A new report from the Royal Pharmaceutical Society (RPS), backed by charities and patient groups, calls on the Government to create a national strategy to manage medicine shortages and to change legislation to allow community pharmacists to amend prescriptions when medicines are in short supply.

The report, Medicines Shortages: solutions for empty shelves explains how medicine supply chains are global and complex, with shortages caused by manufacturing problems and disrupted, less resilient supply chains. The report finds that supply chain issues are in part due to the consolidation of manufacturing outlets and cost-driven pressures.

The findings also highlight that supply chain vulnerabilities have combined with unplanned spikes in demand, such as shifts in prescribing practice or increased diagnosis of some conditions, to create a perfect storm of unstable supply.

This has made it harder for patients to access treatment, causing frustration, anxiety and in some cases, harm to patient health.

The report calls on the UK Government to create a national strategy to both prevent and manage medicine shortages that would streamline efforts across the NHS, reduce inefficiencies caused by duplication of effort and ensure information and guidance for professionals and patients is available as soon as shortages occur.

The report also urges the Government to legislate to allow community pharmacists to make minor amends to prescriptions when medicines are in short supply. This simple change would enable a different quantity, strength or form of the medicine to be provided. For example, changing tablets to a liquid version of a medicine, or substituting a pack of 20 mg tablets with 2 x 10 mg packs when necessary.

At present, patients have to return to their GP to get their prescription amended, delaying access to medication, increasing bureaucracy and intensifying pressure on an already overburdened system. This move already has support from medical organisations, patient groups and other pharmacy bodies.

Other recommendations in the report include:

• Improve reporting by manufacturers: prompt alert of the risk of shortages would transform the impact on patients, and those consistently failing to report should be fined.
• Build supply chain resilience: strengthen NHS procurement contracts to ensure manufacturers can meet supply demands and respond to shortages quickly.
• Improve data connectivity: Use better demand forecasting and share information across the supply chain to prevent stock issues before they happen.
• Enhance systems for life critical medicines: improve collaboration across the health service to coordinate access to specific medicines.

James Davies, RPS Director for England and co-author of the report, said:

“Taking a new approach to medicine shortages is essential. A properly resourced UK-wide medicines shortages strategy that helps prevent and manage shortages would greatly improve the resilience of the supply chain. This would relieve stress and anxiety for patients and free up time for pharmacists to focus on patient care rather than constantly chasing down supplies.

“Community pharmacists must be allowed to make minor changes to prescriptions during shortages. The current outdated system inconveniences patients, wastes time and causes frustration. The Secretary of State for Health should give pharmacists the authority to act in the best interests of their patients, rather than remain subject to ‘empty shelf syndrome’.”

Bruce Warner, Chair of the advisory group for the report, said:

“This report provides a comprehensive assessment of what is causing medicines shortages, their impact on patients, pharmacists and healthcare professionals, and what more can be done to mitigate and manage shortages.

"Better collaboration across the whole medicines supply chain is needed and improving early reporting of shortages by manufacturers to the Department of Health and Social Care is of critical importance. Prompt notice of a supply problem allows time to act, find solutions and produce clear guidance, meaning health professionals are fully informed and patients are saved from delays and confusion that can cause distress and harm to health."

Sharon Brennan, Director of Policy and External Affairs at National Voices, a coalition of 200 health and social care charities in England said:

“Our members report that patients are rationing their medicines to make their supplies last, that deteriorations in health have led to job losses or dropping out of education, and that patients are buying falsified medicines from the internet. This is on top of many hours wasted calling round pharmacies to track down medication and the frustration, worry and anxiety felt by those that can’t access their medicines. We know from members that people often don’t know where to turn for help and advice, and that the situation is especially bad for those who are facing health inequalities.

“We urge the Department of Health and Social Care to recognise the serious and worsening impact medication shortages are having on patients, and to commit the same level of urgency to improving the situation as it has to other NHS access-to-care issues such as diagnosis and waiting lists.”

Read the report's executive summary.

Read the full report.