For patients’ sake, no-deal Brexit must be avoided

Despite much preparation, crashing out of the EU without a deal throws up too much uncertainty for patients for it to be a viable option.

Empty medicine cabinet

The Pharmaceutical Journal has spent the past few weeks asking pharmacy organisations about their state of preparations for a possible no-deal Brexit at the end of October 2019. The good news is that there seems to have been progress since the previous Brexit deadline of 29 March 2019.

These extra six months have greatly improved Brexit preparations. For example, the UK government has reviewed all of its no-deal Brexit arrangements and has scrapped a plan to use planes to transport urgent medicines, instead putting in place an express freight service with traceable “door-to-door” delivery services in place. The Pharmaceutical Services Negotiating Committee (PSNC), which has taken part in Brexit talks with the government, is upbeat in its assessment.

Simon Dukes, chief executive of the PSNC, said that preparations for the delayed March 2019 exit were a “robust dress rehearsal” and that he was confident the UK is now even better prepared for a no-deal Brexit.

The Royal Pharmaceutical Society is similarly optimistic, with president Sandra Gidley pointing out the government was ensuring “line by line” that sufficient stock is in place and that the only problems that may arise lay with medicines that were already in short supply. But this does not mean that the threat of no-deal Brexit has gone away.

In some ways, it would have been easier to leave the EU at the end of March 2019 rather than October 2019

From a healthcare perspective, in some ways it would have been easier to leave the EU at the end of March 2019 rather than October 2019. Flu season will put additional pressure on a system that NHS leaders are warning is “running red hot” as we approach the busy winter period.

The publication, in September 2019, of the government’s “reasonable worst case scenario” on leaving the EU without a deal is not reassuring reading. It warns that medicine supply chains could experience “severe extended delays” in the event of no-deal, adding that while mitigations are being put in place, some medicines will not be able to be stockpiled because of their short shelf life.

Some manufacturers are even putting in place their own transport solutions, with the Association of the British Pharmaceutical Industry saying that shortages are still possible despite all the contingency planning

Add to this the long-term effect of a no-deal Brexit pulling the plug on UK access to European-wide systems that share information on the safety and veracity of medicines, and you have a worrying amount of uncertainty (See feature, ‘No-deal Brexit: pharmacy bodies question the UK government’s readiness’).

The government has a duty of care to the most vulnerable, and gambling with their health is completely unconscionable

If we are going to leave the EU without a deal, it is time for more clarity. Government non-disclosure agreements for pharmacy organisations are hampering the dissemination of vital information. The Pharmaceutical Journal calls for these to be lifted so that pharmacy professionals can understand how they will access medicines in the event of a no-deal Brexit.

But ultimately, the best course of action is to remove these risks altogether. Even at the best of times, pharmacists are having to cope with multiple medicines shortages and the potential for unforeseen consequences is multiplied in a no-deal scenario. Politics aside, patients must have certainty that their medications will be there when they need them. The government has a duty of care to the most vulnerable, and gambling with their health is completely unconscionable.

Putting together a ‘mini deal’ for medicines has been suggested, and this may be helpful, but the best course of action is to abandon the damaging prospect of no-deal altogether. Looking at all the evidence so far, this looks like the wisest course of action.

Last updated
The Pharmaceutical Journal, For patients' sake, no-deal Brexit must be avoided;Online:DOI:10.1211/PJ.2019.20207069

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