Medicine shortages in the UK have been a regular feature on newspaper front pages in recent years. As a doctor on the frontline, I see how this instability in our medicine supply chain is playing out on the ground.
I work in a large city hospital and am used to meeting disgruntled patients who have had to wait hours in clinic to receive treatment. But just imagine their concern when I have to explain to them that the medication we would usually treat them with is not available, and that they will have to take an alternative instead or stay in hospital for even longer as a result.
In the past year, I have heard of patients having to go without medication for common conditions such as attention deficit hyperactivity disorder (ADHD), diabetes and even acne that would otherwise be easily managed, or being forced to take alternatives that are less appropriate. And new EU plans for its members to work together to stockpile key medicines will only worsen shortages in the UK.
Patients tell me they feel others are receiving better treatment than they are. And they are right, in some ways. What am I supposed to tell them?Healthcare professionals are being put in a difficult situation having to explain why we are making compromises in their care. I worry this will only further increase negativity and abuse towards NHS staff, which has been on the rise in recent years. It all adds to the sense among patients and healthcare professionals alike that the health service is not working for the most vulnerable.
Seeing the tangible outcome of shortages of certain types of medication is worrying. Some patients who rely on medication to manage their ADHD are going weeks without it, despite it being vital for their mental health during what has already been a difficult winter. For some of them, this means they are unable to continue to live their lives in a functional way, being unable to work and even carry out basic day-to-day tasks until their medication arrives at the pharmacy.
The situation is similar for some anti-epileptic medications, shortages of which can be incredibly dangerous. Patients who aren’t on the correct medication can develop seizures requiring them to be put into an induced coma, which can have life-changing implications. Thankfully, I have not yet heard of a case due to shortages but this is something that doctors such as me worry could happen if the supply crisis is not addressed.
The insecticide permethrin, used to treat scabies infection, is another medication that has been in short supply. Scabies is on the rise in Britain and the shortage of permethrin could mean the condition cannot be treated before it can spread. Some patients with suspected scabies are being told to isolate in hospital, which does not kill the parasite and potentially exposes others to infection. It also means a longer stay in hospital for those affected.
With the NHS already in desperate need of beds during the winter months, having to treat patients in hospital when they would normally be sent home with medication comes at a price – both for the NHS and the communities they serve.
There has been a recent shortage of a tablet known as Sando-K, which is prescribed very often in hospital to treat low potassium levels. Doctors in some parts of the country are having to instead prescribe a fluid potassium chloride bag, which is given intravenously and puts elderly patients with comorbidities at a greater risk ofcomplications.
Different issues have been suggested as the root cause for the supply shortages, from Brexit to increased taxes on pharmaceutical companies, to manufacturing issues. But, whatever the ultimate cause, to me, it is becoming crystal clear that political inaction is worsening the situation. Recent figures suggest that since 2022, the number of medication shortages has almost doubled, and it is of no benefit to healthcare professionals or patients for the government to regurgitate the same excuses every time this happens.
We have been weathering this storm for too long, so why are our leaders so afraid to act? It should be an absolute scandal that in 21st-century Britain our medicine supply is so unstable that doctors are having to make compromises to treat patients appropriately.
Patients need to know that it is not the staff, who often work 60-hour weeks or more to look after them, who are at fault. As doctors, our most important job – to care for our communities – is only getting harder. Our politicians must take action now to address this situation before more lives are hurt.