MMedicine shortages in Britain have regularly appeared on the front pages of newspapers in recent years. As a physician on the front lines, I see how this instability in our drug supply chain plays out on the ground.
I work in a large city hospital and am used to meeting dissatisfied patients who have had to wait hours in the clinic for treatment. But imagine their worries if I have to explain to them that the medicines we would normally treat them with are not available, so they will have to take an alternative or stay in hospital even longer.
Over the past year I have routinely seen patients go without medication for common conditions such as Attention Deficit Hyperactivity Disorder (ADHD), diabetes and even acne that could otherwise be easily controlled, or forced to take alternatives that are less suitable . And new plans from the EU for its members to work together to stockpile key medicines will only worsen Britain’s shortages.
Patients tell me that they feel like others are getting better treatment than they are. And in some ways they are right. What should I tell them? Healthcare professionals are put in a difficult situation as they have to explain why we are compromising their care. I fear this will only further increase the negativity and abuse towards NHS staff, which has been increasing in recent years. It all contributes to the feeling among patients and healthcare professionals alike that healthcare is not working for the most vulnerable.
It is worrying to see the tangible consequences of shortages of certain types of medicines. Some patients who rely on medication to control their ADHD are having to go weeks without medication, despite it being vital for their mental health during what has already been a difficult winter. For some of them, this means that they can no longer live their lives in a functional way, work or even perform basic daily tasks until their medicines arrive at the pharmacy.
The situation is similar for some antiepileptic drugs, a deficiency of which can be incredibly dangerous. Patients who are not on the correct medication can experience seizures, requiring them to be put into an induced coma, which can have life-altering consequences. Fortunately, I haven’t heard of a case due to shortages, but this is something doctors like me fear if the supply crisis is not addressed.
The insecticide permethrin, used to treat scabies infections, is another drug in short supply. Scabies is on the rise in Britain and the permethrin shortage could mean the condition cannot be treated before it can spread. Some patients with suspected scabies are told to isolate in hospital, which does not kill the parasite and potentially exposes others to infection. It also means a longer hospital stay for those affected.
With the NHS already in dire need of beds over the winter months, treating patients in hospital when they would normally be sent home with medication comes at a cost – both for the NHS and the communities they serve.
There has recently been a shortage of a tablet called Sando-K, which is very commonly prescribed in hospital to treat low potassium levels. Doctors in some parts of the country must instead prescribe a liquid potassium chloride bag, which is administered intravenously and puts older patients with comorbidities at greater risk of complications.
Several issues have been suggested as the root cause of the supply shortages, from Brexit to higher taxes on pharmaceutical companies and production problems. But whatever the ultimate cause, it becomes crystal clear to me that political inaction is making the situation worse. Recent figures suggest that drug shortages have almost doubled since 2022, and there is no benefit to healthcare professionals or patients if the government makes the same excuses every time this happens.
We’ve weathered this storm for too long, so why are our leaders so afraid to take action? It should be an absolute scandal that in 21st century Britain our drug supply is so unstable that doctors have to make compromises to treat patients properly.
Patients need to know that it is not the fault of the staff, who often work 60 hours a week or more to care for them. As physicians, our most important job – caring for our communities – is only becoming more difficult. Our politicians must act now to address this situation before more lives are injured.
