Medicines Shortages Cost NHS £220 Million, MPs Warn

Medicines shortages in England have become a “chronic, structural challenge,” according to a new report from the All-Party Parliamentary Group (APPG) on Pharmacy.

MPs and peers warned that supply problems are disrupting care, risking patient safety, and putting further strain on NHS services.

“What was once considered an occasional inconvenience is now a daily reality in pharmacies across the country,” said APPG chair Steve Race MP in a foreword to the group’s report.

Widespread Disruption and Added Costs

The report estimated that medicines shortages cost the NHS an extra £220 million in 2022-2023. 

Nearly all pharmacists surveyed (96%) said they were spending more time managing supply problems, with 40% devoting 1-2 hours each day to the task.

Nine in 10 reported a drop in patient satisfaction, and almost two thirds said they had to contact prescribers multiple times daily to resolve issues.

Medscape News UK recently reported how continuing shortages had become a “new normal” for pharmacists and patients, with the supply chain “at breaking point.”

“The impact on frontline care is stark,” the group’s report said. Treatments for ADHD, epilepsy, menopause, diabetes, and bacterial infections were among those being disrupted. In some cases, the shortages were leading to treatment delays, drug rationing, and adverse health outcomes, especially for those with chronic conditions.

The APPG cited a “complex interplay” of causes behind the shortages. These included manufacturing issues, supply chain vulnerabilities, increased demand, and geopolitical events. The global nature of pharmaceutical supply chains means that disruptions in one region can have knock-on consequences elsewhere. Economic factors — such as pricing pressures and market consolidation — have further contributed to the crisis, according to the report.

Biosecurity Threat and Policy Limitations

In March, the Centre for Long-Term Resilience warned that the UK remained “perilously vulnerable” to medicine supply shocks. Shortages of antimicrobials, vaccines, and diagnostic tools could leave the country unprepared for biosecurity threats.

Serious Shortage Protocols (SSPs) allow pharmacists to exercise their judgement to make limited substitutions or supply a reduced quantity that is in stock. Pharmacists are also allowed to offer clinical pathway consultations and provide treatments for seven common conditions under the Pharmacy First scheme. However, most prescriptions still require GPs to issue a revised prescription, even if an equivalent medicine is in stock.

Calls for Urgent Reform

The APPG report made 12 urgent recommendations. These include:

• Allowing pharmacists to substitute doses or formulations during shortages
• Expanding UK-based medicines manufacturing
• Creating a real-time, UK-wide drug shortage communication system

Potential Serious Risks to Patient Safety

Henry Gregg, chief executive of the National Pharmacy Association, said the findings reflected the reality faced by pharmacy teams. “Ongoing shortages of medicine cause huge challenges for patients and pharmacies alike, and in certain cases pose a serious risk to patient safety,” he said.

Gregg said that pharmacy teams were under “enormous pressure,” spending hours hunting down stock for “distressed and frustrated patients.”

He backed calls for pharmacists to be permitted to exercise their professional judgement to supply an appropriate alternative medication when the prescribed version is unavailable.

“It is particularly frustrating for pharmacists to be unable to meet a clear need when they have a perfectly safe and effective solution in their pharmacy already,” Gregg said. 

He added, “MPs are right that it is madness to send someone back to their GP to get a prescription changed, and it risks a patient either delaying taking vital medication or forgoing it altogether — which poses a clear risk to patient safety.”

Dr Sheena Meredith is an established medical writer, editor, and consultant in healthcare communications, with extensive experience writing for medical professionals and the general public. She is qualified in medicine and in law and medical ethics.