The Department of Health and Social Care (DHSC) has issued a further five new Serious Shortage Protocols (SSPs) for Phenoxymethylpenicillin (Pen V) to enable the continued supply of antibiotics to patients.
“The new SSPs, introduced with immediate effect, allow community pharmacists to consider different oral antibiotic preparations, to enable the continued supply of antibiotics to patients and mitigate the ongoing supply disruptions affecting Phenoxymethylpenicillin,” said DHSC.
On Friday (16 December) SSP043-SSP047 has been authorised by the Secretary of State to provide pharmacists with procedures to follow in providing suitable alternative oral antibiotics to substitute Phenoxymethylpenicillin.
“For each SSP, DHSC has included specific patient counselling points which must be taken into account when deciding whether supply in accordance with an SSP is suitable for a patient.”
It has also urged the pharmacists to consider if a suitable supply can be made by using an alternative formulation of Phenoxymethylpenicillin following relevant SSP, before supplying an alternative antibiotic. DHSC added: “Where that is not possible only specified antibiotics can be substituted for prescriptions for a duration of no longer than 10 days, in order of preference depending on availability and the dosing needs for the patient.”
All current oral antibiotic SSPs
| SSP | SSP endorsement guidance | SSP Expiry |
| SSP040 Phenoxymethylpenicillin 125mg/5ml oral solution sugar free (issued 15/12/2022) | SSP040 guide | 31 January 2023 |
| SSP041 Phenoxymethylpenicillin 250mg/5ml oral solution sugar free (issued 15/12/2022) | SSP041 guide | 31 January 2023 |
| SSP042 Phenoxymethylpenicillin 250mg/5ml oral solution (issued 15/12/2022) | SSP042 guide | 31 January 2023 |
| SSP043 Phenoxymethylpenicillin 125mg/5ml oral solution (issued 16/12/2022) | SSP043 guide | 31 January 2023 |
| SSP044 Phenoxymethylpenicillin 125mg/5ml oral solution sugar free (issued 16/12/2022) | SSP044 guide | 31 January 2023 |
| SSP045 Phenoxymethylpenicillin 250mg/5ml oral solution (issued 16/12/2022) | SSP045 guide | 31 January 2023 |
| SSP046 Phenoxymethylpenicillin 250mg/5ml oral solution sugar free (issued 16/12/2022) | SSP046 guide | 31 January 2023 |
| SSP047 Phenoxymethylpenicillin 250mg tablets (issued 16/12/2022) | SSP047 guide | 31 January 2023 |
In response to the issuing of SSPs, Gordon Hockey, PSNC’s Director, Legal, said yesterday:
“We asked DHSC to introduce Serious Shortage Protocols (SSPs) to help mitigate the ongoing supply disruption affecting the availability of phenoxymethylpenicillin (Pen V) and are pleased to see that some have now been introduced. However, PSNC was not involved in the development of these protocols and our team is urgently clarifying some points to provide contractors with additional guidance and to seek assurances around the reimbursement of any alternatives supplied. We will issue our additional guidance as soon as possible.
More widely, PSNC has also been pressing DHSC to think broadly about what other measures could help to manage the current situation and consider the introduction of greater flexibilities, such as allowing pharmacists more professional discretion to amend prescriptions separate to SSPs.”
Sukhi Basra