Key Summary
- The duration of Serious Shortage Protocols in place for HRT treatments and Creon have broken previous NHS records.
- Pancreatic cancer patients who take Creon to digest food are reportedly skipping meals.
- Pharmacists spend hours sourcing scarce medication, while GPs have to alter prescriptions to fit in with supply issues.
Pharmacy and other primary care leaders have warned that the UK is witnessing the 'most severe' medicine shortage that pharmacists and general physicians (GPs) have ever seen.
The National Pharmacy Association (NPA) has warned that medicine shortages pose a ‘serious risk to patient safety’ and urged the government to convene an urgent task force to tackle the issue.
The Royal College of GPs has also raised concerns about the impact medicine shortages have on patients, GPs and pharmacists.
The warnings come as new data shows that the UK now has the longest-running shortages for an individual medicine in history.
The duration of Serious Shortage Protocols (SSPs) in place for HRT treatments and Creon has broken previous NHS records.
HRT, Creon supply hit
SSPs have been in place for Creon since May 2024 and was extended by the NHS in April until 10 July 2026, running for over two years, a new record.
Creon is a drug to help people with pancreatic cancer and cystic fibrosis digest food.
Pharmacies have reported cases of patients rationing medication and, in some instances, skipping meals because they were unable to obtain supplies.
Estradot, a common HRT drug, has had an SSP in place since December 2024, a year and a half ago, another record, also extended by the NHS in April to run until 10 July.
Challenge for pharmacists, GPs
As over a thousand GPs and pharmacists meet in Birmingham at a landmark new conference organised by the National Pharmacy Association and publishing group Cogora this weekend, senior health leaders said that medicine shortages ‘have never been so chronic and severe’.
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Pharmacists and GPs have been faced with record numbers of shortages in recent months for commonly dispensed medicines, including for painkillers, blood pressure medication and medicines to manage epilepsy.
Pharmacists and GPs, who face an unprecedented workload, spend significant time managing a growing number of medicine shortages.
Pharmacists spend hours sourcing scarce medication, while GPs have to alter prescriptions to fit in with supply issues, causing patients inconvenience and worry.
A new survey by the National Pharmacy Association found that:- 98 per cent of pharmacies encountered patients who had visited several pharmacies in a day to source a prescription in the last year.
- 96 per cent of pharmacies felt the current situation posed a serious risk to the safety of their patients.
- 83 per cent of pharmacy teams faced abuse or anger from patients due to a prescribed medicine being unavailable.
- 89 per cent of pharmacies were unable to dispense a medicine at least once a day last year due to supply issues.
Pharmacies have reported to the NPA having to comfort concerned patients and carers regularly, with one pharmacist saying that they were "experiencing the most amount of shortages I have known for the past 30 years".
Senior pharmacy leaders have called for the government to convene an urgent task force including manufacturers, wholesalers, and clinicians, to try and tackle a complex and growing problem.
The NPA has also called for amendments to ‘antiquated legislation’ that prevents pharmacists from making simple amendments to prescriptions when an item is out of stock.
Pharmacists cannot switch a cream to an ointment or a tablet to a capsule when they feel that is a clinically appropriate change.
Instead, they have to send patients back to their GP in order to make changes, delaying medicines reaching a patient and wasting significant amounts of time.
GPs, pharmacies to fight shortage
The conference will support GPs and pharmacies to help patients navigate an alarming and growing list of shortages for commonly dispensed medicines.
This includes improved information sharing between pharmacies and GPs surgeries about medicines in or out of stock as well as better dialogue about how to support patients with a complex medicines regimen.
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NPA chair Olivier Picard said, "This data confirms what pharmacists and GPs have been experiencing for many months; medicine shortages are becoming more frequent, lasting longer and causing increasing disruption for patients.
"These shortages are some of most severe the UK has experienced.
"Our medicines market has never been so volatile, with patients and primary care colleagues at the sharp end of events outside of their control.
“It is deeply distressing to find patients who have travelled from pharmacy to pharmacy to find the medicines they need without success. Although medicine shortages are frustrating and worrying, we are clear that in some instances they pose a serious risk to patient safety.
“Pharmacies spend significant time hunting stock and liaising with GP teams when they should be getting on with caring for their patients.
“We’re urging the government to convene an emergency taskforce to bring together all parts of the supply chain to tackle this issue.
“As well as this, the government should amend legislation that prevents pharmacies from making simple substitutions to a prescription, where are a safe alternative is in stock.
“We hope this conference is a chance to bring together pharmacies and GPs to share ways we can work together to support our patients through a growing number of shortages.
"Improving dialogue and information sharing ahead of time between GP surgeries and pharmacies can help mitigate some of the impact of disruption to supply chains.”
The Royal College of GPs president, Professor Victoria Tzortziou Brown said, "Medicine shortages can be frustrating for patients, GPs and pharmacists alike, especially when patients have to endure lots of back and forth to acquire a suitable alternative. At a time when GPs and pharmacists are working under significant pressures, medicine shortages only add to this.
"With appropriate safeguards in place, the College is supportive of pharmacists being able to make limited changes to prescriptions when a medicine is unavailable and a safe, clinically appropriate alternative is available within agreed prescribing guidance. We would also support systems that enable timely communication between pharmacists and GP practices when shortages arise, without creating unnecessary administrative burden.
"The most important thing is that patients are able to access the medication they need safely and without delay. More widely, it's essential that when shortages occur, the underlying causes are quickly identified and resolved."
PERT shortage
Alice Billin, head of Policy and Public Affairs at Cystic Fibrosis Trust, said, “Secure access to medicines is critical for everyone with cystic fibrosis. As the recent challenges with PERT have shown, the impact of shortages is huge, affecting physical and mental health. We will continue to work with the Government to make sure a long-term resolution to shortages is achieved and everyone with CF is able to access the medicines they need.”
Anna Jewell, director of Services, Research and Influencing at Pancreatic Cancer UK said, "Pancreatic Enzyme Replacement Therapy (PERT) is vital for people with pancreatic cancer and is essential for people to digest food, maintain a healthy weight, and live well. Difficulties obtaining an adequate supply of PERT can cause people significant distress and anxiety, as not having enough can have an impact on symptom control, and their ability to remain well enough to tolerate treatment.
"Although the supply of Creon and other brands of Pancreatic Enzyme Replacement Therapy (PERT) has generally improved over the last year, we know some people who rely on this medication are still facing challenges in securing the PERT they need, such as having to visit multiple pharmacies. We are closely monitoring the situation to ensure that the government and manufacturers are continuing with work to establish a more robust supply of this vital medication.”
Epilepsy patients on 'cliff-edge'
Epilepsy Society Chief Executive Clare Pelham said, “We understand how worrying it can be for patients to run low on essential medication. Epilepsy is a cliff-edge condition, which means that missing even a single dose can have life-threatening consequences.
"We are calling on the UK Government to ensure their essential medicine supply chains are robust and water-tight so that no one is left vulnerable to global events. And especially to protect people with cliff-edge conditions. At times of national pressure, we must always look first to protect the most vulnerable."
