Serious Shortage Protocols (SSPs) page lists current SSPs and provides detailed guidance on endorsement, submission, reimbursement and reconciling SSP claims.
You can also watch our Funding & Reimbursement Short: Dispensing and claiming SSPs for an overview of how to correctly endorse and claim for supplies made under an SSP.
If there is no active SSP in place, continue through the steps below to consider the other options available to manage the supply issue.
3. Try other suppliers or check manufacturer contingency arrangements
Pharmacy teams should check whether the medicine can be obtained through another supplier or whether the manufacturer has alternative ordering or contingency arrangements in place.
Community Pharmacy England maintains a Manufacturer contingency arrangements page, which summarises arrangements manufacturers have put in place for ordering products where community pharmacies are unable to source them through usual channels. Please note, this is not an exhaustive list.
4. Signpost the patient to another pharmacy
Where appropriate, pharmacy teams should check whether another pharmacy has stock available and signpost the patient accordingly.
5. Contact the prescriber
An alternative strength, formulation or medicine cannot be supplied against the existing prescription unless this is permitted by an active SSP. Pharmacy teams may therefore need to contact or signpost the patient back to the prescriber so that the prescription can be amended or a new prescription issued.
6. Report new shortages
There may be occasions where a supply problem has not yet been published on the Medicines Supply Tool or an MSN has not been issued. If stock cannot be obtained from any supplier, pharmacy teams should report the shortage to Community Pharmacy England.
Before reporting a shortage, pharmacy teams are reminded to check the Medicines Supply Tool and try other suppliers or manufacturer contingency arrangements, as outlined above.
We collate reports received from pharmacy teams and escalate relevant issues to the DHSC medicines supply team for investigation.
Quota issues
DHSC best-practice guidance states that manufacturers and wholesalers should manage quota allocations fairly and have a clear process for reviewing allocations where usage or demand changes.
Where a pharmacy is unable to obtain sufficient stock because of a manufacturer or wholesaler quota restriction, please use our separate Report a quota issue form.
If the medicine is available but cannot be obtained at or below the published Drug Tariff price, this should instead be reported to us as a pricing issue. See further information below.
In some cases, a medicine may still be available to purchase, but only at a price above the Drug Tariff reimbursement price. These issues are managed through the price concession process rather than the medicines shortage reporting route.
Where a drug listed in Part VIIIA, Part VIIIB or Part VIIID of the Drug Tariff cannot be obtained at or below the published Drug Tariff price, pharmacy owners should report the pricing issue to Community Pharmacy England.
When submitting a report, please provide full details of the supplier and the actual price paid for any products sourced above the published Drug Tariff price.
Report a product over Drug Tariff price
We use reports from pharmacy owners, alongside other market information, to investigate pricing issues and determine whether it is appropriate to submit a price concession request to DHSC. These reports also support our discussions with DHSC when considering or negotiating proposed concession prices.
Where a price concession is granted, pharmacy owners are automatically reimbursed at the concessionary price for that dispensing month. No additional endorsement is required.
Further information on current price concessions and how the process works is available from our Price Concessions Hub.
Medicine shortages can be frustrating and worrying for patients, particularly where their usual medicine cannot be supplied immediately.
Where possible, pharmacy teams should explain:
- that the medicine is affected by a supply problem;
- what steps the pharmacy has taken to try to obtain it;
- whether there is national guidance or recommendations in place for managing the shortage; and
- what the patient needs to do next.
A range of resources are available to help pharmacy teams explain medicine supply issues to patients:
- Where’s my medicine? patient leaflet – colour
- Where’s my medicine? patient leaflet – black and white
- Department of Health and Social Care (DHSC) and NHS England Advice for patients during a medicines shortage leaflet
- Medicines Supply Poster and Digital Screen files
- Social Media Assets
For additional support with challenging conversations, pharmacy teams may also find the SPS resource Navigating difficult conversations with confidence useful.
Prescribers and other NHS colleagues
Medicine shortages often require community pharmacy teams to work with prescribers and other NHS colleagues to ensure patients can continue to access appropriate treatment.
The following resource explains the pressures affecting medicines supply, how pharmacy teams manage shortages and what prescribers and other NHS colleagues can do to support patients.
Medicine Shortages: A briefing for ICSs, GPs and other NHS prescribers
Politicians and the public
Community Pharmacy England has been highlighting the daily medicines shortages affecting pharmacies and their patients, but everyone working in the sector can help make sure this issue is recognised more widely
The Pharmacy Pressures Survey 2026 quantified the extent of medicines shortages, with 86% of pharmacies are spending longer procuring medicines than they did last year. The survey results are already being used to raise awareness of medicines supply issues, alongside wider pressures, through our work briefing politicians and the media. Pharmacy owners can support this effort by writing to their MP and posting on social media. Find guidance and resources in our Pressures Awareness Toolkit.
Why do medicine shortages occur?
Medicines supply chains are long and complex, and shortages can arise for many different reasons. While some supply issues may be localised, medicine shortages can also be national, and sometimes global, problems which can affect both the availability and pricing of medicines.
Factors contributing to medicine shortages can include:
- manufacturing issues, including shortages of raw materials or active pharmaceutical ingredients (APIs), and other supply disruption;
- issues with manufacturing capacity and flexibility;
- discontinuation or commercial withdrawal of medicines from the market;
- market and reimbursement pressures, including where low medicine prices can make the UK a less attractive market for manufacturers and reduce supply chain resilience;
- medicine recalls and product quality issues;
- unanticipated increases in demand, including where shortages of one medicine increase demand for alternatives;
- changing prescribing patterns in response to changes in guidance or patient need;
- distribution and logistical problems, including capacity issues;
- international trade barriers;
- increased exporting linked to currency fluctuations;
- suppliers withholding or managing stock; and
- quota restrictions used to manage stock allocations.
Further medicines supply resources
The Healthcare Distribution Association (HDA) has produced an infographic highlighting the factors that can affect medicines supply, as well as measures taken to help mitigate the risk of patients not receiving their medicines.
For more information on this topic please email ds.team@cpe.org.uk
