Chinwag - Autumn 2019

Q.3 Are there plans to stockpile medicines in the UK ahead of 31 October 2019 Yes, plans are in place to support medicine suppliers to build buffer stocks of prescription-only and pharmacy medicines in case there are difficulties in shipping medicines using current transport routes. This is part of the measures outlined. The stockpiling element of the government’s medicines contingency measures is for medicines and medical products that would require a prescription or that patients would usually get under supervision from a pharmacist, and that are either made in the EU/EEA or contain ingredients or components made in the EU/EEA. DHSC has been working closely with medicines suppliers and has received assurances from companies that they had an additional six-week stockpile of the vast majority of in-scope medicines. Regular updates and reassurances have also been sought. Q.4 Should patients keep ordering repeat prescriptions and taking medicines as normal? Yes. There is no need for patients to change the way they order prescriptions or take their medicines. Patients should always follow the advice of doctors, pharmacists or other prescribers. The NHS does experience temporary shortages of some medicines, and has tried-and-tested ways of making sure patients receive their medicines and medical products, even under difficult circumstances. If patients order extra prescriptions, or stockpile, it will put pressure on stocks, meaning that some patients may not get the medicines or medical products they need. Q.5 What about medicines with short shelf-lives? For medicines that cannot be stockpiled because they have short shelf-lives, such as medical radioisotopes, DHSC has asked suppliers to arrange alternative routes using air freight, which some suppliers do already. DHSC is continuing to work with suppliers of short shelf-life medicines, including medical radioisotopes, to ensure that robust contingency arrangements are in place.

Q.6 If there are problems with the

government contingency plans or there are shortages for any other reason, will patients still be able to get suitable prescription medicines and medical products? Yes. The NHS has tried-and-tested ways of mitigating the impact of temporary medicines shortages. In addition to these, a new clinically chaired Medicines Shortage Response Group (MSRG), which the DHSC Medicines Supply Team and Commercial Medicines Unit report to, has been created to support the management of medicines shortages. The MSRG will receive regular reports from the pharmaceutical industry. It will work with stakeholders to explore options to mitigate and manage any issues. This might include working with the Medicines and Healthcare products Regulatory Agency (MHRA) to expedite regulatory procedures, working with manufacturers to manage remaining supplies, expediting the delivery of further stock and commissioning clinical advice on alternative options from specialist clinicians. This means that if a medicine is temporarily unavailable, patients may be supplied with the most suitable alternative by a pharmacist. This will be under very strict parameters, for a limited time and approved by very senior medical staff. This might be a reduced quantity of the patient’s medicine, a different brand of the same medicine or perhaps a different strength of their usual medicine to make up the dosage. On rare occasions, it may mean a different medicine to do the same thing, or if the patient’s device is unavailable, a different device. Pharmacists will be provided with clear national clinical guidance in each case should this become necessary. Clinicians will make the decision in discussion with patients, who will be provided with all the necessary information on any decision in order to ensure the patient’s informed consent. This will ensure that patients continue to receive the treatment they need. Q.7 What about ‘over the counter’ medicines? General sales medicines, which can be sold in general retail outlets without the supervision of a pharmacist are not included in the stockpiling element of the government’s approach to medicines supply because there are multiple alternatives available. However, all over the counter medicines are part of the government’s approach outlined above. This includes DHSC’s work with suppliers to support their contingency plans, including the re-routing of supply chains away from the ports where delays are more likely to occur and improving suppliers’ readiness of their logistics and supply chains to meet the new customs and border requirements from 31 October 2019 in a ‘no-deal’ EU exit.