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Shortages have been awful but government progress has been slow


Shortages have been awful but government progress has been slow

Over the last few weeks, the national media has become increasingly focused on the risks that Brexit will bring to continuity and security of our medicines supply.

As another Brexit deadline passes and we hurtle towards the next one, navigating a general election on the way, this is a problem that the media have only barely touched on in terms of understanding its broader implications and consequences.

Now Halloween has passed, Boris Johnson is focused on winning an election and implementing the withdrawal agreement on December 31. Imagine a busy pharmacy over Christmas with the added pressure of people rushing to get prescriptions for fear of going short.

It’s clear that yet again, these things are not part of the thought process – just short-term political headlines.

Serious shortages are already a major concern for pharmacy. The latest survey by the PDA shows pharmacists are spending more time sourcing medicines and often unsuccessfully.

There is a range of factors, from API shortages to manufacturing problems in China, much of which have absolutely nothing to do with Brexit. Ninety per cent of those surveyed believed shortages had worsened in the last 12 months.

More time is being spent chasing wholesalers in search of stock at a reasonable price. Indeed, 62% said they were spending at least an hour every day on just that. That is the tip of the iceberg.

Several pharmacists said more staff are having to be deployed to source medicines or deal with the consequences of non-availability and prescriptions are being referred back to GPs to change to alternatives.

There is little confidence amongst pharmacy staff that this is going to improve any time soon.

A recent debate in parliament showed MPs had started to hear about the problems caused by shortages. Prompted by a poster campaign to encourage patients to contact their MPs, the debate was more informed about the impact this is having on patients and pharmacists.

A quarter of those who responded to the PDA survey said they were aware of patient harm as a result of shortages.

Many were able to comment on specific examples where patients have had to be given alternative medicines such as a different manufacturer of blood pressure tablets which have not been completely suitable and caused complications including falls.

What came out in the survey is the stress all of this is placing on pharmacists. When patients do not get their medicines, some of them are taking it out on the pharmacist. We have had reports of shouting and abuse at staff. Furthermore, 81% said shortages are likely to get worse in future.

Employers will have to think about how they support their staff and provide sufficient staffing to cope with the extra demands placed on a pharmacy as a result of shortages – whether through sourcing alternatives from wholesalers or dealing with GPs and patients and changing the prescriptions.

All of this takes time and resource. Right now it is staff, or independent contractors, that are bearing the brunt. The PDA’s job is to represent pharmacists and that includes reminding employers they have a duty to avoid putting their staff at risk.

While the government spent about £100 million in advertising and preparing the country for a no deal Brexit on October 31, it has monumentally failed to use its Brexit preparations to solve some longer-term issues on medicine supply.

Our survey also showed huge support for a de-prescribing service that should be operated by patient-facing pharmacists to reduce the demand for medicines. The PDA called on the Treasury to use some of its Brexit preparation funding to assess patients’ medicines use as part of a broader review, which would help to manage demand and preserve limited supplies.

The government told us it is looking at this but progress has been painfully slow.

When, or if Brexit happens, this country will need better preparations for shortages, which may be for a range of reasons. We need to think more long-term and reduce the dependency on certain drugs where we can.

That would be better for patients and better for the Treasury.



Claire Ward is director of public affairs at the Pharmacists' Defence Association.



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