The Government has been forced to intervene formally 50 times in the past two years to authorise the use of alternative drugs because of serious medicine
shortages hitting patients, new analysis by the National Pharmacy Association (NPA) has found today.
78 per cent of all Serious Shortage Protocols, produced by the Department of Health and Social Care (DHSC) due to medicine shortages, were issued in
2022/24 - more than three times the rate in the previous two years.
The NPA, which represents independent community pharmacies in the UK, is warning that shortages are leading to pharmacists having to increasingly turn
patients needing vital medication away.
Analysis by the NPA of the NHS's Serious Shortage Protocols (SSPs) issued to pharmacies and other providers over the last five years has found that:
The number of SSPs issued in the last two years is 3.5 times higher than in the previous two years.
A report released by the Independent Commission has blamed Brexit supply issues for medicine shortages.
NHS is forced to pay extortionate prices to fulfil the demand for vital antibiotics, anti-depressants, Attention Deficit Hyperactivity Disorder (ADHD), and
Hormone Replacement Therapy (HRT) drugs.
The report highlights the impact of affected medicine supply issues on community pharmacies and patients.
Janet Morrison, the chief executive of Community Pharmacy England, backed the report and said that the "medicine shortages and market instability appear to be
as bad as they have ever been".
She also explained how the Ukraine conflict, the COVID-19 pandemic, and broader economic instability also play a major factor in the situation.
There has been extensive national media coverage today (August 11) on how medicine shortages have forced patients to visit multiple pharmacies to get their
prescriptions filled or return to their GP to be prescribed alternative drugs.
These media reports have been based on a survey involving more than 1,500 pharmacists in the UK, in which over a half of those polled said that their patients'
health had been put at risk in the last six months.
In response to a query from Pharmacy Business, the Department of Health and Social Care (DHSC) said it monitors the medicines supply chain closely to prevent any
shortages and acts swiftly when any issue arises.
A DHSC spokesperson told Pharmacy Business: "We take patient safety extremely seriously and we routinely share information about medicine supply issues directly
with the NHS so they can put plans in place to reduce the risk of any shortage impacting patients, including offering alternative medication.
People who use pharmacies in parts of Pendle have suffered shortages or delays in buying prescription medicines such as insulin, councillors have been told.
In the Barnoldswick area, a number of pharmacies have been impacted and some councillors hope a new regional NHS organisation might look into the problems.
However, pharmacies in the neighbouring town of Nelson are facing shortages with other medicines. A pharmacists in Nelson Pharmacy told Pharmacy Business that he
was struggling to meet local demand for children's paracetamol due to ongoing shortages.
Pendle Council's West Craven Area Committee heard about the issues at its latest local meeting, held in Earby.
An agenda for the committee stated: "Pharmacy provision in West Craven. It is reported that there is an acute problem with people being unable to get prescriptions
filled, with Whitworth chemists suffering a breakdown in service. Previously, Well chemists has suffered similar problems."
Speaking at the meeting, Lib-Dem Coun David Whipp said: "It's quite an appalling situation where people are queuing 30 minutes to get a prescription filled but when
they get to the counter they are told it's not ready. They have to go home and come back at 5pm. It's an ongoing problem.
"It includes insulin, which is critical for people with diabetes. I know several people who have failed to get insulin, It's a very serious problem."
He added: "I think the committee should contact the local integrated care service. I think they are responsible for primary care which includes pharmacies. We need
to find out what's happening and improve things in future. "
The British Generic Manufacturers Association (BGMA) has raised concerns over the rise in the VPAS rate for 2023 to 26.5 per cent.
The Department of Health Social Care (DHSC) today announced that the 2019 voluntary scheme payment percentage for 2023 will be 26.5%. The 2019 voluntary scheme
for branded medicines pricing and access is an agreement between the Department of Health and Social Care, NHS England and the Association of the British
Pharmaceutical Industry.
BGMA believes that the high VPAS tax for 2023 risks more medicines shortages, rising prices for the NHS via reduced competition, and new medicine launches to the
UK being deferred.
Mark Samuels, Chief Executive of BGMA, said: "Raising the VPAS tax to 26.5% will damage the UK's medicines supply because it will make some products lossmaking. It
is more than a five-fold tax increase from 2021, and no industry can cope with this unpredictable and exceptional tax volatility.
Staff shortage has begun to bite the community pharmacy sector with several high street pharmacies closing doors due to workforce crisis triggered by the NHS poaching.
More than 200 pharmacies closed last year and several are reducing their hours, posing a significant risk to patients' access to care, medicines and advice.
Many in the industry have raised concerns related to workforce crisis and warned that plans for community pharmacies to help ease pressure on GP surgeries could also take a hit.
The NHS plans to recruit a total of 6,000 pharmacists in England by 2024, equivalent to nearly three full years of new pharmacists.
Since 2019, 3,000 pharmacists have been recruited into NHS primary care networks, which accounts for around 10 per cent of the community pharmacist workforce.
People are advised to be prepared and order their repeat prescriptions in time so that they don't run out of their routine medicines over the Christmas and
New Year break when services are likely to be busier than normal.
As GP practices will be closed over the bank holidays and only some pharmacies will remain open, local NHS leaders have urged patients to plan ahead to avoid making
last-minute requests for collecting repeat prescriptions, which can add avoidable pressure for doctors, pharmacies, and other NHS services.
Sati Ubhi, Chief Pharmacist at NHS Cambridgeshire & Peterborough, have cautioned patients that running out of their usual medication can have serious consequences.
"By ordering medicines as soon as possible, it allows enough time for it to be processed and dispensed and helps avoid a last-minute rush," she told Fenland Citizen.
A combination of factors, including the doctors' strike, medicine shortages, and funding scarcity, indicates that this upcoming winter could be the most
challenging period for both community pharmacies and the NHS, Community Pharmacy England has said.
In a September 4 blog post, CPE Chief Executive Janet Morrison emphasised that the relentless pressures show no signs of easing. "Pharmacy businesses, like
numerous other sectors, are grappling with the challenges of staying afloat in the current economic climate, compounded by the detrimental effects of historical
funding cuts."
"The doctors' strike, despite ongoing assurances from the Health Secretary that their pay deal is final, will inevitably exacerbate the demand for both primary
and secondary care, leading people to turn to their local pharmacies for assistance," she added. "This, in turn, will heighten the pressure on community pharmacies."
"Whatever the coming winter brings I am sure of two things: that community pharmacies are going to be more critical to the health of the population than ever
before, and that your representatives here will be fighting on all fronts to get you the help that you need."
The ongoing pharmacist workforce crisis has posed a significant risk to patients' access to care, medicines and advice - particularly affecting the elderly and vulnerable living in areas with health inequalities.
Many from the sector have raised concerns about this issue with the Company Chemists' Association (CCA) recently acknowledging the shortage of pharmacists or pharmacy technicians in the country to meet the needs of patients and the NHS.
The trade body representing almost 50 per cent of the community pharmacy sector said that pharmacy teams are exhausted after working tirelessly during the pandemic,
adding that Covid, Brexit and NHS reforms have exacerbated the shortage.
Covid and winter-related sickness absences are adding to the strain and with Brexit it has become difficult to attract overseas pharmacists to the UK.
harmacists in the town of Barnoldswick in Lancashire are reportedly suffering from various problems including a lack of medicines and the movement or loss
of pharmacy staff.
Problems, including delays with supply of insulin, were reported at a recent Pendle Council West Craven meeting.
And this week the head of one pharmacy chain, Whitworth, highlighted a range of issues faced by his teams including supply chains, costs, loss of staff and NHS
reimbursement for contractors.
In Barnoldswick, queues have formed inside and outside pharmacies as people attempt to get prescriptions. Some said they had to wait for days to get what they
needed, had made repeat-visits to pharmacies and were unsure when medicines might arrive.
They also said the number of pharmacies in the area have fallen over the years.
Two town centre pharmacies, Whitworth and Well, are located opposite each other, close to a doctors' surgery. Standing in one queue outside Whitworth was Marilyn
King.
She said: "I have been waiting seven days to get my prescription for blood pressure and some other medicines. This week, I've come back time after time. But the
staff say sorry, they have not got it in because nobody has delivered it.
"I came here on Saturday, when there was a queue. But the pharmacist was not here. I came again on Tuesday and then Wednesday. Then finally, just when I reached
the front of the queue, they asked me to come back in an hour…
Considering the shortage of Fluoxetine 10mg tablets, the Department of Health and Social Care (DHSC) has extended the serious shortage protocol (SSP) for the medicine to February 11, 2022.
Earlier the SSP for Fluoxetine 10mg tablets was set to expire on November 12.
Extension of the transition period will enable use of No Cheaper Stock Obtainable (NCSO) endorsement and use of EPS tokens to claim for supplies made in accordance
with SSPs.
The NHS Business Services Authority (NHSBSA) has accepted that either the new 'SSP' or existing 'NCSO' endorsement for any SSP claims can be submitted using electronic prescriptions (EPS) tokens of FP10 paper prescriptions, during the period.
The Royal Pharmaceutical Society (RPS) on Wednesday announced that it is spearheading a new project, which aims to delve into the root causes of the
growing challenge of medicines shortages across the United Kingdom and provide solutions to mitigate its impact on patients and pharmacy practice.
A newly formed advisory group, chaired by RPS Fellow Dr. Bruce Warner, is set to convene later this month. The group will have experts from primary and secondary
care, patient advocacy groups, the pharmaceutical industry, suppliers, regulatory bodies, governmental representatives, and NHS officials.
The group aims to formulate a robust report to provide expert thought leadership and support for the wider debate on UK policy. Their work will be informed by a
thorough literature review, stakeholder interviews, online RPS member events, and patient stories.
Community Pharmacy England (CPE) has cautioned that patients in the UK will continue to encounter difficulties in accessing medicines unless the government
addresses supply problems and resolves the critical financial state of community pharmacies.
CPE Chief Executive Janet Morrison and Mike Dent, Director of Pharmacy Funding, on Monday 19 February, gave evidence to the Health and Social Care Select
Committee's Pharmacy Inquiry, highlighting the impact of ongoing medicines supply issues on pharmacies and patients.
Morrison indicated that a combination of the ongoing "financial squeeze, operational pressures, and medicines supply and pricing issues" has left pharmacy
businesses fighting for survival.
"As the NHS continues to grapple with wider challenges, this is a battle that patients cannot afford for pharmacies to lose," she said.
Morrison warned that if pharmacies continue to close, not only business owners and pharmacy teams will suffer, but patients and local communities will also
face the consequences.
A Lake District pharmacy is grappling with significant medication supply issues, affecting its ability to provide essential drugs to customers amidst
nationwide drug shortages.
According to Simon Butterworth, whose family has operated Collins & Butterworth Pharmacy in Hawkshead for nearly 40 years, voiced his concerns to the ITV stating
that the staff is "having to spend time hunting for (medications), looking for it or doing our best to find ways to solve that problem" for distressed patients.
"They've got to know when they can get the medications they need," he added.
Butterworth also highlighted the financial strain pharmacies face due to the NHS's fixed tariff system.
"Certain items are actually costing more to buy than we get paid for them by the NHS. An item we were trying to get this morning was 250 per cent higher than the
tariff price, which is significant and builds up over lots of items," he explained.
The Royal Pharmaceutical Society (RPS) England Chair Thorrun Govind has called for Government action to support pharmacy teams experiencing huge demand for
their services.
"Pharmacy teams are under immense pressure at the moment, in common with other NHS services, and working extremely hard with health service colleagues to provide
the right care for patients," said Govind.
"As winter pressures mount, pharmacies see increased numbers of patients seeking support with illness and also because they have heard other areas of the health
service are struggling to cope.
The society has also stated staffing pressures, alongside an increase in workload has created an extra burden which takes a toll on the wellbeing of pharmacy teams.
Govind added: "Issues such as medicine shortages can also take up many hours of time for pharmacy teams tracking down medicines when they could be directly helping
patients. In community pharmacies, rising costs and fairly static funding are adding to business pressures.
"However, pharmacies remain the most accessible part of the health service and provide expert advice to patients without the need for an appointment and are open
long hours and at weekends."
The Department of Health and Social Care (DHSC) has notified pharmacies over the shortage of Buserelin (Suprefact) 5.5mg/5.5ml solution for injection vials
is out of stock until mid-August 2022.
Limited supply of Buserelin (Suprefact) 5.5mg/5.5ml solution for injection vials remains available in NHS Trusts and health boards.
Buserelin (Suprecur) 5.5mg/5.5ml solution for injection vials are currently available, however, this stock is short dated (expires end of July) and further stock
is expected mid-August 2022.
Buserelin (Suprecur)150microgram/dose nasal spray is out of stock until late-December 2022. Limited supply remains available in NHS Trusts and Health Boards.
Nafarelin (Synarel) 200microgram/dose nasal spray remains available but is currently unable to support an uplift in demand (until mid-August 2022 when it can
support a partial uplift in demand).
Amid the ongoing furore over shortages of Lateral Flow Device (LFD) test kits that led pharmacy staff to bear customers' wrath, the National Pharmacy Association (NPA) and Company Chemists Association (CCA) have jointly appealed the public to be "patient and courteous to pharmacy teams".
In an open letter, the two organisations have urged patients and customers to be patient, courteous and safe while visiting their local pharmacies.
Highlighting the efforts put in by healthcare workers to keep everyone safe through this tough winter, the two organisations said the pressure of Covid-19 and shortage of LFD kits have sometimes led to verbal abuse of pharmacy staff.
Mark Lyonette, NPA chief executive said: "The vast majority of pharmacy customers and patients are polite and understanding. The supply situation with Lateral Flow Tests is stretching people's patience, but that's no excuse for abusive behaviour and people need to understand the constraints on pharmacy teams at this time."
Alongside their routine job of providing medicines, health advice and a range of NHS services, pharmacies have put in extra effort to protect people during the pandemic.
he Healthcare Distribution Association (HDA) and the Pharmaceutical Services Negotiation Committee (PSNC) have urged the NHS England and the Department of
Health and Social Care (DHSC) to issue urgent communications requesting that all those involved in medicines supply do not hoard, stockpile or over-prescribe Strep
A antibiotics.
In a statement HDA said that the sudden spike in demand for antibiotics used for the treatment of Strep A has meant that there is not enough of these medicines in
the supply chain currently to meet this increased demand. As a result, wholesalers are working extremely hard with manufacturers to increase the supply of antibiotics.
It added: "As regards pricing, the prices charged to pharmacies by HDA wholesale distributors will directly reflect the increase in prices wholesalers are having
to pay for these medicines from manufacturers at the moment, in order to be able to continue supplying these medicines to pharmacies. This will be the case until
supply and demand are more in sync."
In the parliamentary drop-in-event hosted by Community Pharmacy England last week, Members of Parliament (MPs) questioned the Health Secretary on the rising
issue of medicines supply.
"Eighteen community pharmacists in my constituency are reporting challenges on medicine supplies. What more is the Minister going to do to get a grip of this
situation?", Mike Amesbury MP for Weaver Vale, who was present at the event last week, asked the Health Secretary.
In his response, the Health Secretary, Steve Barclay MP said: "We have a long-standing team in the Department focused on medical supplies, which are a continual
issue; as a matter of routine business, there are often challenges in that area."
The Shadow Pharmacy Minister, Karin Smyth MP, also asked: "People across the country rely on local, accessible pharmacies, but whether it is high street closures
or supply problems leading to the absurd situation where women are phoning or visiting multiple pharmacies for a prescribed dose of hormone replacement therapy and
other drugs…They have repeatedly announced plans to expand the role of community pharmacies but have failed to update legislation that could possibly help. … Why
will they not do so?
The Royal Pharmaceutical Society (RPS), professional membership body for pharmacists and pharmacy, has published its manifesto for the general election,
highlighting key issues facing the next government after the election on July 4.
Local candidates are urged to recognise and support the vital role pharmacists play in supporting people's health.
The RPS teams are gearing up to influence government policy in various crucial areas. Their key asks include:
Ensuring Secure Patient Access to Medicines
Supporting a Better-Connected NHS
Enhancing Accessible Prescribing in Local Communities
Maximizing Health Improvement through Locally Accessible Pharmacy Teams
Supporting the Workforce to Deliver Patient Care
Unlocking the Potential of New Advances in Medicines
Supporting the UK's Global Position in Science and Research
Acknowledging the efforts of pharmacists and their teams, Professor Claire Anderson, President of the RPS, noted that they are "working incredibly hard to
maintain patient access to care amid workforce challenges, medicines shortages and financial pressures."