Medicine shortages in England ‘beyond critical’, pharmacists warn

Medicine shortages in England are now so critical that patients are at risk of immediate harm and even death, pharmacists have warned.

The situation is so serious that pharmacists are increasingly having to “pay debts” to patients – telling someone that only part of their prescription can be filled and asking them to come back later for the rest, once the pharmacist has collected the rest .

According to Community Pharmacy England (CPE), which published the report, hundreds of different medicines have become difficult or impossible to obtain. Widespread and often long-lasting shortages posed “immediate risks to the health and well-being of patients” and caused suffering, the report said.

“The drug supply challenges facing community pharmacies and their patients are beyond critical,” said Janet Morrison, CEO of CPE. “Patients with a wide range of clinical and therapeutic needs are affected on a daily basis and this goes well beyond discomfort, leading to frustration and anxiety and impacting their health.

“If some patients do not have access to the medicines they need, this can lead to very serious consequences, even requiring them to go to the emergency room. Medicine shortages lead to delays in obtaining timely access to certain critical or potentially life-saving medicines.”

In recent months, important medications for the treatment of type 2 diabetes, ADHD and epilepsy have become unavailable. Last year there were shortages of HRT, adrenaline and antibiotics.

James Davies, director of the Royal Pharmaceutical Society for England, said: “Drug shortages are disrupting the treatment of some patients and destabilizing their health.”

Drug manufacturers, wholesalers and suppliers needed to work more closely with ministers and the NHS “to ensure a more stable supply of medicines”, he added.

CPE, which represents the 10,500 community pharmacies in England, based its findings on a survey of the views of owners of 6,100 pharmacy premises and 2,000 employees. It found:

• 79% of pharmacy staff said drug shortages were endangering patients’ health.

• 91% of pharmacy owners had seen a “significant increase” in the problem since last year.

• 99% of pharmacy employees discovered that a medication was unavailable at least weekly, and 72% encountered it several times a day.

Pharmacists face abuse and hostility from patients who are frustrated and angry because they cannot get their prescribed medications.

“Most people are very understanding, but they are worried and scared, and inevitably that sometimes boils over and people take it out on us,” says Fin McCaul, the owner of an independent community pharmacy in Greater Manchester. “We’ve had patients who were irritated and angry, and there were times when people spit at us. I regularly see the staff burst into tears at the end of the day because of the enormous pressure this all brings.”

In total, 84% of pharmacy staff have experienced aggression from patients, according to CPE.

Experts say global supply and production problems have contributed to medicines becoming unavailable. But Morrison added: “Low drug prices have made Britain a less attractive market for manufacturers and this is contributing to reduced supply chain resilience.”

In a major report last month, the Nuffield Trust think tank warned that medicine shortages had become a “new normal” and were being exacerbated by Brexit.

Mark Dayan, leader of the Brexit programme, said: “Almost every available indicator shows that we have faced once-unthinkable levels of medicine shortages again and again since 2021. The crisis jumps back and forth between products and circumstances, with no signs of slowing down.”

While other Western countries such as Italy and Germany were also hit by supply disruptions, Brexit creates some additional obstacles for Britain as our market is now partially separated from the wider European supply pool, Dayan added.

Other medications that are still in short supply include insulin, which people with type 1 diabetes must take, and the liquid form of salbutamol, which is used to tackle severe breathing problems in asthmatics.

A Department of Health and Social Care spokesperson said: “There are around 14,000 approved medicines and the vast majority are in good stock. Supply issues can arise for a variety of reasons and are not specific to Britain.”