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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


Supply Shortage of GLP-1 RA Injections

A NPSA alert has been issued (click here to view) advising that there are very limited, intermittent supplies of all GLP-1 RAs. Supply is not expected to return to normal until at least the end of 2024. 


Please refer to the BNSSG Quick Reference Guide for Selecting Glucose Therapy during GLP1 RA Supply Shortage on the endocrine guidelines page for information about management of patients with Type 2 Diabetes who may be affected by this supply issue. Note actions in the NPSA alert are to be completed as soon as possible. A Clinician Guide and Patient information leaflets about stopping GLP1s and the stock shortage are also available on the endocrine guidelines page


Supply disruptions of medicines used in the treatment of attention deficit hyperactivity disorder (ADHD)

Please see Avon and Wiltshire Mental Health Partnership Guidance and BNSSG Patient Information Leaflet about methylphenidate


National Shortage of Bumetanide 1mg and 5mg tablets

A Medicine Supply Notification (MSN) for: Bumetanide 1mg and 5mg tablets has been issued by Medicines and Healthcare products Regulatory Agency (MHRA) advising Bumetanide 5mg tablets are out of stock until early March 2024. Bumetanide 1mg tablets will be out of stock until January 2024.
Please refer to the MSN and SPS website for further information on the supply issue. Please also refer to BNSSG ICS guidance – National Shortage of Bumetanide 1mg and 5mg tablets - which has been developed to support clinicians with bumetanide switches and can be found on here


Shortage of salbutamol 2.5mg/2.5ml and 5mg/2.5ml nebuliser liquid unit dose vials

Please see Adult and Paediatric Primary and Community Care Guidance for Shortage of Salbutamol Nebuliser Liquid Units