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REMEDY : BNSSG referral pathways & Joint Formulary

BNSSG Adult Joint Formulary

Management of Stock Shortages

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Management of stock shortages

Stock shortages will occur periodically due to outside factors and can cause anxiety and may impact on patient care.

Please note the guidance ‘A guide to managing medicines supply and shortages1’ from the Department of Health and Social Care with NHS England and NHS Improvement for both primary and secondary care. This document outlines the national, regional and local management and communication routes for medicines supply issues to ensure continuity of supply and ensure that patients receive the treatment and medication required. These are followed in BNSSG.

In summary, when a medicine is unavailable:

  • Where possible an alternate drug from the formulary should be used.

  • Where there is no alternate drug on the formulary a non-formulary option may be considered in discussion between primary and secondary care.

  • Once the stock shortage has resolved the formulary drug should be reinstated.

 The Specialist Pharmacy Service has developed a new Medicines Supply Tool, which can be accessed via the website here. Please note a log in is required to access this tool.

A Serious Shortage Protocol (SSP) may be issued if the Department of Health and Social Care (DHSC) decide there is a serious shortage of a specific medicine or appliance. SSP updates are available via the NHS Business Services Authority website here.



  1. Document Title: A Guide to Managing Medicines Supply and Shortages. Publishing approval number: 000920. November 2019



October 2022 Supply Shortage of Dulaglutide and Semaglutide Injections

Please see 'Advice to support clinicians in the management of patients affected by the supply shortage of Dulaglutide (Trulicity®and Semaglutide (Ozempic®) injections. ' 

See 6.3.1 GLP-1's formulary page for further information 

Recent updates regarding the supply of Dulaglutide and Semaglutide (January 2023):

Dulagutide now has an anticipated re-supply date of July.2023.
Semaglutide (all strengths) now has had the re-supply date pushed back to 31.01.2024.