GPs require improved communication about medicines shortages, Lords warn

Medicines shortages in the UK is a national security issue that should be given more priority, a report from the House of Lords has warned.

Chief among its recommendations is for shortages to be better communicated to GPs to enable them to support patients.

The Government is not proactive in protecting the UK from fragile supply chains despite the ‘significant risk to people’s health’, the report found.

Instead, it relies on reactive action once medicines shortages have already happened.

And the Department of Health and Social Care provides little oversight or leadership regarding medicine stocks in the UK, nor the potential risks against critical medicines, ‘whose absence would have significant impact on patients should they be in short supply’, it said.

There is also a lack of communication to GPs, pharmacists and other frontline staff about both shortages and solutions, the House of Lords Public Services Committee concluded.

As well as undermining patient care, medicines supply disruptions place additional pressure and cost on the NHS including GP practices, it said.

It comes amidst increasing concerns about ongoing issues with medicines shortages, including pancreatic enzyme replacement therapy, HRT, and rheumatology, diabetes and epilepsy drugs.

The majority of active ingredients required for medicines used by the NHS are controlled by China and India or other single sources, the committee found.

And while 80% of medicines prescribed in the NHS are generic and could be made by any manufacturer, only a quarter are produced in the UK.

The committee heard that medicines supply notifications are not integrated into GP systems so they may be unaware of issues when prescribing.

The Government needs to improve how it shares information about shortages and availability with GPs, hospitals and pharmacies, the report found.

Medicine supply should be included in the Government’s National Risk Register, with regular preparedness exercises to practise for large-scale medicine manufacturing issues.

And more must be done to boost the UK manufacture of generic medicines and ingredients used by the NHS, it recommended.

Last year, a committee of MPs found that medicines shortages in England have escalated from being isolated incidents to ‘a persistent challenge’ with ‘significant consequences for patients.

Baroness Morris of Yardley, who chaired the inquiry, said the DHSC had not been particularly proactive in tackling medicines supply issues.

‘There is a general lack of oversight and leadership to address current shortcomings across the medicines supply and manufacturing process.

‘We’ve set out a number of recommendations in our report which should help tackle the issues raised.

‘Chief amongst these is the need for better communication of any shortages to GPs, hospitals and pharmacies so they can take necessary action to support patients and more importantly, the recognition that medicines supply chain resilience is a national security issue that should be on the national security risk register and prioritised accordingly.’

‘There needs to be senior government oversight of the issue with cross department coordination so that necessary action can be taken to both tackle issues when they occur and head off issues by taking timely preventative measures.’

Dr James Davies, director of research and insights at Community Pharmacy England, and who gave evidence to the inquiry said the report was ‘yet more clear evidence of the escalating medicines supply crisis’.

Their data shows one in four community pharmacy teams are spending more than two hours a day sourcing alternatives for their patients.

‘We cannot let persistent shortages become business as usual.’