Medication shortages ‘impacting upon patient safety’, pharmacy leaders warn

Shortages of certain medicines are putting patient safety at risk, experts have warned, as well as exposing pharmacists to abuse and aggression from frustrated and anxious members of the public.

Leaders from the sector told the PA news agency the system is “unviable and broken”, and called on the Government to recognise the seriousness of the issue.

They spoke of shortages in medication to treat the likes of epilepsy, ADHD and diabetes, as well as some cancer drugs and hormone replacement therapy (HRT).

Dr Leyla Hannbeck, chief executive of the Association of Independent Multiple Pharmacies (AIMP), said the situation is “the worst that we have ever seen”.

“Our supply system is consistently unable to cope as soon as the demand for a medicine goes up – for example, scabies medicines, ADHD medicines, diabetes medication and some cancer medicines, HRT medicines – the list continues.

“Every week we get a message informing us that a particular popular medicine is going to be out of stock for a period of time.”

Patients impacted by the shortage in ADHD medication shared their experiences with PA, including researcher Dr Sami Pinarbasi, 38, who said it has been a “nightmare” to get 40mg of Lisdexamfetamine each month.

“It’s just a nightmare to get hold of it at the moment,” he added. “Every time I have to get a prescription, I ring about between 30 to 40 pharmacies so it’s just been really hard to get hold of the stuff.”

Dr Pinarbasi, who is based in Greater Manchester, said the drug helps him focus but without it he is unable to sit in quiet surroundings and cannot concentrate.

“It makes it harder for me to be public because I don’t want people to see the symptoms, in case I get judged,” he added.

Reading-based Sam Stevenson, 35, also told PA it was “frustrating and a little bit anxiety-inducing” that he has not been able to go on Lisdexamfetamine because of shortages.

The creative producer who works in the video game industry said he was diagnosed with ADHD over a year ago and tried one medication that “wasn’t really working” for him.

“Now we’re four or five months on, and I still have nothing,” Mr Stevenson said. “I’m still reaching out, weekly or every other week asking where are we, and there’s just no answer.”

Speaking to the Health and Social Care Committee on Tuesday, William Pett, head of policy, public affairs and research at Healthwatch England, said some people with ADHD have had to ration medication.

He said the group is not only concerned about the medical implications of this, but also the “rigmarole” patients are going through to get hold of drugs.

“If they’re not going back to their GP to ask for an alternative prescription, then what they’re having to do is phone around multiple pharmacies, if they can get through. They have to rely on posting desperate messages on local Facebook groups to try and find out from other people in the area.

“Now, wouldn’t it be fantastic if in this day and age patients were able to go online to some kind of database to see where pharmacies are stocking medication?”

He said you can do it “if you want to pick up a Hoover from Argos” but it is not available for stocks of medicines.

Elsewhere, NHS England and the Department of Health and Social Care published a National Patient Safety Alert in relation to a shortage of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) earlier this month.

The range of drugs help manage blood glucose levels in people with type 2 diabetes but there has been a surge in off-label prescriptions for some to aid weight loss. The alert said supplies are not expected to return to normal “until at least the end of 2024”.

Douglas Twenefour, head of care at Diabetes UK, said ongoing shortages “are having serious implications for many people with type 2 diabetes and are still a major concern”.

Dr Hannbeck told PA that frontline pharmacists “are regularly witnessing the stress that these shortages cause for patients, but they feel helpless”, with some spending “hours” on the phone every day trying to source medicines.

“It is very difficult to source medicines that are on the shortage list,” she told PA.

“In addition, as pharmacists we are worried that some of these medicines’ shortages have an impact on patient safety because it affects their treatment, in some cases delays to their treatment, or, as some patients report, their symptoms return when they cannot get hold of their medicines.”

She added that many pharmacists are reporting an increased levels of “abuse and aggression from patients because they cannot get their medicines”.

Nick Kaye, chairman of the National Pharmacy Association (NPA), said: “Community pharmacy teams are under pressure – it’s taking time away from the delivery of clinical service.

“People are getting quite grumpy, quite rightly. They don’t understand the increased pressure and why things take so long. People are also worried.

“At the end of the day there’s a person involved and a pharmacy team trying to sort that out. It’s hard. As a pharmacist you have no reception team, no care navigator – you are stood in front of the person.”

Alwyn Fortune, policy and engagement lead for Wales at the Royal Pharmaceutical Society, said reasons for shortages “are wide and varying” and can be down to “manufacturing problems, key ingredients missing and global demand putting pressure on supplies”.

Dr Hannbeck added that pricing is also an issue for the sector: “We are seeing the prices of significant number of medicines increasing, leaving pharmacy operators out of pocket.

“It is an unviable and broken system. Many pharmacies are closing their doors for good because of funding challenges.

“We have for several years highlighted this issues to the Government officials to ensure the Department of Health and Social Care (DHSC) puts in place processes and procedures that improve the current system regarding the medicines supply because the current system is clearly not working.

“Patients are without their medicines and some case at risk of harm, pharmacists are out of pocket exhausted and yet it seems the officials refuse to see the seriousness of this situation.”

A DHSC spokesperson said: “We do not recognise these figures. There are around 14,000 medicines licensed in the UK and the overwhelming majority remain in good supply.

“We have well-established processes to prevent, manage and mitigate medicine shortages quickly when they do arise and that includes working closely with industry, the NHS and others.

“When an issue does occur, it is commonly managed with minimal disruption to patients.”