Update on bone cement supply – 27th March

Dear Colleagues,

NHS Supply Chain remains in close contact with Heraeus Medical, who confirmed yesterday that they are in the first stages of the validation of processes involved in the production of Palacos™ bone cement. Pending the success of this process, manufacturing is intended to resume for a small initial batch, which is planned to be available in early June with an increase, but not normal supply, anticipated from the end of June/early July at the earliest.

This will not meet current demand, however NHS Supply Chain has secured additional units of High fatigue G™ and Refobacin™. The production and availability of Simplex™ is also greater than expected. Whilst an increased supply of Vancogenx™ is also expected from the middle of April, NHS Supply Chain are waiting on confirmation from Summit Medical about increased volumes and delivery dates into the UK. NHS supply Chain plans to ensure that these alternatives are available for as long as necessary.

We recognise that these products have individual handling characteristics and some adjustment in mixing technique and working practice may therefore be required.

It is also important to re-emphasise that:

• No surgeon is required or compelled to use this cement.
• Surgeons should only use the product in clinical situations in which they feel appropriately trained, familiar and confident.
• Some surgeons may feel unable to proceed with certain cemented procedures using alternative products. Where this is the case, departments may wish to consider supportive local arrangements, such as reallocating surgeons to outpatient activity or to procedures that do not require cement, in order to maintain service continuity and make best use of available expertise.

From a patient communication perspective, colleagues may wish to continue to reassure patients that:

• Orthopaedic bone cements are fundamentally composed of the same core material (PMMA) and function in the same way to secure implants.
• The mechanical properties are equivalent in commonly used products.
• All implants continue to be monitored through established surveillance mechanisms, including the National Joint Registry.
• Patients retain the right to defer surgery if they wish. However, based on available evidence, we do not consider deferral necessary solely on the grounds of cement substitution alone. The ICN page is scheduled for an updated by Monday for the formal position: Supply Issues Heraeus Medical Bone Cement Products » NHS Supply Chain

Although this arrangement is being coordinated through NHS England, the alternative cement supply will also be available to the devolved nations.

We are grateful for your continued cooperation and professionalism, and further updates will follow as additional operational detail becomes available.

Yours faithfully

Fergal Monsell, BOA President

On behalf of:

Tim Board President BHS
Alasdair Santini President BASK
Xavier Griffin President OTS
Hiro Tanaka President BOFAS
Mark Falworth President BESS
Amir Qureshi President BLRS