NHS England updates trusts on the Heraeus Medical bone cement disruption, outlining prioritisation, alternatives and communication steps to protect urgent care
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The NHS has issued a national advisory after a production problem affected Heraeus Medical bone cement products. A packaging fault at the supplier’s primary production site paused output. Production has since restarted, but availability will remain constrained.
The advisory, published by NHS England on 18 February 2026, warns that stocks currently moving through the UK supply chain may meet roughly two weeks of normal demand.
NHS England projects a supply shortfall of six to eight weeks thereafter.
The notice targets operational, clinical and procurement leaders across trusts, integrated care boards and independent sector providers. It outlines immediate patient-safety measures, guidance on sourcing alternative products, and actions to manage theatre capacity and patient communications while access to some cement products is limited.
Scope and immediate supply position
The advisory covers all regions of England and applies to elective and urgent orthopaedic cases that routinely rely on the affected bone cement range. It identifies specific product lines in current stock notices and advises local teams to review inventory immediately.
NHS England recommends trusts and providers confirm current stock levels, prioritise cases by clinical urgency, and consider sourcing alternative cement brands where clinically appropriate. The advisory also urges procurement teams to liaise with existing suppliers and regional stock coordinators to identify near-term supplies.
The supplier has restarted production, but replenishment will be gradual. Existing stocks held within trust cold chains remain usable. No formal recall has been issued. Because bone cement requires a controlled cold chain to maintain stability, routine redistribution via NHS Supply Chain is restricted. NHS Supply Chain is not commissioned to provide cold chain logistics for these products.
Practical implications for elective and urgent care
Trusts should continue to use on-site stock that has remained within approved cold-chain conditions. Clinical teams must verify cold-chain records before use. Where temperature deviations are recorded, local pharmacy and infection-control teams should assess product integrity and advise clinicians.
Procurement leads and regional stock coordinators should prioritise allocations for urgent and trauma cases. Elective procedures that rely exclusively on the affected cement should be reviewed and, where clinically appropriate, rescheduled or performed using verified alternative materials.
Surgical teams should document any substitutions in the patient record and notify their governance or safety office. Hospitals should escalate supply shortfalls through existing regional channels rather than attempting unapproved external redistribution.
Trusts advised to maintain clear local guidance on screening, handling, and documenting affected products. Regular updates will follow from national supply and clinical governance bodies as replenishment progresses.
Regular updates will follow from national supply and clinical governance bodies as replenishment progresses. Trusts are asked to concentrate remaining supplies of bone cement on procedures with the highest clinical need. Priority should go to urgent trauma cases, urgent elective arthroplasty for patients who cannot receive uncemented implants, and complex revision operations that cannot safely be postponed. Examples include fractured neck of femur and infected joint revisions that require antibiotic-loaded cement. Clinical teams should review and prioritise waiting lists to ensure stock is reserved for these high-priority indications.
Switching products and clinical safety
Where substitution is unavoidable, clinicians must assess brand and formulation differences before use. Differences in setting time, viscosity and antibiotic loading can alter surgical technique and patient outcomes. Surgical teams should consult product technical data sheets and pharmacy colleagues to confirm compatibility with planned implants and antibiotic regimens.
Trusts should implement local protocols for any temporary product switch. Protocols must include staff briefings, updated mixing and handling instructions, and monitoring for adverse events. Pharmacy and sterile services must verify supply-chain documentation and batch traceability before products are released for clinical use.
Clinical governance teams should record all switches and report incidents through existing safety systems. Ongoing monitoring of outcomes will support timely adjustments to practice as replenishment continues.
Ongoing monitoring of outcomes will support timely adjustments to practice as replenishment continues. Trusts should identify and secure alternative bone cement products from other suppliers where feasible. Some substitutions may be implemented within weeks. Others will not be like-for-like and will require staff training, adjustments to perioperative technique and documented evaluation. Clinicians must assess alternatives for clinical suitability in collaboration with procurement, clinical governance and executive leadership. Any substitution should be based on a documented risk assessment and on available evidence. These steps are essential to protect patient safety and preserve procedural quality.
Coordination with independent and regional providers
Integrated care boards and hospital trusts are being urged to engage independent sector providers in their regions to agree how constrained supplies of specific bone cements will be prioritised. NHS England requests that ICB colleagues support mutual aid arrangements to allocate available stock according to the established clinical prioritisation framework. The aim is to avoid ad hoc or inequitable distribution and to ensure decisions follow consistent clinical criteria.
Managing theatre capacity and patient communication
Where limited access to particular bone cement products requires cancellation of arthroplasty lists, trusts should repurpose theatre time promptly and efficiently. Options include scheduling alternative procedures that do not require the affected cements, offering the freed theatre capacity to other surgical specialties, or reallocating orthopaedic surgeons to outpatient clinics, triage duties, or other tasks aligned with waiting-list demand. Trusts are asked to sustain pathways that protect referral-to-treatment (RTT) performance and to review business continuity plans in light of current constraints.
The guidance emphasises clear patient communication about cancellations, alternative treatment options and expected timelines. Maintaining transparent, timely updates will help preserve patient safety and trust while systems implement prioritisation and mutual aid arrangements.
Trusts must provide transparent, timely updates to anyone affected by delays or rescheduling. They should explain the reason for changes and outline the expected next steps. Clear explanations will reduce anxiety and enable patients to make informed choices about their care. Maintaining open channels of communication supports patient safety and preserves trust while prioritisation and mutual aid arrangements are implemented.
Operational coordination and next steps
The Department of Health and Social Care, NHS England and NHS Supply Chain will continue daily coordination with suppliers to limit disruption. Teams will identify clinically acceptable alternatives where feasible. Because the products require cold-chain distribution, NHS Supply Chain cannot apply conventional demand-management controls to stock outside its network.
Trusts with supply concerns should contact their NHS Supply Chain Customer Services Advisor or their integrated care system manager. If necessary, trusts may escalate issues through established emergency preparedness, resilience and response (EPRR) routes. NHS bodies will continue to monitor the situation and update affected providers and patients as new information becomes available.
Local implementation and ongoing updates
Trust leaders must cascade this advisory to relevant teams, including theatre and anaesthetic leads, surgical and trauma and orthopaedic teams, procurement teams and communications. They should share Annex A, which lists affected product lines and potential alternatives, and keep it updated as new information emerges.
Proactive engagement and clinical-led prioritisation are essential to maintain patient safety while limited stocks of Heraeus Medical bone cement are recovered. For the latest supply information, teams should follow the NHS Supply Chain notice and any subsequent NHS England communications dated 18 February 2026 or later.
