Community Pharmacy NI yesterday told MLAs about a growing shortage of many common medicines including the painkiller, co-codamol 30/500mg which is likely to extend for several months.
Without urgent intervention Northern Ireland is at risk of facing more frequent and more severe disruption in the weeks ahead, MLAs were told.
In Northern Ireland, approximately 50,000 packs, equating to around 5m tablets, of co-codamol are dispensed each month to a population of fewer than 2m people.
As things stand, community pharmacies may be forced to ration supplies of medicines related to shortages, potentially affecting on average 50 to 100 patients per pharmacy so that people have some supply and do not run out of vital medicines.
Co-codomol shortages may lead to rationing
News catch up – Monday 2 February
Community Pharmacy NI highlighted that this is not an isolated example with another shortage affecting low-dose, dissolvable aspirin used primarily as an anti-platelet medicine for patients at risk of stroke or heart attack.
When questioned by an All Party Group on the potential impact for Northern Ireland, Community Pharmacy NI confirmed that chemists here are typically trying to source stock for over 100 common medicine lines in short supply.
While the current shortages are driven by global manufacturing and supply chain constraints, the organisation stressed that these issues represent significant medicines security and supply concerns in Northern Ireland.
There are potentially direct implications for patient safety and consequential pressures for GPs, out-of-hours services and other parts of the health system, the group said.
Gerard Greene, Chief Executive of Community Pharmacy NI said: “Today’s discussion made clear that community pharmacy in Northern Ireland is operating under sustained and increasing pressure.
“The gap between medicine costs and reimbursement is widening, and pharmacies here are also struggling to pay medicine wholesaler bills and receive sufficient supply of many common medicines to meet patient need.
“The supply issue sees community pharmacies working intensively to source medicines, often under severe constraints.
“We have pharmacy teams reporting back to us daily that they are seeing growing numbers of other commonly prescribed medicines also in short supply.”
He said that “all of this is taking place while pharmacy teams try to support patients who are understandably keen to get the medicines they need”.
“We are appealing to the public to be patient with pharmacy teams as they try to source medicines, and we are appealing once again to the Minister to again prioritise support for the sector so that pharmacies can pay medicine wholesalers,” continued Mr Greene.
“This does not involve finding new funding for the sector, but rather to remove clawback which reduced the payments pharmacies received last year for medicines dispensed by £23m.
“The stability of the medicines supply chain, while it is a UK wide issue, is of particular concern to us locally because of Northern Ireland’s small market and additional logistical costs compared to GB.”
He said pharmacists have raised their concerns with the Health Minister and are calling on the Minister and the NI Executive to work with the UK Government to strengthen medicines security and supply for Northern Ireland, including ensuring that medicine stock is appropriately ring-fenced, so patients continue to receive the medicines they rely on.
“If this is not addressed, there is a real risk that Northern Ireland will become a lower-priority market for medicine wholesalers, with serious implications for patient safety, continuity of care and the resilience of the wider health system.”
Community Pharmacy NI is advising patients strongly against picking alternative medicines or altering doses without professional guidance, as this may be clinically inappropriate and, in some cases, harmful.
Community Pharmacies in Northern Ireland dispense millions of packs of commonly prescribed medicines each year and even relatively small interruptions in supply can have a rapid and disproportionate impact on patients, pharmacy teams and local health services.
The All Party Group said it is calling on the Department of Health to treat this as an urgent patient safety and system resilience issue and to set out, without delay, a clear plan to stabilise community pharmacy funding and cashflow, so pharmacies can continue to secure medicines for patients.
They also want arrangements put in place to reduce the operational burden created by shortages, including faster, more practical mechanisms for switching to clinically appropriate alternatives when supply fails.
The members of the APG have made it clear that community pharmacy is not an “optional extra” in the health service, but is a frontline service.
Failure to act now risks avoidable harm to patients and escalating pressure across the entire system, the APG said in a statement.
Alliance Party Health spokesperson Danny Donnelly MLA
Its chairman, Danny Donnelly MLA, said: “Today’s warnings about a sharp deterioration in medicine availability, significant medicine price increases and pharmacies in Northern Ireland struggling to pay medicine wholesalers is very concerning.
“Medicines are such a vital part of the lives of everyone across our population and the Minister needs to do all he can to support pharmacies to be able to get the medicines patients are prescribed.
“It is imperative that he recognises the severity of this issue and works immediately with the local community pharmacy sector to reduce the impact and risks to patients.”