Our advice to help NHS procurement teams understand when mutual aid is appropriate and how to request this.

Mutual aid

Mutual aid is a form of voluntary cooperation where people support each other to meet shared needs.

NHS hospital pharmacy

NHS hospitals can transfer medicines between each other when standard supply routes can’t deliver quickly enough. Examples include national shortages, sudden increases in demand, or urgent patient needs for medicines not usually stocked.

You should only use mutual aid in exceptional circumstances. It is not a replacement for the normal supply chain. The main aim is to provide timely access to medicines for specific patients. Only request mutual aid after all other supply options have been tried. Sometimes, you may need to arrange mutual aid outside normal working hours, often through on-call staff.

Refer to our advice on navigating a supply issue if you are managing a shortage. 

MHRA and mutual aid

The MHRA accepts that hospital pharmacies may need to obtain small quantities of medicine from other pharmacies to meet a specific patient’s needs. MHRA considers the activity of mutual aid to fall within the definition of the provision of healthcare services.

In such circumstances, provided the transaction meets all the following criteria, MHRA will not deem such transactions as commercial dealing. Hospital pharmacies will not be required to hold a Wholesale Dealer’s Licence (WDA(H)) if:

  • the transaction takes place on an occasional basis
  • the quantity supplied is small
  • the supply is made on a not-for-profit basis
  • the supply is not for onward wholesale distribution

This underlines the principle that mutual aid is an exceptional activity rather than a routine one. Only make requests after all usual supply routes have been explored.

SPS procurement and mutual aid

During normal working hours, requests for mutual aid should be made by hospital pharmacy procurement teams via the regional SPS procurement teams. They will be able to triage requests to determine if mutual aid is a suitable option and will have visibility of trust stock holding data via Exend.

Where required, the SPS regional procurement teams will help identify hospital pharmacies within the region that may be able to help. The requesting site will be directed towards the most suitable options. They must then liaise with the relevant hospital pharmacies themselves to arrange transfer of stock.

Should mutual aid between regions be required normally only in highly exceptional circumstances, such as, requirement for highly specialised medicines used in a limited number of centres nationally. The SPS regional procurement team will liaise with SPS regional colleagues in other regions to identify possible options, and then facilitate the connections between the two hospital pharmacies.

Out of hours

SPS procurement teams are not available out of normal working hours. There may also be or in other circumstances where the team cannot be contacted in a timely manner. Hospital pharmacies may have to link directly with other hospital pharmacies in the region to facilitate mutual aid requests.

For this reason, it is important for hospital pharmacy teams to understand the best practice principles to follow for mutual aid requests.

Information needed for mutual aid requests

Providing clear information upfront helps speed up the process.

You should include:

  • medicine name, brand (if relevant), form, and strength
  • any acceptable alternatives, such as a different strength or form
  • quantity needed, either in packs or estimated use over a set period
  • when you need the supply, with a specific date (avoid vague terms like “ASAP”)
  • whether you need the full amount at once
  • whether the supply is for immediate use or to cover a future shortage
  • reason for the request, such as a known supply issue, potential shortage, or lead time problem
  • any supporting information from suppliers or wholesalers about availability
  • actions you’ve already taken, such as contacting other hospital pharmacies and their responses

Actions after mutual aid agreement

Once a mutual aid supply is agreed, you should:

  • contact the supplying hospital pharmacy to arrange collection and transport
  • consider any product-specific transport needs, such as cold chain requirements or bulky items
  • provide a purchase order if the supplying hospital pharmacy requires one
  • review any learning points to help reduce future mutual aid requests, such as improving inventory management or stock holding

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