Rowan Williams
A national strategy must be introduced to tackle the ongoing problem of medicines shortages in the UK, a major report published by the Royal Pharmaceutical Society (RPS) has said.
In ‘Medicines shortages policy: solutions for empty shelves’, published on 26 November 2024, the RPS called for “a cohesive cross-government and NHS strategy to improve medicines supply chain resilience and medicines security in the context of changing pharmaceutical market dynamics and the ongoing increases in medicines shortages globally”.
“The strategy should incorporate current national policy, ongoing work and existing measures, and create greater alignment in managing shortages across primary and secondary care,” the report added.
Among its 20 recommendations, the report also calls for better demand forecasting and for information to be shared across the supply chain “to prevent stock issues before they happen”, and for pharmacists to have information available to patients on when out-of-stock medicines would be available again.
In a press release published alongside the report, the RPS said that the UK is experiencing a “perfect storm” of unstable medicines supply, leading to patients feeling anxious and frustrated.
In July 2024, The Pharmaceutical Journal reported that 70% of pharmacists said medicines shortages had put their patients at risk during the previous six months.
Then, in June 2024, a survey by the British Generic Manufacturers Association revealed that half of UK adults had been affected by medicines shortages since 2022.
The RPS report has also highlighted that the UK represented just 2.4% of the global pharmaceuticals market in 2023, but has to compete with other developed economies for medicines supplies.
“Community pharmacies are also struggling with an unstable economic model, potentially contributing to local shortages,” it added.
“Just-in-time supply chains can exacerbate supply issues, and a lack of visibility into stock levels in primary care hampers collaboration to manage shortages effectively.”
The RPS said these can combine with other factors, including changes in prescribing practices; for example, guidelines changing to recommend switches to a different medicine, without the allowance of sufficient time for supply chains to adjust.
There have also been surges in demand arising from; for example, greater awareness of the impact of menopause, and increasing numbers of ADHD diagnoses.
Bruce Warner, former deputy chief pharmaceutical officer for England and chair of the RPS advisory group on medicines shortages, said: “Better collaboration across the whole medicines supply chain is needed and improving early reporting of shortages by manufacturers to the Department of Health and Social Care (DHSC) is of critical importance.
“Prompt notice of a supply problem allows time to act, find solutions and produce clear guidance, meaning health professionals are fully informed and patients are saved from delays and confusion that can cause distress and harm to health.”
James Davies, director for England at the RPS, who co-authored the report, said: “Taking a new approach to medicine shortages is essential.
“A properly resourced UK-wide medicines shortages strategy that helps prevent and manage shortages would greatly improve the resilience of the supply chain. This would relieve stress and anxiety for patients and free up time for pharmacists to focus on patient care rather than constantly chasing down supplies.
“Community pharmacists must be allowed to make minor changes to prescriptions during shortages. The current outdated system inconveniences patients, wastes time and causes frustration. The secretary of state for health should give pharmacists the authority to act in the best interests of their patients, rather than remain subject to ‘empty shelf syndrome’.”
Also commenting on the report, Sharon Brennan, director of policy and external affairs at National Voices, a coalition of health and social care charities, said: “Our members report that patients are rationing their medicines to make their supplies last, that deteriorations in health have led to job losses or dropping out of education, and that patients are buying falsified medicines from the internet.
“This is on top of many hours wasted calling round pharmacies to track down medication and the frustration, worry and anxiety felt by those that can’t access their medicines.
“We urge the DHSC to recognise the serious and worsening impact medication shortages are having on patients, and to commit the same level of urgency to improving the situation as it has to other NHS access-to-care issues, such as diagnosis and waiting lists.”
Commenting on the report, Duncan Rudkin, chief executive of the General Pharmaceutical Council (GPhC), said: “This important report shines a light on the complex global issues that are causing medicines shortages. Our council shares the concerns outlined in this report about the significant impact these shortages are having on both patients and pharmacy teams, and has heard first-hand of the frustration, distress and harm that medicines shortages can cause. We fully agree with the report’s conclusion that further action is needed now.
“Although the GPhC has no direct role in medicines supply, we are determined to play our part in the next steps wherever possible, including in educating pharmacy teams about medicines shortages, and supporting them through our standards and guidance when they are facing challenging situations.”
A spokesperson for the DHSC said: “We know how frustrating and distressing medicine supply issues can be for patients.
“This government inherited ongoing global supply problems that continue to impact medicine availability, and we are working closely with industry, the NHS, manufacturers and other partners in the supply chain to resolve current issues as quickly as possible.
“Whilst current serious shortage protocols allow pharmacists to supply alternative medicines, we are committed to cutting red tape and to better using the skills of pharmacists. That includes making prescribing part of the services delivered by community pharmacists.”
