Hancock urged to give pharmacists freedom to manage shortages


Pharmacists, GPs and patients have joined together to call for a change in the law to reduce bureaucracy and speed up patient access to medicines when they are in short supply.

A joint letter to Matt Hancock MP, Secretary of State for Health and Social Care, calls for pharmacists to be able to alter prescriptions to minimise the impact of medicine shortages on patient care.

The letter, co-signed by the Royal Pharmaceutical Society, the British Medical Association, the Royal College of GPs, patient group National Voices and others, calls on the Government to amend medicines legislation to allow pharmacists to make changes to prescriptions and provide a different quantity, strength, formulation or generic version of the same medicine if it is in short supply.

The letter also calls on the Government to work with stakeholders to implement the changes ahead of the end of the UK transition from the EU at the end of this year.

At present, community pharmacists are legally obliged to contact prescribers, or refer patients back to prescribers, to amend original prescriptions even for minor adjustments such as supplying two packets of 20mg tablets if the 40mg packet prescribed is out of stock.

This is frustrating for patients, pharmacists and doctors causes delays in access to medicines and takes up health professionals’ time which could be better spent supporting patient care. The proposal is restricted to the way a prescribed medicine is provided, rather than changes to the medicine itself.

President of the Royal Pharmaceutical Society Sandra Gidley said:


“We urgently need this change ahead of the triple whammy of a second wave of coronavirus, the flu season and a potential no-deal Brexit, all of which would again place heavy demands on the medicines supply chain and primary care services.  Pharmacists are experts in medicines and need greater flexibility under the law to make simple changes to prescriptions that help patients get the medicines they need when they need them. It makes no sense to have to turn patients away without their medicine when the answer could literally be sitting on the shelf.”

Chair of the British Medical Association’s GP Committee Dr Richard Vautrey said:


“At a time of significant increase to GP workload and the problems with supply of medications, allowing pharmacists to make these changes so that patients can obtain their medicines in a timely manner can only be a good thing for both doctors and patients. GP practices have to deal with a significant amount of bureaucracy which takes precious time away from seeing patients and changes like this will go some way in addressing that, especially as we head into winter and at a time when we are seeing the number of Covid cases increase again.”


Chair of the Royal College of GPs Professor Martin Marshall said:


It can be frustrating for GPs, pharmacists and patients when prescriptions can’t be dispensed due to shortages – and that minor adjustments to prescriptions which could be dispensed can’t be made by an experienced pharmacist without being reviewed by a GP. Unfortunately, not only does this step increase GP workload, but often it slows down patient access to medication. Pharmacists are highly skilled in their area of expertise – medicines – so trusting them to make appropriate and sensible decisions regarding medicines, depending on supplies, will in turn allow GPs to focus on patients who need our care the most.”


National Voices Chief Executive Charlotte Augst said:


“People who use medicines have told us that they experience delays and shortages not only as an inconvenience, but that it can cause them anxiety and distress.


“Where a medicine can be safely swapped for one that is just a different package size or quantity, it is better for everyone for this option to be discussed with the patient and a shared decision to be made that enables the pharmacist to simply provide the medicine that helps the patient. Anything else just adds inconvenience and ultimately cost for no added benefit.”


You can read the full letter here.


Do you think pharmacists should be allowed greater powers to make minor changes to prescriptions in time of medicine shortages?



Urgent action required on medicine shortages



Medicines shortages are a growing problem across Europe, not just in the UK, according to a new report by the Pharmaceutical Group of the European Union (PGEU).


All responding countries experienced medicine shortages in community pharmacies in the past 12 months, and the vast majority (87%) of respondents indicated that the situation got worse compared to 2018. All classes of medicines are affected by medicine shortages in community pharmacies.


In the majority of responding countries (67%), over 200 medicines were listed as in short supply at the time of completing the survey.


All responding countries indicated that they believe medicine shortages cause distress and inconvenience to patients. Interruption of treatments (75% of countries), increased copayments as a result of more expensive/non-reimbursed alternatives (58%) and suboptimal treatment/inferior efficacy (42%) are also perceived as negative consequences of medicine shortages on patients.


Medicine shortages are believed to affect community pharmacy businesses in most countries by a reduced level of patient trust (92% of countries), financial loss due to time invested in mitigating shortages (82%) and reduced employee satisfaction (79%).


Across European countries, strong differences exist in terms of legal solutions community pharmacists can offer in case of a shortage. Generic substitution (79 % of countries), sourcing the same medicine from alternative authorised sources (such as other pharmacies) (63%), and importing the medicine from a country where it is available (46%) are the solutions which can be provided in most of the European countries.


The time pharmacy staff have to spent on dealing with medicine shortages has increased from 5,6 hours per week (2018) to 6,6 hours per week on average.


25% of responding countries indicated that there is still no reporting system for shortages in place which can be used by community pharmacists in their country, despite that pharmacists often experience or foresee supply difficulties before the industry or wholesalers are aware that there is, or will be, a problem.


Community pharmacists receive the needed information on shortages in most countries from wholesalers (71%), medicines agencies (67%) and pharmacy organisations (42%).


The 2019 PGEU Medicine Shortages Survey Results cover the responses from 24 European countries and is created from the perspective of community pharmacists across Europe.


Pharmacy associations from all the countries in the PGEU survey said they had experienced medicines shortages in 2019.  Of the 24 countries, 21 said the situation had got worse in the last 12 months.  In the majority of counties, over 200 medicines were listed as being in short supply at the time of completing the survey, which was carried out in November and December 2019.  The most widespread shortages were medications affecting the central nervous system, respiratory medicines and cardiovascular medicines.


The shortages were reported to have caused distress and sometimes serious harm.


National Pharmacy Association Policy Manager Helga Mangion said:


“This data is further evidence of a widespread problem in this country and across Europe.


“Because of heroic efforts by pharmacists, patients usually get their medicines when and where they need them, but longstanding faults in the medicines supply chain too often leave patients waiting. It’s time for urgent action, to reduce the risk of harm and to allow pharmacists to spend more time with patients instead of hunting for stock.”


The NPA is part of the UK’s delegation to PGEU, alongside the Royal Pharmaceutical Society and the Pharmaceutical Society of Northern Ireland.


You can view the survey results below.


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