Background:
The DHSC is responsible for the continuity of supply of medicines and manufacturers have a legal requirement to inform DHSC of any supply problems.
DHSC and NHSE/I have now launched an online Medicines Supply Tool, which provides up to date information about medicine supply issues. The contents of this report can now be viewed on the Tool. To access the Tool, you will be required to register with the SPS website. Please be aware that emails from SPS may be diverted to your junk mail folder.
Further information may be issued by a Medicine Supply Notification (MSN) to providers.
We are also aware that prescribers may also be asked for an alternative by pharmacies if there is a local supply issue. This will need to be considered on a case-by-case basis.
Serious Shortage Protocols (SSPs) have also recently been introduced to enable community pharmacies to dispense agreed alternatives without requesting a prescription amendment.
How to access information:
SPS Medicines Supply Tool : Requires simple free registration process and log in to access – Medicines Supply Tool – SPS – Specialist Pharmacy Service – The first stop for professional medicines advice
Mims Shortage Tracker : requires registration and is only available to subscribers – not free Drug shortages – live tracker | MIMS online
PrescQIPP : Out of stock bulletins and intelligence – Requires simple free registration process and log in to access – Out of stock bulletins and intelligence | PrescQIPP C.I.C
Current SSPs: https://psnc.org.uk/dispensing-supply/supply-chain/live-ssps/
BSW ICB Medicines Shortages - Local tips
Medication Unavailable - alternative request form for Community Pharmacy use
Prescribing available medicines to treat ADHD during national shortages
Oct 2023 - National information, including links to the relevant National Patient Safety Alert and lists of availability of ADHD medicines (content maintained by DHSC) is hosted by SPS Medicine Supply Tool https://www.sps.nhs.uk/articles/prescribing-available-medicines-to-treat-adhd/ [note SPS website requires users to register and log in].
Additionally, SPS have published a series of national resources to support the ongoing management of supply disruption of medicines used to treat ADHD:-
- Continuing management of the ADHD medicines shortage
- Supporting system response to the ADHD medicine shortage
- Considerations when prescribing guanfacine
- Considerations when prescribing modified-release methylphenidate
- Prescribing available medicines to treat ADHD
Medicines Information Bulletin from AWP - Managing ADHD Medicines Shortages in ADULTS: Advice for Primary Care (October - December 2023)
BSW ICB commission a CAMHS service from Oxford for ADHD in children and young people. They have produced these Patient Information Leaflets to be shared with patients:
Lis-dexamfetamine (Elvanse and Elvanse Adult)
Methylphenidate (Equasym XL, Xaggitin XL, Concerta XL, Xenidate XL)
This information from a bordering CAMHS service might be useful:
AWP Sirona and CAMHs information for children and young people - Managing ADHD Medicine Shortages in CAMHS: Advice for Primary Care (October – December 2023)
Community paediatric teams contact information:
| HCRG Contacts | ||
| Wiltshire SPA | ||
| Telephone | 03002470090 | |
| vcl.wiltshirespa@nhs.net | ||
| BANES SPA | ||
| Telephone | 03002470055 | |
| hcrg.bathnesspa@nhs.net | ||
| Swindon area | ||
| Contact via Cinapsis advice and guidance email for Community Paediatrics | ||
| CAMHS Services – Oxfordshire 9am – 5pm Monday to Friday | ||
| Oxfordshire Neurodevelopmental Conditions Pathway | NDC.OxonCAMHS@oxfordhealth.nhs.uk | |
| Getting More Help South | OxonCAMHSGMHSouth@oxfordhealth.nhs.uk | |
ClinOx ADHD Medication Shortages - including guidance from Buckinghamshire, Oxfordshire and Berkshire West (BOB)
Prescribing available GLP-1 receptor agonists during national shortages:
July 2023 - National shortage of GLP1 Receptor Agonists
DHSC have recently issued a Tier 3 (high impact) Medicine Supply Notification for GLP-1 receptor agonists used in the management of type 2 diabetes.
The ICB is currently working on a plan to provide further support to patients and local healthcare providers in due course. In the meantime, we feel it is important that we are providing consistent information to patients about this issue.
We have created some local resources that we hope will help support practices who we know are already dealing with a growing number of queries related to this issue.
Community pharmacy colleagues have been advised:
- Not to suggest alternative GLP1 RAs or different dose even if they do have stock as per MSN directive.
- Not to suggest that patients routinely contact surgeries, DSNs or Prescription Ordering Direct (POD) service for a clinical review unless the patient is feeling unwell as a result of stopping GLP1 RA.
Surgeries have been advised:
- That GLP-1 RAs should only be prescribed for their licensed indication and to avoid initiating people with T2D on GLP-1 Ras for the duration of the national shortage.
- To avoid switching between brands of GLP-1 Ras and avoid substituting higher dose preparations by ‘doubling up’.
- To order stocks sensibly in line with demand during this time, limiting prescribing to minimise risk to the supply chain whilst acknowledging the needs of the patient.
- To encourage patients to engage with structured education and weight management programmes where available (details of locality arrangements to follow).
- To undertake a review process (searches and template PILS have been sent to practices and are included as links below).
Patients will be triaged with higher risk patients being proactively invited for review.
Prescribing Incentive Scheme FY 23/24 - Review of GLP-1s as response to national shortage – Supporting information
GLP-1-stock-shortage-patient-information-leaflet-without-cover-letter
GLP-1-stock-shortage-patient-information-leaflet-with-cover-letter
Diabetes UK have a FAQ factsheet for people affected by the shortages: Diabetes UK - FAQS - GLP-1 RA Shortages
Please continue to check Stock Shortages - Medicines (bswtogether.org.uk) for local updates as well as utilising the national information hosted by SPS Medicine Supply Tool Shortage of GLP-1 receptor agonists used in the management of type 2 diabetes (semaglutide, dulaglutide, liraglutide, exenatide) – SPS - Specialist Pharmacy Service – The first stop for professional medicines advice [note SPS website requires users to register and log in)
Further Comments:
OptimiseRx also create messages if there are known supply issues with the prescribed medication at the point of prescribing to alert the prescriber to consider an alternative.
Contact bswicb.prescribing@nhs.net for support with specific shortages or feedback.