Supply Issues Heraeus Medical Bone Cement Products (ICN 3261)

Heraeus manufacturing position:

• Heraeus continues to reintroduce their products back into the UK market in a phased way that ensures continuity of supply.
• While supply is improving, product availability has not yet returned to normal levels. Trusts should therefore maintain a resilient supply position.
• NHS Supply Chain will lift suspensions on each Heraeus product as it becomes available to order.

Change:

• The following products are now available to order from our online catalogue, ahead of delivery in the week beginning 10 August 2026:
  • FQQ1111 – Palacos MV+G 1x40g
  • FQQ1081 – Palacos Plain 1x40g
  • FQQ1011 – Palacos R+G 2x40g
  • FQQ1021 – Palacos R+G 1x40g.
• This is in addition to the following product, which also remains available to order.
  • FQQ1001 – Copal G+C 1x40g.
• The following products remain suspended to allow Heraeus to build stock. The supplier estimates these products will be available in September 2026. Keep checking this ICN for updates.
  • FQQ388 – Copal G+V 1x40g
  • FJI4643 – Palacos Fast 1x40g
  • FQQ1101 – Palacos MV+G 2x40g
  • FQQ1061 – Palacos LV+G 1x40g
  • FQQ1151 – Palacos MV plain 2x40g
  • FQQ1131 – Palacos MV+G 2x20g
  • FQQ1091 – Palacos Plain 2x40g
  • FQQ1031 – Palacos R+G 1x60g
  • FQT85049 – Palacos R+G 2x20g.
• The following products remain suspended and don’t currently have an expected availability date:
  • FQQ113 – Copal spacem 2x40g
  • FJT30864 – Palacos Pro 55
  • FJT30863 – Palacos Pro 75
  • FQQ1071 – Palacos LV 1x40g
  • FQQ1161 – Palacos MV plain 1x40g
  • FQQ1041- Palacos R+G 2x20g.

Next steps:

• Trusts can order products as they become available from the dates indicated above.
• Trusts can continue to order the alternative products:
  • FQT85055 and FQT85054 – Zimmer Biomet High Fatigue G
  • FQT85035 – Johnson & Johnson CMW Smartset GHV Gentamicin
  • FQT85014 – Tecres Vancogenx Dual Antibiotic HV revision cement.
• Continue to check this ICN for updates on when Heraeus products will be available to order, as the supply position may be subject to change.
• If you have any questions, please speak to your NHS Supply Chain Customer Service Advisor or your ICS Manager for further support.

Heraeus manufacturing position

• NHS Supply Chain has agreed with Heraeus a phased approach to reintroduce their products back into the UK market in a way that ensures continuity of supply.
• While supply is improving, product availability has not yet returned to normal levels. Trusts should therefore maintain a resilient supply position.
• All open back orders will be cancelled by Heraeus to ensure demand reflects current need. Heraeus will demand manage future orders, typically providing allocations of two weeks’ stock based on historic ordering patterns.
• NHS Supply Chain will lift suspensions on each Heraeus product as it becomes available to order, starting with their dual antibiotic bone cement which can be ordered from 27 July 2026.
• Heraeus is also building up stock of its main Palacos products but cannot meet full UK demand immediately so they will be available through NHS Supply Chain from 10 August 2026, with orders placed from 4 August 2026.

Change:

• The following product is available to order as normal from 27 July 2026 via the NHS Supply Chain catalogue:
  • FQQ1001 – Copal G+C 1x40g.
• The following products will be available to order from the NHS Supply Chain catalogue from 4 August 2026, ahead of delivery in the week beginning 10 August 2026:
  • FQQ1111 – Palacos MV+G 1x40g
  • FQQ1081 – Palacos Plain 1x40g
  • FQQ1011 – Palacos R+G 2x40g
  • FQQ1021 – Palacos R+G 1x40g.
• The following products remain suspended to allow Heraeus to build stock. The supplier estimates these products will be available in September. Keep checking this ICN for updates:
  • FQQ388 – Copal G+V 1x40g
  • FJI4643 – Palacos Fast 1x40g
  • FQQ1101 – Palacos MV+G 2x40g
  • FQQ1061 – Palacos LV+G 1x40g
  • FQQ1151 – Palacos MV plain 2x40g
  • FQQ1131 – Palacos MV+G 2x20g
  • FQQ1091 – Palacos Plain 2x40g
  • FQQ1031 – Palacos R+G 1x60g
  • FQT85049 – Palacos R+G 2x20g.
• The following products remain suspended and don’t currently have an expected availability date:
  • FQQ113 – Copal spacem 2x40g
  • FJT30864 – Palacos Pro 55
  • FJT30863 – Palacos Pro 75
  • FQQ1071 – Palacos LV 1x40g
  • FQQ1161 – Palacos MV plain 1x40g
  • FQQ1041 – Palacos R+G 2x20g.

 Next steps:

• Trusts can order products as they become available from the dates indicated above.
• Trusts can continue to order the alternative products:
  • FQT85055 and FQT85054 Zimmer Biomet High Fatigue G
  • FQT85035 Johnson & Johnson CMW Smartset GHV Gentamicin
  • FQT85014 Tecres Vancogenx Dual Antibiotic HV revision cement.
• Continue to check this ICN for updates on when Heraeus products will be available to order, as the supply position may be subject to change.
• If you have any questions, please speak to your customer service advisor or your ICS Manager for further support.

Change:

Heraeus manufacturing position

• The supply disruption continues to improve, with manufacturing underway.
• NHS Supply Chain expects to able to update trusts on a timetable for the reintroduction of Heraeus products into the UK within the next week.
• Initial supply may be intermittent so you should seek to maintain a resilient position until a full return to business-as-usual.
• In preparation for this, NHS Supply Chain will be suspending all Heraeus Bone Cement National Product Codes (NPCs) to enable the supplier, and their distribution partner, to examine their order book. These will be:
  • FQQ1011 – Palacos R+G 2x40g
  • FQQ1021 – Palacos R+G 1x40g
  • FQQ1031 – Palacos R+G 1x60g
  • FQT85049 – Palacos R+G 2x20g
  • FQQ1091 – Palacos Plain 2x40g
  • FQQ1081 – Palacos Plain 1x40g
  • FQQ1061 – Palacos LV+G 1x40g
  • FQT85017 – Copal LV 1x40g
  • FQQ1001 – Copal G+C 1x40g
  • FQT85018 – Palacos MV plain 1x40g
  • FQQ1151 – Palacos MV plain 2x40g
  • FQQ1111 – Palacos MV+G 1x40g
  • FQQ1101 – Palacos MV+G 2x40g
  • FQQ1131 – Palacos MV+G 2x20g
  • FQQ113 – Copal spacem 2x40g
  • FQQ388 – Copal G+V 1x40g
  • FJI4643 – Palacos Fast 1x40g.

Zimmer Biomet High Fatigue G

• Demand management on the alternative Zimmer Biomet High Fatigue G is being lifted, enabling trusts to order the following products normally:
  • FQT85055 – Antibiotic Hi-Fatigue G Bone Cement 1×40 packs.
  • FQT85054 – Antibiotic Hi-Fatigue G Bone Cement 2×40 packs.

Next steps:

• Trusts should continue to order the alternative Zimmer Biomet High Fatigue G or Johnson & Johnson CMW Smartset GHV Gentamicin products until Heraeus products become available in sufficient quantities:
  • FQT85055 – Antibiotic Hi-Fatigue G Bone Cement 1×40 packs
  • FQT85054 – Antibiotic Hi-Fatigue G Bone Cement 2×40 packs
  • FQT85035 – Antibiotic SMARTSET GHV GENTAMICIN 40G BONE CEMENT.
• Continue to check this ICN for updates on when Heraeus products will be available to order.

If you have any questions, please speak to your customer service advisor or your ICS Manager for further support.

Change:

• Temporary switch required on Zimmer Biomet High Fatigue G.
• One product code is temporarily unavailable to order due to a supplier shortage:
  • FQT85055 – Antibiotic Hi-Fatigue G Bone Cmt 1×40 packs.
• Trusts should switch to product code:
  •  FQT85054 – Antibiotic Hi-Fatigue G Bone Cmt 2×40 packs.
• There is good availability of FQT85054 although it remains subject to Protect Demand Management to ensure fair supply of available stock across the NHS.

Next steps:

• Trusts should continue to order the alternative Zimmer Biomet High Fatigue G Bone Cmt 2×40 packs instead.
• Continue to check this ICN for updates on Heraeus products.

Haraeus manufacturing position:

• Heraeus Medical has confirmed it has fully resumed production of pouch bone cements at its main site after resolving a technical machine failure that temporarily limited manufacturing.
• Due to required production cycles and sterilisation times, the first products are expected to be released to the global market from the end of June 2026. It is expected to be July or August before all product variants are available and the backlog cleared, enabling a full return to business as usual.
• We will update this ICN once we have firm confirmation from Heraeus of when individual products will be available in the UK.
• See our Downloads ▼ section to view the customer letter from Haraeus with the update on the manufacturing position.

Zimmer Biomet High Fatigue G:

• NHS Supply Chain has taken delivery of higher quantities of the alternative Zimmer Biomet 2×40 packs. These can be ordered using the following product code:
  • FQT85054 – Antibiotic Hi-Fatigue G Bone Cmt 2×40.
• FQT85054 is subject to Protect Demand Management to ensure fair supply of available stock across the NHS.
• From now on, orders will predominantly be for 2×40 packs, although 1×40 packs are still available. The product code to order the 1×40 is FQT85055:
  • FQT85055 – Antibiotic Hi-Fatigue G Bone Cmt 1×40.
• FQT85055 is subject to Protect Demand Management to ensure fair supply of available stock across the NHS.

Next steps:

• Trusts should continue to order the alternative Zimmer Biomet High Fatigue G or Johnson & Johnson CMW Smartset GHV Gentamicin products until Haraeus products become available in sufficient quantities.
• Continue to check this ICN for updates on when Haraeus products will be available to order.
• See our Downloads ▼ section  to read a customer briefing which sets out the alternative products available and the way to order them, including demand capture and escalation processes. Please ensure you follow these processes.
• See our Downloads ▼ section to find a series of information sheets to support clinical decision making over the use of the alternative products.
• Follow the national guidance issued by NHS England and the British Orthopaedic Association to support local decision making on stock availability and elective procedures.
• See our Downloads ▼ section to view our Zimmer Biomet High Fatigue G Bone Cement Mixing Guidance.
• See our Downloads ▼ section to obtain a demand capture or escalation form.
• If you have any questions, please speak to your customer service advisor or your ICS Manager for further support.

Change

• We are working closely with Heraeus on their recovery. The validation phase of manufacturing is ongoing, and as such the manufacturing of product has not yet commenced. The lead time from manufacturing to finished product is approximately eight weeks.
• We will update this ICN once Heraeus confirms that production has restarted at scale and will provide firmer timelines as soon as they are reviewed and agreed with Heraeus.
• Please ensure quantities ordered for alternatives are for your immediate requirements and in line with national guidance.

Impact

• We remain in a national supply disruption classified as an incident. Demand management measures are in place to ensure fair allocation nationally and continuity of patient care across the NHS.

Next steps

• Regular updates and trust action will be shared on this ICN.

Change:

• We remain in a national supply disruption classified as an incident. Demand management measures are in place to ensure fair allocation nationally and continuity of patient care across the NHS. During this period, we remind trusts to only order products needed for their immediate requirements in line with national guidance.
• We expect the inbound stock position to improve from mid-April 2026 and will provide further updates on stock availability at this time.

Impact:

• Please ensure quantities ordered are for your immediate requirements in line with national guidance.

Next steps

• Regular updates and trust action will be shared on this ICN.

Change:

• Advice on Vancogenx Bone Cement:
  • On customer webinars there have been several requests for advice on dual antibiotic loaded bone cement.
  • Summit Medical distributes the Vancogenx Bone Cement from Tecres. This is a dual antibiotic bone cement which has Gentamicin and Vancomycin.
  • This is indicated for use with patients who are being treated for infection or in revision surgery situations where additional antibiotics are required.
  • This product information has been reviewed and deemed acceptable by the orthopaedic clinical team at NHS Supply Chain and by the British Orthopaedic Association (BOA) specialist societies.
  • Vancogenx is established in the UK and used in multiple hospitals across the NHS.
  • See our Useful Links section to view product information about Vancogenx Bone Cement on the Tecres website.
  • See our Downloads section to view the Instructions for Use and Product Information guides for Vancogenx.

• Ordering Vancogenx Bone Cement:
  • Vancogenx Bone Cement is available by eDirect using the following product codes:
    • FQT85014 (MPC – 12A2530) – VANCOGENX – RADIOPAQUE BONE CEMENT 1x40G HV (High Viscosity) (with Vancomycin and Gentamycin)
    • FQQ352 (MPC – 12A2520) VANCOGENX – RADIOPAQUE BONE CEMENT 1x40G LV (Low Viscosity) (with Vancomycin and Gentamycin).

Next steps:

• See our  Useful Links▼ section to view the Vancogenx product website.
• See our Downloads▼ section to read the Instructions for Use and product information guide.
• Please check this ICN regularly for further updates.
• If you have any questions, please speak to your customer service advisor or your ICS Manager for further support.

Change:

• Zimmer Biomet High Fatigue G Bone Cement Mixing Guidance:
  • Our Head of Strategic Engagement for Orthopaedics, Trauma and Spine, Khalid Shihadah has shared advice on mixing Zimmer Biomet High Fatigue G Bone Cement.
  • See our Downloads ▼ section to view the guidance.

• Johnson & Johnson:
  • The Johnson & Johnson CMW Smartset GHV Gentamicin is an existing product available through our online catalogue, with additional quantities now secured to support customers who previously ordered Heraeus products.
  • This is a cold-chain item so will continue to be delivered via our eDirect route. Once delivered the product should be stored as an ambient product.

Next steps:

• See our Downloads ▼ section to view our Zimmer Biomet High Fatigue G Bone Cement Mixing Guidance. If further guidance is needed, please contact your Zimmer Biomet representative in the first instance.

Change:

• Johnson & Johnson additional stock:
  • Johnson & Johnson CMW Smartset GHV Gentamicin 40g Bone Cement additional stock is now available to order.
  • This is one of the two identified alternatives to the unavailable Heraeus bone cement products.
  • Johnson & Johnson has requested that customers place all orders for this stock by ordering packs of 10 using:
    • FQT85035 – Antibiotic SMARTSET GHV GENTAMICIN 40G BONE CEMENT.
  • Submit a demand capture form for any stock you wish to order.
  • Trusts should consider the use of this product along with the Zimmer Biomet High Fatigue G to meet the gap in stock availability from Heraeus.
  • Smartset is a cold chain product, so will be delivered via our eDirect route.

• Zimmer Biomet training video:
  • Zimmer Biomet has produced a video to support NHS trusts with training on how to prepare and use its High Fatigue G bone cement, the other identified alternative.
  • See our Useful Links section to view the video.
  • Company representatives are also available to support face-to-face training.

• Ordering:
  • If you are ordering daily, please ensure you are placing the order for requisition points that are open for an everyday delivery.

• Bank holiday ordering:
  • To support customers during the upcoming Bank Holiday periods, daily order thresholds for either product will be increased by 20% in advance of each holiday closure. This temporary uplift helps accommodate additional demand and ensures continuity of supply on non-delivery days:
    • Easter – Thresholds increased from Monday 23 March 2026
    • May Day Bank Holiday – Thresholds increased from Monday 27 April 2026
    • Spring Bank Holiday – Thresholds increased from Monday 18 May 2026.
  • To do this, you should increase your order volumes for daily ordering or amend the quantity if you have standing orders set up.
  • All orders are subject to demand management and can only be fulfilled where stock is available. Please ensure orders remain in line with BAU levels, plus the 20% daily threshold increase for the bank holiday.

Next steps:

• See our Useful Links section to view the Zimmer Biomet High Fatigue G training video.
• See our Downloads ▼ section to read a customer briefing which sets out the products available and the way to order them, including demand capture and escalation processes. Please ensure you follow these processes.
• See our Downloads ▼ section to find a series of information sheets to support clinical decision making over the use of the alternative products.
• Complete a demand capture form to inform us of your intended stock requirements.
• See our Downloads ▼ section to obtain a demand capture or escalation form
• Check this ICN regularly for further updates.
• If you have any questions, please speak to your customer service advisor or your ICS Manager for further support.

Change

• The IT issues which were preventing the National Product Code FQT85055 for Zimmer Biomet High Fatigue G bone cement showing in our online catalogue have been resolved.
• We are aware some trusts order bone cement products via your pharmacy teams. We will require those teams to place orders for products in line with the usual demand management route as we are unable to consolidate these to enable weekly orders to be placed.

Impact

• Orders for FQT85055 can now be placed as normal via the catalogue again.
• Your pharmacy teams should place orders using the guidance in the customer briefing in our downloads section.

Next steps

• See our Downloads ▼ section to read a customer briefing which sets out the products available and the way to order them, including demand capture and escalation processes. Please ensure you follow these processes.
• See our Downloads ▼ section to find a series of information sheets to support clinical decision making over the use of the alternative products.
• Check this ICN regularly for further updates.
• See our Downloads ▼ section to obtain a demand capture or escalation form.
• If you have any questions, please speak to your customer service advisor or your ICS Manager for further support.

Change

• We’re experiencing an IT issue that is preventing the National Product Code FQT85055 for Zimmer Biomet High Fatigue G bone cement showing in our online catalogue today (Thursday 26 February 2026).
• Please be assured that stock is available.

Impact

• This will impact your ability to place orders.
• If you have a standing order in place and were expecting a delivery on Monday 2 March 2026 that order may have been affected.

Next steps

• To order the product today, please contact your Customer Service Advisor, who will process the order on your behalf.
• If you have a standing order and were expecting a delivery on Monday 2 March 2026, please also get in touch with your Customer Service Advisor so they can confirm that your order has not been affected and reorder for you.
• We expect the code will be visible in our catalogue again from tomorrow (Friday 27 February 2026).
• A further update will be provided tomorrow (Friday 27 February 2026).

Change

• Two clinically assured alternative products have been identified as alternatives for high viscosity bone cement with gentamicin – Zimmer Biomet High Fatigue G and Johnson & Johnson CMW Smartset GHV Gentamicin.
• The following National Product Code (NPC) will be available to order through our online catalogue only from Wednesday 25 February 2026 for the Zimmer Biomet High Fatigue G product:
  • FQT85055
  • FQT85054 will be available from 10 March 2026.
• The NPCs for the J&J CMW Smartset GHV Gentamicin products will be available from early March 2026. This ICN will be updated when they are available to order via our online catalogue.

Impact

• We have Zimmer Biomet stock available in addition to normal supplies from suppliers other than Heraeus. Please order at normal levels. Stock held by both NHS Supply Chain and individual suppliers will be demand managed to prevent over ordering.
• Heraeus is continuing to allocate the small amount of available stock it has on a back-order basis. They do not currently have stock to facilitate any new orders.
• On our customer webinar several questions were asked around ordering processes via pharmacy teams. These are being reviewed and we will update this ICN once our teams have considered how ordering processes can be amended to support this.

Next steps

• See our Downloads ▼ section to read a customer briefing which sets out the products available and the way to order them, including demand capture and escalation processes. Please ensure you follow these processes.
• See our Downloads ▼ section to find a series of information sheets to support clinical decision making over the use of the alternative products.
• Follow the national guidance issued by NHS England and the British Orthopaedic Association to support local decision making on stock availability and elective procedures.
• Review the revised product listing in our downloads section which has further information on the impacted products and alternative products that could be used.
• See our Downloads ▼ section to obtain a demand capture or escalation form.
• Place orders daily to ensure uninterrupted supply
• Consider utilising the standing order function which is available in our online catalogue.
• Check this ICN regularly for further updates.
• If you have any questions, please speak to your customer service advisor or your ICS Manager for further support.

• National guidance for clinicians on how to handle the impact of the supply disruption has been issued jointly by the NHS England National Clinical Directors and the British Orthopaedic Association.
• See our Downloads ▼ section to read the national guidance and suggested alternative products.

Next steps

• Trusts and ICBs should follow the national guidance issued by NHS England and the British Orthopaedic Association to support local decision making and the national stock position.
• Review the product listing in our downloads section which has further information on the impacted products.
• Check this ICN regularly for further updates.
• If you have any questions, please speak to your customer service advisor or your ICS Manager for further support.

• Two further product codes are impacted:
  • FQT85017 and FQT85018.
• 17 codes are now affected in total.
• The product listing has now been updated with further information on the affected products.
• See our Downloads ▼ section to view the updated product listing.
• Bone Cement is distributed via temperature controlled cold chain logistics, which is required to ensure the stability of the product. NHS Supply Chain is not commissioned to provide cold chain services so we cannot bring stock into our warehouse network or apply conventional demand management.
• We are working closely with Heraeus and alternative suppliers to secure available stock. Suppliers with stock are being asked to apply demand management measures to support the national stock position. Use will be prioritised in line with NHS England pathway guidance, with a particular emphasis on prioritising trauma care.

Change:

• This impacts 15 Heraeus Medical product codes:
  • FQQ1001, FQQ388, FQQ113, FJI4643, FQQ1061, FQQ1151, FQQ1111, FQQ1131, FQQ1101, FQQ1081, FQQ1091, FQQ1021, FQQ1031, FQT85049 and FQQ1011.
• The supply issue is due to supplier manufacturing issues.

Impact:

• We are engaging with alternative suppliers in this market and are identifying their ability to provide alternative products that are compliant routes to market in this period of disruption. This will be communicated as soon as possible via a product listing update to this ICN.
• Heraeus Medical have indicated this will take a minimum of two months to return to full production. Firmer timeframes will be shared as the supplier response plan is determined.

Next Steps:                   

• Regular updates and trust action will be shared on this ICN.
• See our Downloads ▼ section to view the product listing and the customer letter from Heraeus Medical about the supply disruption.
• Please ensure Clinical teams and Orthopaedic teams within your trust are made aware of this issue.
• Trusts should start to consider the impact to their trust and review local decision-making for using alternative products.
• If you have any questions, please speak to your customer service advisor or your ICS Manager for further support.