Date published: 18 February, 2026
Date last updated: 18 February, 2026
Elective care

Heraeus Medical – bone cement products

Classification: Official
Publication reference: PRN02394

To: 

  • Trust chief operating officers (COOs)
  • Trust medical directors
  • Trust heads of procurement
  • Trust heads of emergency preparedness, resilience and response (EPRR)
  • Trust directors of communication
  • Trust materials management teams
  • Independent sector (via trusts)

cc.

  • Regional COOs
  • Regional directors of communication
  • Regional deputy directors of EPRR
  • Regional medical directors
  • Integrated care board (ICB) EPRR leads
  • ICB medical directors
  • ICB procurement leads
  • ICB communication leads

Dear colleagues,

Heraeus Medical – bone cement products

We are writing to update you on a significant disruption that has emerged in relation to the supply of bone cement products sold by Heraeus Medical.

Stock position and alternatives

A packaging fault temporarily halted production at Heraeus’ main production site. Whilst production has now restarted, product availability will be impacted for at least two months. This is a global issue.

Stock already in the UK supply chain may be sufficient for ~two weeks’ supply, at normal ordering volumes, beyond this there will be a period of six-eight weeks’ gap in supply.

Please note, existing stock already in trust cold chain storage is not affected, and no stock recall is in place. Independent provider partners will also be impacted.

Work is underway to secure additional stock from alternative suppliers where possible

A list of the affected products, and potential alternatives is included in Annex A.

Further information on supply and alternatives can be found on NHS Supply Chain’s dedicated webpage, which will be regularly updated: Supply Issues Heraeus Medical Bone Cement Products » NHS Supply Chain

Implications for care

These products are used in both trauma and elective orthopaedic procedures, usually in arthroplasty.

Action 1: Trusts and ICBs should work to ensure available supply is focused on higher risk activities (for example urgent care and Trauma provision). Where use of a specific type of products is necessary. Trusts should review and clinically prioritise waiting lists and types of activity to maximise use of available stock, based on patient need, staff preference, training on alternative products and scarcity of supply.

An indicative clinical prioritisation is as follows:

  1. Trauma and urgent patients (e.g. fractured neck of femur, those requiring a cemented stem, or other urgent cases requiring the use of quick-setting bone cement).
  2. Urgent elective arthroplasty – primary treatment for patients with significant pain/disability which are not suitable for uncemented implants.
  3. Patients undergoing complex revision hip/knee revision cases which cannot wait 6-8 weeks – for example patients with infection who require antibiotic cement.
Action 2: Trust and ICBs should proactively have conversations with Independent Sector (IS) providers in their area to ensure bone cement resources are prioritised for those patients within the clinical priority list above. ICB colleagues are asked to support and coordinate mutual aid where required.

Use of alternatives and changes to clinical practice

For some trusts and units switching to alternative suppliers should be comparatively straightforward and achievable within weeks. Other switches may not be ‘like-for-like’ and will require staff re-training and changes to process, given the different technical specifications of the products and use cases.

Action 3: Clinicians should determine if the available alternatives are suitable, working closely with procurement colleagues and wider trust leadership. Any decisions to substitute products (as an interim measure or longer term) should be grounded in evidence‑basd practice and patient safety and informed by a documented risk assessment.

Business continuity and maximising use of available capacity

Action 4: Trusts should consider how to utilise any additional theatre time that is released, if arthroplasty or other elective procedures are not possible given lack of Heraeus products.

This could include focusing on procedures other than arthroplasty if cement is required but not available. Alternatives would be to allow other specialities to use the theatre time and staff whilst this issue persists. It will be important to find alternative clinical activity for affected surgeons who are not able to use those theatre lists.

If it is unavoidable to cancel orthopaedic cases during this time, the freed up clinical time should be refocused into additional outpatient activities, focussing on new patients, which is where the largest part of the orthopaedic waiting lists resides. Time should also be reprioritised for clinical triage for patients waiting more than 18 weeks. Every effort must be made to continue to improve RTT performance during this time. Trusts are also urged to revisit their business continuity and resilience plans where appropriate.

Next steps

The Department of Health and Social Care (DHSC), NHS England and NHS Supply Chain will continue to work with suppliers to minimise the length of disruption and maximise availability of clinically acceptable alternatives, with daily incident coordination meetings. We will also work with suppliers to explore how to ensure available stock is allocated as equitably as possible across trusts.

Bone cement is distributed via temperature controlled cold chain logistics, which is required to ensure stability of the product. NHS Supply Chain are not commissioned to provide cold chain services and therefore it is not possible for stock to be brought into the NHS Supply Chain network or apply conventional demand management controls. 

NHS Supply Chain are working closely with the affected supplier and alternative suppliers to secure available stock, and to support suppliers’ demand management processes to prioritise need in line with NHSE prioritisation guidelines.

Action 5: Trust colleagues are asked to share this information with relevant teams in your organisation who may be affected by the supply disruption, for example: theatre leads, anaesthetic leads, surgical teams, and trauma and orthopaedic leads.
Action 6: Trusts are also asked to ensure transparent and timely communication with patients, particularly in circumstances where treatment waits may be extended or scheduled surgery requires rearrangement. It is essential that patients are kept fully informed of any changes to their care pathway.

Further communications and contact details for queries

If trusts have concerns on products and supply following the actions set out above, they should contact their NHS Supply Chain Customer Services Advisor and their ICS Manager in the first instance or escalate via EPRR routes to ICB and regional tiers.

Updates will be provided in due course via further NHS England communications, the Important Customer Notice (ICN), and through existing meetings and networks such as the following: the ICB procurement leads network, Independent Healthcare Provider Network, Clinical Procurement Specialists Network (CPSN) and British Orthopaedic Association.

Your cooperation and proactive engagement are vital to the success of this strategy, ensuring we continue to provide safe and effective care across all settings.

Yours sincerely,

Prof Tim Briggs, National Director for Clinical Improvement and Elective Recovery, Chair of GIRFT, NHS England
Ian Eardley, National Clinical Director for Elective Care, NHS England
Fergal Monsell, President, British Orthopaedic Association

Annex A – affected product lines and potential alternative products

As of 18 February 2026 – see ICN for latest information.

Date published: 18 February, 2026
Date last updated: 18 February, 2026