This page contains Frequently Asked Questions (FAQs) on Serious Shortage Protocols (SSPs) last updated on 16 July 2019.

This page will continue to be updated as details are confirmed with NHS England and Department of Health and Social Care (DHSC).

Q. When may supply in accordance with an SSP be refused?

A. Contractors may refuse to supply an alternative product or quantity in accordance with the SSP, if the supervising pharmacist considers that supply of the different or alternative product or quantity is unreasonable or inappropriate. Contractors must refuse to supply an alternative product or quantity in accordance with the SSP, if such a supply has already been made in accordance with the presented prescription.

Q. Do patients have to consent/agree to SSP supplies?

A.Yes, patient consent/agreement is required for supply of an alternative product or quantity in accordance with an SSP.

Q. Do patients pay prescription charges for SSP supplies?

A. Generally, prescription charges are payable for the supply of alternative products in accordance with SSPs, if they were payable for supply under the original prescription. The exception to this is that no prescription charge is payable if the patient is supplied with a smaller quantity of drug or fewer appliances than originally prescribed. This exception was proposed by PSNC and accepted by DHSC Ministers in order that patients that pay the prescription charge are not disadvantaged by the use of an SSP.

Q. Do the other provisions of the terms of service apply to SSP supplies?

A. Yes. SSPs are now part of the Essential Dispensing Service, part of Schedule 4 of the NHS Pharmaceutical Regulations and, broadly, the terms of service apply; including, for example, that contractors must provide appropriate advice as required and maintain appropriate records.

Specific amendments in the NHS (Amendments Relating to Serious Shortage Protocols) Regulations 2019, to ensure the terms of service are relevant to SSPs, include:

  • Measuring and fitting for appliances (Reg. 8 (4))
  • Relevant standards and formula (Reg. 8 (5))
  • Original pack dispensing (Reg. 8 (10))
  • Suitable containers (Reg. 8 (15))
  • Alternative to referral for an appliance (Reg. 10 (2)(b)

Q. What about reimbursement, remuneration and endorsements for SSP supplies?

A. Reimbursement – is for the medicine supplied in accordance with an SSP, not the originally prescribed medicine or appliance.

Remuneration – the same fees and allowances are paid for SSP supplies as are paid for medicines and appliances supplied against prescriptions. An additional fee payable to contractors for dispensing SSPs is still under discussion between PSNC and DHSC.

Endorsement, Submission and Payment FAQs

Q. What endorsements are required to indicate supply against an SSP?

A. Pharmacy teams will endorse the prescription with ‘NCSO’ (No Cheaper Stock Obtainable) to indicate that a supply was made in accordance with an SSP. They will need to endorse the supplied quantity, the pack size from which the order was supplied and, where required, the brand name or name of the manufacturer or suppliers from which the supply was purchased; as well as an invoice price if there is no list-price available on dm+d.

The use of the NCSO endorsement was selected by DHSC because it has not been used for its original purpose since April 2013 (the price concession system applies a new temporary drug reimbursement price for a month, if granted by DHSC).

The use of the NCSO endorsement will indicate to the NHSBSA that an SSP was used, i.e. that the originally prescribed product was not dispensed by the pharmacy and a different quantity or product was supplied in accordance with an SSP.

Q. Does an SSP number need to be endorsed?

A. No. The SSP number is not required. Endorsing the SSP number is not required as it will be apparent from the prescribed drug. Additionally there are limited character spaces in the free-text endorsement fields so keeping endorsements minimal is ideal. The aim is to keep endorsements as simple as possible.

Q. What is the correct process for endorsement?

A. To ensure correct payments (fees and reimbursement) for products supplied under an SSP, a contractor is required to endorse either the original electronic prescription or its associated dispensing token, or where issued, the paper prescription, with the following information:

  • NCSO – 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 specific SSP.

Further details on SSP endorsements may be made available once the relevant Drug Tariff provisions have been published.

Q. How can I ensure that the prescriptions and tokens I have endorsed with the SSP details will be seen by an exception handler at NHSBSA?

A. All prescriptions and tokens which have the SSP endorsement on them should be placed in the red-separator. To ensure these prescription or tokens are seen by the correct team, they should ideally be placed at the beginning of the red-separator.

Q. Can I use ‘PC’ or ‘PNC’ endorsement instead?

A. No. The ‘PC’ (Prescriber Contacted) or ‘PNC’ (Prescribed Not Contacted) endorsement cannot be used as a substitute endorsement for supply in accordance with SSPs. ‘PC’ endorsement is used when there is a missing dose, drug strength and/or quantity and the prescriber is contacted to confirm the missing details; ‘PNC’ endorsement is used when a prescription is presented with a missing presentation, strength or quantity and the prescriber cannot be contacted.

Q. How will payments for SSPs claimed appear on my Schedule of Payments? 

A. The Schedule of Payment will include two single lines – one for total VAT and other for fees (if applicable).

Q. I have made an error on my SSP endorsement and it is missing information. Will this be referred back?

A. – Yes, if any drug details are missing, then the SSP prescription will be referred back (either by paper or for users using MYS). However, the NHSBSA will make best endeavours to pay by confirming any missing details over a phone call.


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