New SSP issued for Estradot® 75 micrograms patches

In response to a significant ongoing disruption to the supply of Estradot® 75 microgram patches, a Serious Shortage Protocol (SSP) has been issued by the Department of Health and Social Care (DHSC).

Effective today, 29 April 2021, SSP012 provides that for every Estradot® 75 microgram patch originally prescribed, either one Evorel® 75 microgram patch or one Estraderm MX® 75 microgram patch must be supplied. SSP012, 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.

For prescriptions (NHS or private) requesting: Supply permitted under SSP012:
Estradot® 75 microgram patches Evorel® 75 microgram patches
Estraderm MX® 75 microgram patches

The SSP may be amended or revoked at any time but currently expires on Friday 4 June 2021 – PSNC will update contractors on any changes.

Key points relating to SSP012

  • Ensure that patients considered unsuitable for inclusion are promptly referred to their prescriber for further advice.
  • The supervising pharmacist should ensure that the patient’s prescriber is notified when supplying a patient in accordance with this SSP
  • The supervising pharmacist should explain to patients who are supplied in accordance with this SSP on monitoring and managing potential side effects, such as:
    • Vaginal ‘breakthrough bleeding’;
    • Irritation caused by wearing a different patch to one they are used to;
    • Patches coming off or not adhering properly.
  • Patients who experience persistent side effects from alternative patches supplied in accordance with this SSP should be referred back to their prescriber promptly
  • For endorsing requirements please refer to NHSBSA’s supporting guidance or PSNC’s Briefing 009/21: Serious Shortage Protocol (SSP): SSP012 – Estradot® 75 microgram patches

Pharmacists must exercise their professional judgement to ensure the alternative products are suitable for the patient.

Contractors will receive an email to their shared NHSmail account informing them of this SSP and pharmacy teams are advised to read the documentation for SSP012 in full and to implement the protocol with immediate effect. Pharmacists are required to read and comply with the requirements outlined within the individual SSP as published on the NHSBSA website for SSP012:Estradot® 75 microgram patches.

For further information please read PSNC’s Briefing 009/21: Serious Shortage Protocol (SSP): SSP012 – Estradot® 75 microgram patches


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 the Drug Tariff Part VIIIA reimbursement price for Evorel® 75 microgram patches or Estraderm MX® 75 microgram patches. 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)

Support in implementing the SSPs

The following resources have been developed to support pharmacy teams in using these protocols.

Current versions of SSPs

Serious Shortage Protocols Operational Guidance

Serious Shortage Protocols Questions & Answers

PSNC’s Serious Shortage Protocols (SSPs) Endorsing Factsheet

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

Background information on SSPs

Further information on what SSPs are and when they may be used is available via the links below.

Serious Shortage Protocols (SSPs) on-demand webinar

Serious Shortage Protocols (SSPs) webpage

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