Serious Shortage Protocols (SSPs)

Published on: 3rd October 2019 | Updated on: 29th June 2022

SSPs are a potential way to help pharmacies to manage any serious shortages of medicines that may occur, without needing to refer patients back to prescribers. It is important to note that although legislation permits the issuing of SSPs from 1st July 2019, an SSP will only be considered and issued if there is a serious shortage of a specific medicine.

If, in the Secretary of State for Health and Social Care’s opinion, there is, or may be, a serious shortage of a medicine or appliance then he or she may consult, for instance with medical experts, and decide to issue an SSP. The SSP will specify an alternative product or quantity that may be supplied (an alternative strength or formulation, or generic or therapeutic alternative or less of the product) by community pharmacies. Community pharmacy contractors must consider the SSP and, if, in the supervising pharmacist’s opinion – exercising his or her professional skill and judgment – the alternative product or quantity is reasonable and appropriate for the patient, they may supply the alternative product or quantity (only as specified in the SSP and subject to any conditions in the SSP), provided that the patient consents/agrees to the alternative SSP supply.

Active SSPs

SSP Expiry Date Supporting Information
SSP005: Fluoxetine 10mg tablets
12 August 2022 SSP005 guide
SSP019 Oestrogel® Pump-Pack 0.06% gel – restriction 29 July 2022 SSP019 guide
SSP020 Ovestin® 1mg cream – restriction 29 July 2022 SSP020 guide
SSP021 Premique® low dose 0.3mg/1.5mg modified-release tablets – restriction 29 July 2022 SSP021 guide
SSP022 Oestrogel® Pump-Pack 0.06% gel (750microgram per actuation) – substitution 19 August 2022 SSP022 guide
SSP023 Oestrogel® Pump-Pack 0.06% gel (750microgram per actuation) – substitution and restriction 19 August 2022 SSP023 guide
SSP024 Ovestin® 1mg cream – substitution 19 August 2022 SSP024 guide
SSP025 Ovestin® 1mg cream – substitution and restriction 19 August 2022 SSP025 guide
SSP026 Lenzetto® 1.53mg/dose transdermal spray –  restriction 19 August 2022 SSP026 guide
SSP027 Lenzetto® 1.53mg/dose transdermal spray –  substitution 19 August 2022 SSP027 guide
SSP028 Lenzetto® 1.53mg/dose transdermal spray – substitution and restriction 19 August 2022 SSP028 guide
SSP029 Sandrena®  0.5mg and 1mg gel sachets – restriction 19 August 2022 SSP029 guide
SSP030 Sandrena®  0.5mg and 1mg gel sachets –  substitution 19 August 2022 SSP030 guide
SSP031 Sandrena® 0.5mg and 1mg gel sachets –  substitution and restriction 19 August 2022 SSP031 guide
SSP032 Lipitor® 10mg chewable tablets 12 August 2022 SSP032 guide
SSP033 Paracetamol 120mg suppositories 26 August 2022 SSP033 guide

Details will be updated above as and when changes occur, but the most up-to-date information is available from the NHS Business Services Authority (NHSBSA) website.

Endorsement guidance

To ensure correct payments (fees and reimbursement) are made for any supplies made against an SSP, community pharmacy contractors are required to endorse the paper prescription, or the electronic prescription (where the prescription is issued using the Electronic Prescription Service (EPS)) with the following information:

  • SSP [followed by the three-digit reference number applicable to the SSP] – to indicate that the supply was made in accordance with an SSP;
  • Details of product supplied in accordance with the SSP (drug name, quantity, strength, formulation, supplier name or brand)*;
  • Quantity supplied*;
  • Pack size – best practice where multiple pack sizes are available; and
  • Invoice price – only if NHSBSA has no list-price available on dm+d.

*The drug details and quantity supplied and endorsed will depend on the relevant SSP.

In most cases, SSP endorsements for specific SSPs are shorter.

In addition, to support pharmacy teams, PSNC has also put together some helpful reminders and top tips on the correct SSP endorsement and submission requirements.

Top tips:

  • Always double check that endorsements reflect the requirements outlined in the supporting guidance published for each SSP on the dedicated page of the NHSBSA’s website.
  • Check whether your PMR system enables complete and correct SSP endorsements (please contact your system supplier if you are unsure of how to apply endorsements correctly). If you have suggestions about how system usability and functionality could be improved, feed these back to your PMR supplier.
  • When endorsing using EPS, select the SSP endorsement on your system and input the correct three-digit reference number for example, SSP 019. Remember to insert the leading zero in the three-digit reference number.
  • In addition, endorse the SSP product dispensed including the quantity.
  • Ensure your endorsements are accurate and clear – NHSBSA processing staff must be able to determine what has been supplied.
  • SSP claims submitted using EPS tokens are no longer permitted.
  • 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 a SSP for a reduced quantity.
  • If a patient normally pays for their prescriptions, the paid status should be selected even though no charge is taken for the three months’ worth of HRT medicine supplied in accordance with the SSP.  Once submitted for payment, the NHSBSA will recognise the SSP endorsement and process the prescription as a no-charge item i.e. no prescription charges will be deducted by the NHSBSA.
  • NHSBSA will continue to apply charge deductions for any other chargeable items dispensed on the same prescription form with mixed items.
  • If patient is exempt from prescription charges, the correct exemption reason should be selected.
  • If any claims for SSPs have been endorsed incorrectly and before a claim is submitted for payment, where PMR systems allow, contractors may be able to retrieve any submitted EPS dispense notification messages by using the claim amend functionality.
  • SSPs cannot be supplied past the period of SSP validity. Any other items on the prescription (such as an owing) can continue to be dispensed as usual but must be submitted for payment within three months of expiry of the SSP.
When supplying in accordance with these SSPs, contractors should refer to the updated endorsement guidance for each SSP available on NHSBSA’s SSP page.

PSNC’s support guidance to endorsing SSPs, click here.

NHSBSA’s support guidance to endorsing SSPs, click here.

Submission guidance

To ensure correct reimbursement, pharmacy teams should ensure that all Electronic Reimbursement Endorsement Messages (EREMs) or EPS claim notification messages and/or paper FP10 forms with SSP claims are submitted to NHSBSA in a timely manner.

If SSP claims are submitted electronically, the Dispense Notification (DN) message should be submitted during the period of SSP validity. Pharmacy teams should take into account the EPS 5 day window and EPS submission timing when sending the EREMs i.e. submit claim message no later than the 5th of the month following supply. Any paper prescriptions with SSP claims must be placed in a red separator and dispatched to the relevant division of the NHSBSA by the 5th of the month following that in which supply was made.

If submitting your claim using the EPS dispensing tokens, you must ensure your electronic reimbursement message is marked ‘ND’ or ‘Not Dispensed’

Submission of prescriptions containing both SSP(s) and non-SSP(s)

Contractors have to submit claims for SSPs in the usual manner, i.e. by the 5th of the month following that in which supply was made . However, any prescriptions with mixed (SSP and non-SSP items) may be claimed up to three months after the SSP expires to help deal with claims for any owings on the prescription. Using the example of SSP 009 which expired 17 May 2021, the final cut-off for submission to be reimbursed for this SSP would be with your July bundle (submitted by the 5th of August).

Please note that SSPs cannot be supplied past the period of SSP validity. Any other items on the prescription (such as an owing) can continue to be dispensed as usual but must be submitted for payment within three months of expiry of the SSP.

Declaration of monthly SSP claims using the FP34C form on MYS

  • There is a separate declaration of monthly SSP claims on the digital FP34C submission form via the Manage Your Service (MYS) portal.
  • Here, contractors should endorse the number of SSP claims made each month and not the number of items supplied in accordance with the SSPs.
  • The number of items supplied in accordance with SSPs are to be declared along with the usual item totals.
  • Please note that the NHSBSA will not be using the SSP declaration made on the FP34Cs for reimbursement purposes. Instead the SSP declaration is to provide the NHSBSA with an indication that SSP claim(s) are expected in that month.
  • The SSP declaration is to support contractors when reconciling the number of SSP fees on their payment schedules against the number of SSP claims declared on the FP34C.
All paper FP10 forms should be placed in the front of the red separator for the end-of-month submission bundle

Further Information
Archive of revoked/expired SSPs

For more information on this topic please email dst@psnc.org.uk

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