‘We are busy fighting fires in the background’: pharmacists are facing a record shortage of medicines

a A survey of thousands of pharmacists has found that patients’ health is being put at risk by record medicine shortages in England, leaving patients and pharmacists frustrated as they cannot get the medicines they need.

“I just feel like the government and the NHS are not taking this seriously enough as we are quietly putting out fires in the background,” said Reena Barai, who owns and runs a pharmacy in south-west London. “They don’t realize the impact of this. Is it necessary for patients to die without medication before they wake up and realize that this is a very serious problem that needs to be solved?”

Barai is far from alone. Ian Strachan, owner of four pharmacies in the North West, says: “If you use an inhaler, you need that inhaler; if it is insulin, then you need that insulin. If patients go without medication now, they risk exposing themselves to more complications.

“I have had patients who were hospitalized because of the fear and stress of the uncertainty of finding their medications.”

“We shouldn’t put patients under this stress, they are already sick,” agrees Fin McCaul, an independent community pharmacy owner in Prestwich, Greater Manchester. “Worrying about whether their tablets will be there doesn’t help them get better.”

Anil Sharma, who runs eight pharmacies in Cambridgeshire and Suffolk with his wife, says he has never seen anything like it. “I have been a pharmacist for 25 years, but I have never experienced so many shortages as now. On any given day, up to 10% of the medications we order may not be available.”

The problem, McCaul says, is that patients are increasingly taking out their frustration at pharmacies like his: “In most cases it’s yelling, cursing, banging their fists on the counter, throwing things.”

In rarer cases it leads to physical violence. “I recently had a patient who was so aggressive that she almost punched one of my pharmacy assistants because we didn’t have her medication,” says Sharma. “The other people in line had to restrain her.”

The aggression can be very disturbing to the staff trying to help them. McCaul says his staff was occasionally spit on when medications were not available for patients. “It makes the team tense all day: it’s like walking on eggshells,” he said. “I regularly see employees bursting into tears at the end of the day because of the enormous pressure this all brings.”

Many pharmacists say the price the NHS is willing to pay for medicines is too low. “A big fat KitKat costs about 85 cents in a supermarket,” says Sharma. “Twenty of the 100 most common medicines prescribed by GPs cost the NHS less than 85p.” Other countries pay much more.

Barai says a special task force is needed to investigate drug shortages, bringing together manufacturers, wholesalers, pharmacists and doctors. In the meantime, a short-term solution would be to make it easier for pharmacists to switch patients to appropriate alternative medications without having to get a new prescription. Currently, they must get a new prescription to dispense an identical medicine in liquid form if the GP had asked for tablets, or an ointment instead of a cream.

“I’m a pharmacist, I should just be able to exchange a product that I know is the same in concentration, strength and drug,” she says. “Only the wording is slightly different. Why can’t I change it myself? Why do I have to go back to a doctor for a prescription? It just seems stupid.”

At Prestwich, McCaul says 99.9% of patients are fantastic, and even those who abuse realize pharmacists are not to blame. “If someone becomes violent or abusive, we will lock him or her out of the store. When someone is abusive, they often come back later and say, “I’m really sorry,” and take a box of chocolates or something. Because they know they did something wrong. They know that we are trying to help them and that if there is a problem, it is rarely our fault.”