Another wake-up call! Nuffield Trust report warns patients face 'new normal' of medicine shortages

Medicine shortages and market instability are “at the worst that pharmacies have ever seen”

The latest report from the Nuffield Trust has cautioned that patients in the UK are facing a "new normal" of medicine shortages, exacerbated by supply challenges and the impact of the EU exit.

According to the report, global supply problems have have resulted in a “shock rise” in shortages of life-saving drugs such as antibiotics and epilepsy medication.

“These shortages come at a cost to the patient and the taxpayer, and are happening despite the NHS spending hundreds of extra millions trying to mitigate the problem,” it said.

Although the recent surge in medicine shortages is not directly linked to the EU exit, the report suggested that it “is likely to significantly weaken the UK’s ability to respond to them by splitting it from European supply chains, authorisations and collective efforts to respond to shortages.”

Pharmacy teams spend hours sourcing medicines

While stating that this report should serve as “another wake-up call”, Community Pharmacy England (CPE) has urged the government and NHS to “step in and do more to protect community pharmacies and their patients from these ongoing issues.”

The committee has also emphasised the need for a strategic review of medicines supply and granting more powers to pharmacists to “help them better manage their patients’ medicines when shortages do occur.”

According to Janet Morrison, chief executive of CPE, this action would ensure that patients receive the necessary care and medications when they need them.

In response to the report, she said: “It’s extremely worrying that medicine shortages have become the norm: community pharmacies and patients know this to be the case, and this report further evidences this alarming reality.”

Community Pharmacy England has already warned that medicine shortages and market instability are “at the worst ever seen”, making life incredibly difficult for community pharmacies and their patients.

The CPE noted that in its polling of pharmacy owners, medicine supply issues consistently emerge as “one of the top pressures affecting pharmacies.”

Morrison acknowledged that pharmacy teams work incredibly hard to source the medicines their patients need, but she said that these broader supply chain challenges are “beyond their control.”

“The relationship between price concessions and shortages isn't always straightforward, but it’s clear to us that both the medicine supply and reimbursement systems are at crisis point.

“Pharmacy teams are spending hours trying to source medicines, and pharmacies now often end up supplying medicines at a financial loss, significantly impacting their bottom line and destabilising the pharmacy sector, with many pharmacies on the brink of closure,” she added.

Pharmacists at the sharp end of this problem

Paul Rees, CEO of the National Pharmacy Association (NPA), said it is “totally unacceptable” that medicines shortages have become commonplace in the UK.

He remarked, “At the sharp end of this complicated problem, pharmacists – who are woefully underfunded by the NHS for dispensing medicines – are spending hours a day hunting down stock yet too often have to turn patients away.

“It’s distressing when pharmacy teams find themselves unable to provide a prompt medicines service, through no fault of their own.

“Pharmacy teams have seen the problems get worse in this country over recent years, putting more patients at risk.”

Highlighting that ensuring an adequate supply of medicines is “a basic function” of any modern health system, Rees stressed the importance of adequately funding the supply chain to guarantee the adequate flow of medicines throughout the UK system.

“The solutions have to be international as well as national, but our own government needs to create the conditions for enough medicines to flow into and around the UK system, by properly funding the supply chain at both ends,” he said.

Need end-to-end review of medicines supply chain

Malcolm Harrison, chief executive of the Company Chemists' Association (CCA), said that while there are problems throughout the supply chain, there is an urgent need to review medicines procurement.

"Failure to invest adequately in shoring up the medicines supply chain is a false economy which will only exacerbate the rolling cycle of shortages and price concessions.

"We urgently need an end-to-end review of the medicines supply chain to ensure it is fit for purpose," he commented.

Harrison also noted that pharmacy teams are "at the sharp end having to deal with medicine supply issues on a daily basis."

Empower pharmacists to change prescriptions

Meanwhile, the Royal Pharmaceutical Society (RPS) has called for empowering community pharmacists to change prescriptions, like hospital pharmacists, to help ease medicine shortages.

James Davies, director of RPS in England, said: “We urge the Government to amend medicines legislation to help ease shortages by allowing all community pharmacists to make minor amendments to prescriptions to adjust the strength or formulation required.

“At present, if a liquid version of a medicine is available but tablets have been prescribed and are out of stock, the pharmacist cannot provide the liquid version.”

“The patient has no choice but to return to the prescriber for a new prescription, which causes unnecessary workload for GPs and delays for the patient. Hospital pharmacists have been able to make these changes for years, and their colleagues in community pharmacy should be able to do so as well.”

He also emphasised the importance of improving data-sharing regarding medicine shortages, highlighting that other countries possess more transparent and publicly accessible data.

“A lack of clarity on why a medicine is in shortage and when it is likely to return are huge issues for patients, who are naturally anxious about getting the treatments they need,” he added.