Serious Shortage Protocols: A Quick Guide for Pharmacy Teams

When a medicine is in serious short supply, the government can issue a Serious Shortage Protocol, or SSP. It allows community pharmacists in the UK to supply an alternative to the prescribed item, in line with the protocol, without going back to the prescriber.

How SSPs work

Each SSP is specific to a product and sets out exactly what can be supplied instead, such as a different strength, formulation or quantity. Protocols are time-limited, and they are extended, amended or withdrawn as supply changes.

Recent examples

Two SSPs have become the longest-running for individual medicines in NHS history: one covering Creon, a pancreatic enzyme replacement used in cystic fibrosis and pancreatic cancer, in place since May 2024, and one covering the Estradot HRT patch, in place since December 2024.

Good practice for pharmacy teams

• Check the current list of active SSPs at least weekly.

• Read each protocol carefully: some allow only specific substitutions.

• Use professional judgement, since an SSP permits a switch but does not require one.

• Tell the patient what has changed and why, and record it.

SSPs are a safety valve, not a solution

An SSP helps when a product is short, but it does not create new stock. The best protection is still access to more than one source of supply. Acorn Pharmaceuticals can help pharmacies locate stock of lines that are hard to find through their usual wholesaler.