NHS patients are experiencing some of the most severe shortages of medicines on record, including common painkillers, epilepsy drugs, and hormone replacement therapy (HRT), health leaders have warned. The shortages have forced some patients with impaired digestive systems to skip meals.
Serious Risk to Patient Safety
The National Pharmacy Association (NPA) has warned that medicine shortages pose a serious risk to patient safety. The Royal College of GPs has also raised concerns about the impact on patients, GPs, and pharmacists.
Both organizations have highlighted long-lasting supply issues affecting Estradot, an HRT for menopausal women, and Creon, a drug taken by people with pancreatic cancer and cystic fibrosis to aid digestion. These medications have had serious shortage protocols (SSPs) in place for between one-and-a-half and two years, a new NHS record. SSPs were recently extended by the NHS until July 10. They were introduced by the Department of Health as an emergency short-term measure to manage shortages.
Patients Forced to Ration Medication
Pharmacies report that some patients are rationing medication and, in some cases, skipping meals due to inability to obtain supplies. Bryony Thomas, 48, from Stroud, Gloucestershire, a pancreatic cancer survivor, relies on Creon for life. She has been affected by shortages for two years and had to ration the drug, most recently nine months ago. She continues to ration unless she can share medication through patient groups on social media.
“There was a three-month window where I couldn’t get hold of my enzymes [Creon], so I had to reduce what I was eating. You’d have a much smaller meal, you eat less protein, you eat less fat,” Thomas said. “If I get anything down to under a month [of supply] I start to panic.”
Her mother-in-law makes four-hour round trips to the only pharmacy in Crewe, Cheshire, where the medication is available. Thomas calls for a central distribution mechanism to pool Creon supplies left by deceased patients, as current stocks are destroyed. “It’s really stressful; you’re on the phone for just hours, you’re driving around [to visit pharmacies], and all the patients are having to do this day in, day out,” she added.
Common Medicines Affected
Pharmacies struggle to source commonly dispensed medicines like Ramipril (for high blood pressure) and painkillers such as low-dose aspirin and co-codamol. The NPA cites the Middle East conflict as a factor in supply chain volatility, but not the sole cause. Lack of ingredients, manufacturing disruption, the UK’s smaller medicines budget compared to other EU countries, and changing prescribing habits for HRT also contribute. Prices of some drugs, including paracetamol and cetirizine for hay fever, have increased.
Call for Urgent Taskforce
The NPA, representing 6,000 independent community pharmacies in the UK, urges the government to convene an urgent taskforce including medicine manufacturers, wholesalers, and clinicians. Over 1,000 GPs and pharmacists will meet in Birmingham at a new NPA conference this weekend to discuss improved information sharing about medicines.
Pharmacists and GPs spend significant time managing shortages: pharmacists source scarce drugs, while GPs alter prescriptions to fit supply issues, causing patient inconvenience and worry.
Olivier Picard, NPA chair and pharmacist, said: “Medicine shortages are becoming more frequent, lasting longer and causing increasing disruption for patients. These shortages are some of the most severe the UK has experienced. It is deeply distressing to find patients who have travelled from pharmacy to pharmacy to find the medicines they need without success.” He added that shortages are “frustrating and worrying” and “in some instances they pose a serious risk to patient safety.” Picard called for legislation allowing pharmacies to substitute prescriptions with safe alternatives.
Prof Victoria Tzortziou Brown, president of the Royal College of GPs, said: “Medicine shortages can be frustrating for patients, GPs and pharmacists alike, especially when patients have to endure lots of back and forth to acquire a suitable alternative … It’s essential that when shortages occur, the underlying causes are quickly identified and resolved.”
A Department of Health and Social Care spokesperson said: “The overwhelming majority of medicines licensed in the UK are in good supply and patients should know that when visiting the pharmacy, their prescriptions will be available. Ensuring there is robust supply of medicines is vital and this government is making significant investments in the UK medicine manufacturing industry to strengthen it.”
