Persistent medicines shortages affecting health outcomes, MPs warn

Medicines shortages in England have escalated from being isolated incidents to ‘a persistent challenge’ with ‘significant consequences for patients, a group of MPs has warned.

People with chronic conditions are particularly impacted by shortages which can lead to treatment delays, rationing and adverse health outcomes the All-Party Parliamentary Group on Pharmacy found.

Shortages of medicines for conditions such as ADHD, the menopause, diabetes and bacterial infections have also substantially increased workload and stress for pharmacy teams and other healthcare professionals, a report from the APPG said.

A ‘complex interplay’ of factors that include manufacturing issues, supply chain vulnerabilities, increased demand, and geopolitical events have all contributed to shortages, the group of MPs said.

Yet while there are steps in place to try to tackle shortages, more coordination and investment is needed for ‘meaningful impact’ they conclude.

Among a series of recommendations included in the report was a call for a UK-wide medicines shortages communication and patient support strategy as well as patient-centred pathways for managing shortages in local systems.

Pharmacists should also be able to make dose and formulation substitutions during shortages rather than having to go back to the GP to prescribe an alternative, the report added.

Work is also needed to foster domestic medicines manufacturing capacity, especially around critical medicines.

And procurement contracts should reward ‘continuity of supply and include clear quality and resilience measures’, the MPs recommended.

It is estimated that in 2022/23 the NHS incurred £220 million in additional costs as  a result of supply shortages.

‘Medicines shortages are a now a daily reality significantly affecting pharmacists, GPs, and prescribers,’ the report found.

‘Not only are they disrupting patient treatment plans but shortages are also creating logistical and emotional burdens for healthcare professionals as they navigate supply chain complexities, manage patient expectations, and address the clinical risks of delayed or alternative therapies.’

It pointed to a survey of GPs which found 75% of them reported facing shortages on a daily basis which could take up at least an hour every day, with some reporting more time wasted.

Shortages have also led to frustrations and tension between GP practices and pharmacies and conflict in the management of patients requiring specialist treatment, the report added.

Steve Race, chair of the APPG on Pharmacy, said: ‘Medicines shortages have moved from isolated incidents to a chronic structural challenge for both the NHS and pharmacy sector. 

‘As government continues to recognise and invest in the expanded clinical role of community pharmacy, we must ensure the medicines supply chain underpinning that care is equally robust, resilient and patient-focused.’

Janet Morrison, chief executive of Community Pharmacy England, said the inquiry from the APPG on Pharmacy was yet another strong piece of evidence highlighting the medicines supply situation.

‘Medicine supply issues are a constant worry for community pharmacy teams up and down the country.

‘This is a longstanding issue that must not become the new norm. It is simply unacceptable, and without decisive action, we risk these challenges persisting for many more years to come.’

Duncan Rudkin, the General Pharmaceutical Council’s chief executive, said: ‘We have heard first-hand about the damaging impacts of medicines shortages.  

‘We welcome this report and strongly agree the current situation must not be allowed to become the new normal.

‘We support the recommendations to help tackle medicines shortages, including empowering pharmacists to make dose and formula substitutions when medicines are unavailable, to support continuity of care for patients and reduce pressures on pharmacy teams and GPs.’