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Drug manufacturers have officially warned the government about potential medicine supply problems 28 times per week over the past five years, according to data analysis by the National Pharmacy Association (NPA).
In findings from an analysis of Department of Health and Social Care (DHSC) figures, published on 9 October 2025, the NPA said 7,426 separate warnings had been made to the government since October 2020 — an average of around four a day — with more than one in five (22%) classified by government as carrying a ‘moderate-to-high’ risk to patient safety.
The warnings — known as ‘discontinuations and shortages notifications’ — are made by manufacturers to formally alert the DHSC to the possibility of disruption to supply of a particular medicine or formulation.
The NPA also conducted analysis of medicine supply notifications (MSNs), which are used by the NHS to notify pharmacies and other NHS providers of supply issues affecting a brand or formulation of a medication.
They discovered a 53% increase in the use of MSNs from 2021 to 2024 — with 85 notifications issued in 2021, compared with 130 in 2024.
As a result, the NPA has called on the government to urgently scrap what it said is “dangerous and antiquated legislation” that prevents pharmacists from making substitutions to prescriptions where a prescribed medicine is out of stock.
Current legislation — dating from 1968 — prevents pharmacists from switching a prescription from tablets to capsules, including the flavour of liquid medication.
Separate research published by the NPA in September 2025 revealed that patients experiencing chronic pain, symptoms of psychosis or high blood pressure were waiting up to three weeks for prescriptions to be amended by their GP, going without medication or having to visit A&E to get the medicine they needed.
In September 2025, the government launched a consultation on giving pharmacists greater dispensing flexibilities, but proposed not to allow pharmacists to make substitutions where there is a MSN in place.
In the consultation document, the DHSC said: “If there are no restrictions as to when pharmacist flexibilities can be used, there is a risk that there is a significant increase in alternatives being supplied to what has been prescribed.
“This makes the supply of each product difficult to monitor by the supply chain and predict future demand. Hence there is a risk over time to the continuity of supply,” it added.
“A particular concern is that pharmacists might frequently use higher quantities of lower strengths of a product as an alternative to a higher strength product.”
However, the consultation added that “pharmacist flexibilities would not be enabled when there is a known serious shortage of a medicine prescribed or the alternative to be supplied, except in limited exceptions … to avoid the risk of causing knock-on shortages and disruption to the medicine supply chain”.
DHSC defines a serious shortage as when a medicine’s supply is being actively managed through the issuing of any or all of:
- A serious shortage protocol;
- An MSN; and/or
- An alert through the central alerting system, including (where these apply) the equivalent arrangements in the devolved governments.
Olivier Picard, chair of the NPA, said: “Shortages frustrate patients and can also pose a serious safety risk, as [these data show]. The legislation that prevents pharmacists from making any amendments to prescriptions was signed into law the same year as the advent of colour television and the Beatles were riding high at number one.
“Although it is good news that government are consulting on this issue, it is critical that both pharmacists and patients reply to this consultation and make clear that ministers cannot simply tinker around the edges when highly experienced pharmacists can get people safe access to the medicines they need.”
Claire Anderson, president of the Royal Pharmaceutical Society, said: “We have long called for pharmacists to be able to use their professional judgement to make safe and clinically appropriate substitutions to help manage medicines shortages.
“We have welcomed the government consultation on this issue and hope it will quickly enable change, to reduce delays for patients, free up GP time and boost NHS productivity.”
A spokesperson for the DHSC said: “We know how frustrating and distressing the medicine supply issues we inherited can be for both patients and pharmacists.
“Though the vast majority of medicines are in good supply, the government has robust processes to ensure patients can access alternative treatments during shortages and we’re working across the system to prevent disruption.
“Pharmacists play a vital role in our mission to bring care closer to home. That’s why we are looking at proposals to cut red tape, giving pharmacists more power to supply alternatives — helping patients get their medicines quicker.”
