Two SSPs for Estradot® patches extended

Update 18/10/2024 – The Department of Health and Social Care (DHSC) has provided an update on the Serious Shortage Protocol (SSP) for Estradot® 75micrograms/24hours patches and Estradot® 100micrograms/24hours patches (SSP080 and SSP081). SSP080 was due to expire on 19 January 2025 but the end date has been further extended to Friday 14 March 2025. SSP081 was due to expire on 28 January 2025 but the end date has been further extended to Friday 14 March 2025.

There are no further changes to SSP079 . Please see an updated table below.

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

Effective today 19th December 2024, SSP079, provides that for every Estradot^® 50micrograms/24hours patch originally prescribed either one Evorel^® 50 patch or one Estraderm^® MX 50 patch must be supplied. SSP079, authorised by the Secretary of State, has been developed by clinicians and provides pharmacists with procedures to follow in providing a suitable alternative product to help reduce the number of patients having to return to their prescriber for a replacement prescription.

Effective today 19th December 2024, SSP080, provides that for every Estradot^® 75micrograms/24hours patch originally prescribed either one Evorel^® 75 patch or one Estraderm^® MX 75 patch must be supplied. SSP080, authorised by the Secretary of State, has been developed by clinicians and provides pharmacists with procedures to follow in providing a suitable alternative product to help reduce the number of patients having to return to their prescriber for a replacement prescription.

Effective today 19th December 2024, SSP081, provides that for every Estradot^® 100micrograms/24hours patch originally prescribed either one Evorel^® 100 patch or one Estraderm^® MX 100 patch must be supplied. SSP081, authorised by the Secretary of State, has been developed by clinicians and provides pharmacists with procedures to follow in providing a suitable alternative product to help reduce the number of patients having to return to their prescriber for a replacement prescription.

Community Pharmacy England previously reported that the NHS Business Services Authority (NHSBSA) received a number of EPS SSP claims which did not meet the requirements for a valid SSP claim. A large number SSP claims continue to be deemed invalid by the NHSBSA due to incorrect endorsements applied by PMR systems and/or pharmacy staff. We recommend pharmacy owners to regularly reconcile the value of SSP fees on their payment schedules against the number of SSPs declared on the FP34C submission form. Please refer to our new guidance on reconciliation of SSP claims.

If there is a payment discrepancy and it is believed that the correct SSP endorsing guidance was followed, pharmacy owners may consider requesting a re-check of relevant prescriptions and the NHSBSA will be able to explain why the claim was unpaid or rectify the payments.

Pharmacy teams are reminded to follow the SSP-specific guidance to ensure endorsements are applied correctly, and we also have guidance supporting teams raising PMR-specific claiming issues with their suppliers. Click here for more Top Tips on claiming for SSPs. 

Key points relating to SSP079, SSP080, SSP081

• • This protocol does not allow for the quantity supplied to be less than the number of days prescribed on original prescription.
  • There are no SSPs in place for the other strength of Estradot^® patches – this strength is not affected by supply disruptions and should continue to be dispensed in accordance with the prescriptions
  • SSP079 only allows the substitution of Estradot^® 50micrograms/24hours patches.
  • SSP080 only allows the substitution of Estradot^® 75micrograms/24hours patches.
  • SSP081 only allows the substitution of Estradot^® 100micrograms/24hours patches.
  • 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, using their professional judgement determines that swapping the patient to a different brand of a patch would not be suitable for the patient
  • For endorsing requirements please refer to NHSBSA’s supporting guidance for SSP079, SSP080, SSP081.

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

Pharmacy owners will receive an email to their shared NHSmail account informing them of this SSP and pharmacy teams are advised to read the documentation for the three SSPs 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:

• SSP079 Estradot^® 50 microgram patches
• SSP080 Estradot^® 75 microgram patches
• SSP081 Estradot^® 100 microgram patches

Reimbursement

Reimbursement is for the medicine supplied in accordance with the SSP and not the originally prescribed medicine i.e. in this instance pharmacy owners will be reimbursed the reimbursement price for Evorel^® patches or Estraderm^® MX 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 pharmacy owner and products supplied in accordance with an SSP is to be considered VAT zero-rated:

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

Support in implementing the SSP

Community Pharmacy England’s in-house Drug Tariff and funding experts have created a new video providing guidance on how to correctly endorse and claim for any supplies made against a Serious Shortage Protocol (SSP). This is part of Community Pharmacy England’s ‘Funding & Reimbursement Shorts’ series, which has been created to provide pharmacy owners and their teams with more information on common funding and reimbursement topics.

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

Serious Shortage Protocols (SSPs) Endorsing Factsheet

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