Three new SSPs introduced for HRT medicines

In response to a significant ongoing disruption affecting three Hormone Replacement Therapy (HRT) medicines, the Department of Health and Social Care (DHSC) have issued three new Serious Shortage Protocols (SSPs).

These SSPs, introduced with immediate effect, enable community pharmacists in the UK to supply patients with no more than three months’ worth of these medicines.  The protocols allow for a reduced quantity of the specified medicines to be supplied to help manage the ongoing supply disruption affecting these HRT products.

SSP number Brand name Generic name SSP SSP Expiry Supporting Information
SSP019 Oestrogel Pump-Pack 0.06% gel Estradiol 0.06% gel (750microgram per actuation) SSP019: Oestrogel Pump-Pack 0.06% gel Friday 29 July 2022 SSP019 guide
SSP020 Ovestin 1mg cream Estriol 0.1% cream SSP020: Ovestin 1mg cream Friday 29 July 2022 SSP020 guide
SSP021 Premique Low Dose 0.3mg/1.5mg modified-release tablets Conjugated oestrogens 300microgram / Medroxyprogesterone 1.5mg modified-release tablet SSP021: Premique Low Dose 0.3mg/1.5mg modified-release tablets Friday 29 July 2022 SSP021 guide

Pharmacy teams are advised to read the documentation for SSP019, SSP020 and SSP021 in full and to implement the protocol with immediate effect. 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 three HRT products listed above.

Contractors will also receive an email to their shared NHSmail account informing them of these SSPs.

Please note, these SSPs may be amended or revoked at any time but are currently due to expire on 29 July 2022 – PSNC will update contractors on any changes.


Q. For patients who normally pay for their prescriptions, do charges apply for supplies made against an SSP for reduced quantity?

A. No prescription charge is payable if a patient receives a smaller quantity of the medicine than the quantity originally ordered on the prescription if it was supplied in accordance with an SSP for reduced quantity.

Q. Do these HRT SSPs apply to prescriptions with less than three months’ worth of HRT?

A. No, the HRT SSPs cannot be used if a patient presents a prescription for an amount less than or equivalent to three months’ supply. Pharmacists should refer to the inclusion and exclusion criteria specified in the relevant HRT SSP. Any prescription requesting three months or less of the affected HRT medicine should be dispensed as usual and if the patient pays for their prescriptions, patient charges should continue to be collected for the HRT medicine and other chargeable items ordered on the prescriptions.

Q. Why are SSPs not issued for other HRT products reported to be affected by ongoing supply disruptions?

A. The medicines covered by the SSP019, SSP020 and SSP021 are those considered by the Ministers to be short supply and where an SSP would help manage the supply situation if clinicians advising Ministers think it is appropriate. The DHSC Supply team are constantly the monitoring the supply situation affecting HRT medicines and SSPs for other HRT medicines may be issued if considered appropriate by Ministers.

PSNC will issue further guidance and FAQs shortly.


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 the three HRT products. 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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