By Jeremy Main
As the Covid-19 pandemic has swept across the world the vital role of certain sectors that have for years been under appreciated are now suddenly being called upon more than ever.
One great example of this is pharmacy.
Having long been a pillar of local communities, pharmacies and pharmacists sit at the heart of a well-functioning healthcare system. Yet, they are often taken for granted, especially by those in government – not given enough recognition and desperately under- funded. Suddenly pharmacy and medicines supply are in the spotlight.
What the coronavirus crisis has brought into sharp focus is how almost overnight the sustainability and resilience of pharmacy can be questioned and thrown into doubt. In the blink of an eye, not only is the financial security of community pharmacy being severely tested, but also the health and safety, of pharmacy staff.
It has, therefore, been imperative that community pharmacy’s partners rise to the challenge of providing support to a vital front-line cog in the anti-COVID machine.
Understandably, many patients are un- aware of how many partners sit behind and support pharmacy. From the manufacturers of active pharmaceutical ingredients (API) in India and China, to the air freight providers who are flying in finished medicines, the medicines supply chain is a long one. At a time like this, with both massive global and local disruption, it is even longer and more complex.
But, of course, ultimately all that matters to patients is whether the pharmacist is able to hand over their medicines when they need them. A task that became harder as the demand for medicines in primary care dramatically increases and as GPs change their prescribing habits in response to coronavirus. Given the nature of the medicines supply chain, such an increase in demand has a significant effect, dramatically impacting each complex moving component further up the chain.
The challenges
Take the healthcare distributors that the HDA represents. In many ways, they face a similar challenge to the supermarkets. We have all seen the images of empty shelves with no pasta and bread, eggs or toilet rolls as customers panic buy.
The supermarkets argue that the required food is in the country, they just can’t get it to their shops quick enough. Although patients can’t panic-buy prescription medicines the increase in prescription days written has meant massively increased volumes of medicines have had to arrive at pharmacies at the same time.
Broadly, in the initial few weeks of the surge in demand at community pharmacy, we have not seen a significant spike in the number of additional shortages that could be attributed to the Covid-related increase in the number of scripts. This, of course, has been a team effort. Pharmacists ordering accurately and on time; the pre-wholesalers moving vast quantities of medicines; and the pharmaceutical manufacturers reacting to changing market dynamics.
The level of detail that has been addressed to ensure continuity of medicines supply has been simply astounding. It is a reminder how complex and interdependent the supply chain is. Every stage must be functioning efficiently for patients to receive their medicines. And when every stage is being severely challenged as a result of Covid-19 then the potential for a breakdown is critically high.
The HDA is aligning with pharmacy bodies to identify and mitigate potential risk factors and working around the clock with the government departments to have them formally addressed by official guidance or by the short-term easing of certain less critical regulations.
Shared experiences
Like pharmacy, wholesalers have been facing many new challenges in the day to day operation of their businesses. Due to very strong personal commitment, staff absences have thankfully been lower than many have expected, but nonetheless normal ways of working have had to be flexed or re-designed. Many staff members have been redeployed to add extra capacity in service centres and extra hours and shifts are being worked across our members’ businesses.
For example, one member has moved from a 5.5-day week with 16-hour days to a 24×7 operation to serve customers in London and the South East. Wholesalers are dealing with an unprecedented volume of orders, high call volumes and emergency orders.
Alongside pharmacists and following sustained lobbying we were grateful that the government has classified pharmaceutical wholesalers as key workers, allowing our sector’s staff members to continue to send their children to school. Additionally, we now also have access to the government’s Covid-19 testing regime.
This will mean more team members can be on the warehouse floor to get pharmacy orders packed and out for delivery. Another issue is security. As with many pharmacies our members have also reported increased examples of criminal behaviour – some very serious – targeting medicines distribution. Incidents so far remain low, but extra measures have had to be implemented.
Working together
Our members have over 12,000 warehouse staff and delivery drivers, who alongside the hundreds of staff members in customer support, purchasing, finance, security, IT have been working day and night to support pharmacies in meeting the huge surge in demand for medicines. In many ways, medicines distribution is the hidden player in the supply chain.
Patients interact with their GPs and pharmacists and appreciate that their medicines have been manufactured somewhere in the world. But the 24/7, just in time delivery service provided by HDA members often goes unseen.
Across all our member companies there are numerous examples of teams working selflessly and tirelessly to ensure medicines are delivered safely and on time. It has been a time of unprecedented challenge – and as with other supply chains, of course, not everything has been perfect – but by and large the efforts of our members along with manufacturers and pharmacists have underpinned the overall successful operation of ensuring patients receive their medicines.
In an unprecedented time like this we are all in it together and need to continue working together in the coming weeks and months. Let’s applaud the efforts of everybody involved in the supply of medicines, recognise the challenges we all have and work construc- tively to solve them.
Jeremy Main is independent chair of the Healthcare Distribution Association (HDA).
This article also appears in the May issue of Pharmacy Business.
