This could all change suddenly with a no-deal Brexit.”. A DHSC spokesperson said : “We hold a range of stockpiles for a variety of medicines, including crucial treatments used to treat Covid-19 patients to help ensure there is uninterrupted supply. In the case of Relpax, a migraine drug, which is in short supply, there was a recommendation to break the higher dose tablets in half although the document admitted “there are no data on halving or crushing them to deliver a 20mg dose”. There is increasing evidence that a wide range of medicines are affected. Distribution and logistical problems 9. Dr Nick Mann, a GP in Hackney in London, said: “This situation is absolutely unprecedented. Such shortages will have a high risk of harm to patients.”, Dr Tony O’Sullivan, a retired paediatrician and the co-chair of Keep Our NHS Public, said: “The Health Department’s guidance includes an unprecedented list of drugs unavailable or in short supply. Active ingredients for European products are made at 4420 sites in India, 2794 in China, 1936 in Europe, and 599 in the US.9 Medicines are cheaper to make in developing countries, but disruptions to infrastructure are more likely, distant factories are difficult to inspect frequently, and long supply chains are fragile. Current situation: In order to help maintain supplies, additional batches of this inhaler are being released into the NHS Supply Chain. This is despite the announcement of an additional £145million to aid the NHS over the harsh winter. ... the NHS offers pharmacies a higher price concession rate designed to make up for the shortfall. We need to think about what the stockpiles are looking like.”. Internal document seen by the Guardian shows low supplies for heart, cancer and anti-epilepsy drugs. Mon 18 Nov 2019 01.00 EST 3,752 The NHS is running short of dozens of lifesaving medicines including treatments for cancer, heart conditions and epilepsy, the Guardian has learned. Hospitals across England are experiencing medicine shortages because of "stockpiling and price pressure as the Brexit deadline approaches", NHS Providers has told BBC Newsnight. It is going to render the day-to-day treatments that doctors provide very difficult.”, The report described one drug for stomach and pancreatic cancer which has no date for resupply provided by the manufacturer and “no alternative supplies of UK licensed [drugs] … are available to support this gap in supply. Patients and clinicians alike should be on high alert when the advice includes how to ‘share stocks’ to make them last, to ‘prioritise’ patients already on specific treatments including cancer rather than a new patient and effectively how to ration so many vital drugs. Pharmacists spend hours tracking down stock and working together to help patients.”. However the situation is likely to get worse for a time around the date of exit. The Medicine Shortage Response Group was established in January to provide guidance to the Department of Health and Social Care’s (DH) medicine supply team and NHS commercial medicines unit – which looks at medicine supply and procurement in hospitals – on “individual, critical” medicines supply issues, the DH told C+D earlier this month (April 5). Following concerns raised with us about medicine shortages, the CMA has sought information on the extent to which there are shortages of medicines in the UK and their likely causes. The HPRA is responsible for co-ordinating the management of shortages of human medicines on the Irish market. NHS Providers, which represents hospitals in England, said problems associated with Brexit could conjure a “perfect storm” of problems this winter that could undermine care, including flu, bad weather, workforce shortages, a resurgence of Covid and an epidemic of burnout among staff. “Patients waiting for operations cannot be left behind indefinitely by the Covid crisis. A pharmacist making notes of the medication stock on the shelves in a pharmacy. British Medical Association Consultant workforce shortages and solutions: Now and in the future 3 The COVID-19 pandemic highlights the need to grow the consultant workforce NHS performance measures have been progressively deteriorating over recent years, with record low performance becoming a monthly norm over the past few winters. The DHSC has been approached for comment. Medicine shortages are an everyday occurrence in the UK. Going into a second surge, securing respiratory drugs is a particular priority”, added Cordery. The document stated that in some cases switching drugs would require increased clinical supervision, something which adds to the workload of already hard-pressed doctors. The document said that because there are shortages of many licensed medicines, in some cases unlicensed versions may be imported although “lead times vary”. Tuberculosis medication: two suppliers are out of stock, a third has some stock “but is unable to support any uplift in demand”. “The main supply routes for drugs have been through Europe, both in terms of red tape and logistics, as they’ve come from mainland Europe to the UK through ports. Mann added: “The scale and scope of this list from DHSC of currently unavailable prescription medicines is extremely alarming. managing medicines shortages in the NHS in England. 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