Claire Ward, the director of public affairs at the Pharmacists’ Defence Association (PDA), has said she fears community pharmacies could struggle to get hold of medicines with Brexit looming because some wholesalers may not adequately supply them, instead favouring their “vertically-integrated and owned” pharmacies or “best customers.”

Warning community pharmacists are “no longer in control of the supply of medicines to their patients,” Ward (pictured) said that while the government’s instruction last year to pharmacies not to stockpile medicines was understandable, if they do not stockpile they may not be able to rely on some wholesalers to get products to them.

“When the secretary of state for health and social care was asked about concerns for the availability of medicines, his view was that all will be fine as long as MPs support (Theresa May’s) deal. He urged pharmacy, individuals and business to get behind the (prime minister) to create the much needed certainty. But is that really the case?” Ward told ICP.

“Pharmacists are being placed between a rock and a hard place. Whatever their view on Brexit, the reality is that they are no longer in control of the supply of medicines to their patients.

“They can’t guarantee that there will be availability and equally important, they can’t guarantee the price even if there is availability. So pharmacists will end up having to pay higher prices to supply patients, even when full reimbursement of costs may not be agreed by (the Department of Health and Social Care).

“Right now, independent pharmacists are trying to work out what to do. They have been told not to stockpile and are at risk of investigation if they do. (That is) understandable as the impact of a herd mentality will do much greater damage overall and create earlier and possibly longer shortages.

“But if they don’t stockpile, some wholesalers may not give them adequate supply, perhaps favouring their own vertically-integrated and owned community pharmacies or their best customers. Even if they can get supply in due course, they will be conscious of the costs rising.”

Ward added: "It is all well and good for the secretary of state to ask community pharmacy to support the Brexit deal but few will link their own views to the reality of the situation they are dealing with on a day to day basis. Independent pharmacists feel powerless and at the mercy of the political storm in Westminster and Brussels."

When contacted by ICP, Martin Sawer, executive director of the Healthcare Distribution Association which represents pharmaceutical wholesalers, said: “If these reported comments are correct, then they would appear to demonstrate a misunderstanding of how large automated medicines distribution warehouses operate in practice.

“I would like to offer Claire the opportunity to visit a large wholesaler's service centre to see the orders from all types of pharmacies, from individual independents to large integrated chains, being dealt with in a matter of seconds. There can be no intervention to favour one order over another in these highly automated processes.

“In fact, the issue of real concern should be if we get to a no-deal Brexit scenario, which I very much hope we do not, then all players up and down the medicines supply chain must be able to work together to agree protocols to ensure patients receive the vital medicines they require.

“That is why HDA is a member of the Pharmacy Brexit Forum, which meets regularly with the (Department of Health and Social Care).”

Ward, a former Labour MP, said May’s struggle to force her European Union withdrawal deal through parliament “should concern us all” given the growing uncertainty around the supply of medicines into the UK. The government today lost by 11 votes in the Commons as it attempts to push ahead with the deal.

“The government’s no-deal preparations should concern us all. Just a matter of weeks away and we have no certainty about how medicines will come into the UK if we have exited without a deal,” Ward said.

“The possibility of a dedicated port simply to receive freight ships full of medicines is being discussed but I can’t help remain concerned about supply. We already have some significant shortages and we haven’t even agreed on a Brexit deal or no deal.”

The government has been consulting on proposals to allow pharmacists to substitute prescriptions without contacting patients’ GPs and dispense reduced quantities of medicines as it seeks to avoid a shortage post-Brexit.

Ward said it was “a shame” it had taken “this sort of national crisis to recognise that pharmacists should be given greater power to make decisions in the best interests of patients.”

She added: “But like most policy changes which are Brexit-related, they have their origins in a knee-jerk reaction to the risks being posed. It will of course be pharmacists that are answering to patients when medicines are not available and substitutions are made.”

Ward said the PDA “will be making the case for very clear lines of responsibility to ensure that pharmacists are not at the brunt end of these changes.”