SSPs extended for Estradot® 50mcg and 100mcg patches

Update 16/02/23 – The Department of Health and Social Care (DHSC) has provided an update on the Serious Shortage Protocols (SSPs) for Estradot® 50mcg patches (SSP048) and Estradot® 100mcg patches (SSP049).

  • SSP048 for Estradot® 50mcg patches was due to expire 17 February 2023 but has been further extended to Friday 24 February 2023.
  • SSP049 for Estradot® 100mcg patches was due to expire 17 February 2023 but has been further extended to Friday 17 March 2023.

In response to a significant ongoing disruption to the supply of Estradot® 50mcg and 100mcg patches, two new Serious Shortage Protocols (SSPs) have been issued by the Department of Health and Social Care (DHSC).

Effective 25 January 2023SSP049 and SSP049 provides for the following:

  • SSP048 – for every Estradot® 50mcg  patch originally prescribed, one Evorel® 50mcg patch must be supplied.
  • SSP049for every Estradot® 100mcg  patch originally prescribed, one Evorel® 100mcg patch must be supplied.

Both SSPs are currently set to expire on 17 February 2023.

The SSPs may be amended or revoked at any time – PSNC will update contractors on any changes.

SSP048 for Estradot® 50mcg patches

For prescriptions (NHS or private) requesting: Supply permitted under SSP048:
Estradot® 50mcg patches Evorel® 50mcg patches

SSP049 for Estradot® 100mcg patches

For prescriptions (NHS or private) requesting: Supply permitted under SSP049:
Estradot® 100mcg patches Evorel® 100mcg patches

Both SSPs, authorised by the Secretary of State, have 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.

Key points relating to SSP048 and SSP049

  • These protocols do 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 other strengths of Estradot® patches – these strengths are not affected by supply disruptions and should continue to be dispensed in accordance with the prescriptions
  • SSP048 and SSP049 only allow substitution of Estradot®50 or 100 patches with Evorel®50 or 100 patches, respectively.
  • The SSPs DO NOT allow pharmacists to double up strengths for example, pharmacists cannot supply 2 x Estradot®25 patches against a prescription ordering 1 x Estradot®50 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 these SSPs
  • 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 SSP048 and SSP049 respectively.

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 these SSPs and pharmacy teams are advised to read the documentation for SSP048 and SSP049 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 SSP048: Estradot® 50mcg patches and SSP049: Estradot® 100mcg 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 reimbursement price for either Evorel® 50mcg patches or 100mcg 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

Support the call for more funding by recording information about the informal advice you provide to patients over just one day.

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