Key Summary
- The burden of managing medicines shortages for community pharmacies, general practice and hospitals remains unsustainably high.
- The recent 50 percent cut in ICB staff and the merger of DHSC and NHS England are creating operational challenges.
- The ongoing economic fragility of the supply of generic medicines continues to be a concern.
A new report by the Royal Pharmaceutical Society (RPS) has stated that medicine shortages remain a concern and called for reforming medicines reimbursement and supply in community pharmacy.
The Royal Pharmaceutical Society (RPS) has on Tuesday (24) published "Medicines Shortages: One Year On," a report assessing progress since the launch of its 2024 report "Medicines Shortages: Solutions for Empty Shelves".
The new report looks into the improvements made, where target action could accelerate change, and the continuing areas of concern.
It stated that medicine shortages remain a concern for patients, pharmacists and wider healthcare teams.
Managing shortages
The report stated that while some evidence presented to the House of Lords Inquiry into Medicines Security suggests that national shortages may have reduced over 2025, other evidence suggests that the burden of managing medicines shortages for community pharmacies, general practice and hospitals remains unsustainably high.
It noted that 2026 has already seen some significant medicine shortages.
"Pharmacy teams have highlighted shortages of several common medicines prescribed in high volumes across the UK (dispersible aspirin12, co-codamol13 and ramipril) that are impacting the workloads of community pharmacy and general practice teams as they find solutions for their patients.
"This picture is further complicated by reports that the reimbursement system for community pharmacies may in some cases be impacting timely access to medicines.
"Patients remain at the front line of all these shortages with one in ten people reporting delays of seven days or longer in obtaining their prescriptions. Delayed access because of a medicine shortage has been cited as a factor in patient deaths."
ICB layoffs
Although some local systems have invested in dedicated teams to support the management of medicines shortages, the recent cuts in the number of Integrated Care Boards and the merger of DHSC and NHS England risk creating operational challenges.
"The loss of staff, with 50 percent cuts to ICBs and the merger of DHSC and NHS England is creating operational challenges. System-wide reorganisations risk the loss of local links and expertise that support collaborative working to manage shortages.
"The bandwidth available in teams to support or influence shortage plans may be limited by this disruption."
This large-scale restructuring could disrupt the local links and expertise that support collaborative working.
The report noted that independent pharmacies now account for two-thirds of the market with the number of large multiples reducing.
Price-comparison platforms
"Against a backdrop of financial pressures, pharmacy contractors are evaluating their purchasing behaviours to mitigate against potential losses and are increasingly using real-time digital purchasing platforms to ensure that they purchase medicines cost effectively.
"The impact of these changes on purchasing patterns across the supply chain needs to be evaluated, including the potential impact on how manufacturers forecast demand.
Some stakeholders have warned that the ongoing economic fragility of the generic medicines supply continues to risk the generics market failure.
Shortages remain: Anderson
RPS president Professor Claire Anderson said, “While there have been some very positive steps since our report, patients, pharmacy teams and the NHS continue to feel the impact of medicines shortages.
“Despite some evidence that medicine shortages may have reduced over 2025, this is not felt by pharmacy teams on the ground, who continue to manage shortages of widely prescribed medicines.
“There has been progress across some of the recommendations, including positive collaboration between government, regulators, the NHS and industry. A national strategy must be supported by senior leaders in Government and backed with continued investment. In a global market, shaped by geopolitical uncertainty and competing national interests, the Government must take decisive steps to protect the supply.
“There are continued calls for reforms on medicines reimbursement and supply in community pharmacy and we await the outcome of the Community Pharmacy Contractual Framework negotiations in England.
“RPS has long called for pharmacists to be empowered to make safe, appropriate substitutions when a medicine is in short supply. I welcomed the recent consultation on this issue and the Government must now seize this opportunity and make the most of pharmacists’ skills to support patient access to medicines.”
National Voices chief executive Jacob Lant said, "The spirit of a resilient supply chain embraces the importance of protecting patients. Whether managing a long-term condition or facing an acute health crisis, a secure supply should mean no disruptions to their life or treatment.
“This report highlights ongoing shortages of commonly prescribed medicines, which heighten anxieties in an already fragile system, as patients often do not know when or if their medicine will be available.
“Beyond fortifying supply chains, we need a system that ensures shortages do not force clinicians to make second-best choices or leave patients feeling helpless because of them.”
Much to be done: Davies
Dr James Davies, Director of Research and Insights at Community Pharmacy England, said, “Today’s RPS report recognises that the number of medicines shortages remains high, and their management continues to be complex and time-consuming for all involved. Community pharmacy teams, as the front door to the NHS, are bearing the brunt of this challenge.
"It is worrying that relatively little has changed since the original report despite a rapidly changing situation. These findings demonstrate the urgent need for concerted action across Government and the NHS to support patients’ continued access to their medications. There is still much to be done, not least in accepting flexibilities for pharmacists in the community and improving digital systems.
"Community Pharmacy England is supportive of the report’s recommendations and welcomes its acknowledgement of the need to understand the impact of the CPCF on medicines access for the public.”
Not acceptable: Picard
National Pharmacy Association chair Olivier Picard said, “Medicines shortages are unsustainable for pharmacists and potentially harmful for patients. The NPA has repeatedly demanded action from Government to get a grip on this issue.
“It is good that the RPS too is taking steps to keep up the momentum for change, because it cannot be acceptable that medicines shortages have become a near-permanent fixture in the UK.
“Making better use of pharmacists’ clinical skills and reforming the reimbursement elements of the NHS contractual framework would go some way to easing the pressure on frontline services.
“But there also needs to be clearer accountability within government to ensure progress is driven and sustained over the long term.
“Both patients and pharmacies need meaningful change.”
