HRT patches have serious shortage protocol extended

The Department of Health and Social Care (DHSC) has extended four serious shortage protocols (SSPs) for Estradot patches until 10 July 2026.

The SSPs – SSP079, SSP080, SSP081 and SSP082, covering hormone replacement therapy (HRT) Estradot 50 micrograms/24hours, 75 micrograms/24hours, 100 micrograms/24hours and 25 micrograms/24hours patches respectively – had been due to expire on 17 April 2026.

Under the protocols, pharmacists may supply either Evorel or Estraderm MX patches of the corresponding strength as permitted alternatives.

Guidance states that pharmacy teams must supply the full quantity prescribed and use their professional judgement to assess suitability of the alternative product.

If substitution is not appropriate, patients should be referred back to their prescriber. In addition, prescribers must be notified when a supply is made under an SSP.

Reimbursement is based on the alternative product supplied, not the originally prescribed item. Each SSP claim attracts a single activity fee (currently £1.27) and an SSP fee of £5.35, and products supplied under an SSP are zero-rated for VAT.

Community Pharmacy England has warned that a high number of EPS SSP claims continue to be rejected by NHS Business Services Authority due to incorrect endorsements.

Pharmacy owners have been advised to reconcile SSP payments against their FP34C declarations and refer to updated guidance where discrepancies arise.