What to do if my medication is out of stock NHS ?

In times of urgency, running out of medication or when your medication is out-of-stock can be a cause for concern. This guide will provide you with essential information and resources to help you navigate through such situations effectively and efficiently. It will also explore reasons why your medication might be out of stock.

What to do if you have a prescription

If you already have a prescription and urgently need the medication, there are several steps you can take:

• Check other nearby pharmacies: If your local pharmacy is closed, you can get your medicine from any pharmacy as long as they have it in stock. Use the NHS pharmacy service search to find other nearby community pharmacies and their opening hours, some of which may be open until midnight or even on public holidays
• Contact NHS 111: If you prefer to speak to someone first, call NHS 111 for free by dialling 111 on your mobile or landline. The representative can provide information on out-of-hours pharmacies or other NHS services in your area
• Use the NHS walk-in centre service: Another option is to utilise the NHS walk-in centre service search to find your nearest walk-in centre. These centres often can dispense medicines after a consultation
• Contact your GP surgery: In urgent cases, you can call your GP practice. They should have details of their out-of-hours service recorded on their answering machine. However, it’s important to note that this service should only be used in emergencies and not as a routine practice. You can use the NHS GP service finder to locate your GP surgery’s phone number
• Visit your nearest A&E: If you have exhausted all other options and it is an emergency, you can use this service to find your nearest Accident and Emergency (A&E) department

What to do if you don’t have a prescription

If you run out of prescription medicine without having a prescription, you may still be able to obtain an emergency supply from a pharmacy. Here’s what you can do:

• repeat prescriptions: If your medicine is prescribed as a repeat prescription, take an old prescription or the medicine’s packaging with you, if available
• Contact NHS 111: If your medicine is not prescribed as a repeat prescription, call NHS 111 to discuss your options

Pharmacies: Your first stop

Pharmacies are often the go-to place for obtaining emergency supplies of medication. When visiting a pharmacy in an emergency, there are certain factors to consider:

• Assessment by the pharmacist: You’ll be assessed by the community pharmacist to determine the urgency of your need and the appropriateness of the medicine for you. The pharmacist may need information such as who previously prescribed the medicine and the appropriate dosage
• Emergency supply: The pharmacist may be able to provide an emergency supply of up to 30 days’ treatment for most prescription medicines. However, certain medications like insulin, ointments, creams, asthma inhalers, contraceptive pills, and liquid oral antibiotics may have limitations on the quantity that can be supplied
• Controlled drugs: It’s important to note that only a limited range of controlled medicines can be prescribed in an emergency. Medications like morphine or diamorphine generally cannot be supplied without a prescription
• Payment: In some cases, you may need to pay for the emergency service and medicine, even if you do not normally have to. The cost may vary between pharmacies

Contacting NHS 111

NHS 111 is a valuable resource that can provide assistance and guidance when you urgently require medication outside of regular hours. Here’s how you can utilize this service:

• Free call: Dial 111 on your mobile or landline to reach NHS 111. The representative can provide information on out-of-hours pharmacies or other NHS services in your area
• Consultation: Explain your situation and the urgency of your need for medication. The representative will guide you on the appropriate steps to take

Utilising NHS walk-in centres

NHS walk-in centres are an alternative option for obtaining emergency supplies of medication. Here’s how you can make use of these centres:

• Walk-in centre search: Use the NHS walk-in centre service search to find your nearest walk-in centre. These centres are often open from early morning to late evening, 7 days a week, throughout the year
• Consultation with GP: At the walk-in centre, you may have the opportunity to consult with a GP who can assess your situation and prescribe the necessary medication. In some cases, nurse prescribers may also be able to provide medication after assessment

Contacting your GP surgery

If you find yourself away from home, you may be able to have a consultation with a local GP and obtain a prescription for a limited supply of medication. Here’s what you can do:

• Contact your GP: Call your GP surgery and explain your situation. They may be able to advise you on the best course of action
• Finding open pharmacies: Once you have the prescription, you’ll need to find a pharmacy that is open and able to fulfil your prescription

Emergency situations: A&E

In true emergencies where obtaining medication is critical, you may need to visit the nearest Accident and Emergency (A&E) department. Here’s what you should know:

• Service search: Use the service search to find your nearest A&E department
• Emergency prescription: A&E departments can provide emergency prescriptions in urgent cases. The medical professionals will assess your situation and prescribe the necessary medication

Why might your medication be out of stock?

The NHS is currently grappling with a record number of problems related to the shortage of medicines. According to the British Generic Manufacturers Association, there are currently 111 products facing supply issues, which is more than double the number at the beginning of 2022. These shortages not only impact the availability of essential medications but also affect a wide range of therapeutic areas, including hormone replacement therapies, contraceptives, antidepressants, and immunosuppressants.

Brexit and supply chain disruptions

Brexit, the withdrawal of the United Kingdom from the European Union, has played a significant role in exacerbating the medication shortages in the NHS. The process of disentangling the UK from the EU has created numerous challenges, including disruptions to the pharmaceutical supply chain. Professor Martin McKee from the London School of Hygiene and Tropical Medicine highlights that supply chain disruptions due to COVID-19 and geopolitical factors have affected every country, but Brexit has added to the existing problems.

Government policies and branded generic drugs

The British Generic Manufacturers Association attributes the rise in shortages of branded generic drugs to the government’s voluntary scheme for branded medicine pricing and access (VPAS). This scheme, which aims to control costs and improve access to medicines, has inadvertently led to supply issues. Branded generic drugs, despite representing only 10% of prescription products used in the UK, account for half of the drugs facing shortages. This imbalance raises concerns about the impact of government policies on medication availability.

Global supply chain challenges

Apart from Brexit and government policies, the NHS is also affected by global supply chain challenges. In recent years, the pharmaceutical industry has become increasingly globalized, with the production and distribution of medications relying on complex networks spanning multiple countries. Disruptions in one part of the supply chain can have far-reaching consequences, leading to shortages in another. The COVID-19 pandemic has further exacerbated these challenges, as countries prioritise domestic needs and implement export restrictions on essential medicines.

Manufacturing and quality control issues

Another contributing factor to medication shortages in the NHS is manufacturing and quality control issues. Pharmaceutical companies may face difficulties in producing medications due to various reasons, such as equipment failures, contamination, or regulatory non-compliance. These manufacturing disruptions can result in temporary or prolonged shortages of critical drugs. Additionally, quality control measures and recalls can impact the availability of medications, further adding to the supply problems.

Pricing pressures and profit margins

The pricing dynamics within the pharmaceutical industry can also influence medication shortages. The cost of manufacturing, distributing, and marketing medications can be substantial. To maintain profit margins, pharmaceutical companies may choose to discontinue or reduce the production of medications that are less financially viable. This can lead to shortages, particularly for drugs with low demand or those facing generic competition.

Rationing and stock management

Due to the scarcity of certain medications, healthcare providers may be compelled to ration the available supply. Rationing decisions are typically based on clinical criteria, prioritizing patients with the highest need. While this approach helps ensure that critical patients receive the necessary medications, it can also result in delays or limited access for others. Effective stock management practices, including forecasting demand and implementing contingency plans, are crucial to mitigate the impact of shortages.

Patient safety and treatment disruptions

Medication shortages pose significant risks to patient safety and can disrupt treatment plans. In some cases, patients may need to switch to alternative medications, which may not be as effective or have different side effects. These changes can impact treatment outcomes and patient well-being. Moreover, healthcare professionals may need to invest additional time and resources to identify suitable alternatives and manage the transition, adding to the burden on the healthcare system.

Patient education and awareness

Patient education and awareness play a crucial role in managing medication shortages. By providing patients with information about the reasons behind shortages, alternative treatment options, and potential side effects, healthcare professionals can empower patients to make informed decisions. Open and transparent communication can help alleviate concerns and minimize the impact of shortages on patient care.

Conclusion

The increasing number of medication shortages in the NHS is a complex issue with multiple underlying causes. Brexit-related challenges, government policies, global supply chain disruptions, manufacturing issues, pricing pressures, regulatory hurdles, and stock management practices all contribute to the problem. Addressing these challenges requires collaboration and proactive strategies to ensure the availability of essential medications and safeguard patient care. By understanding the reasons behind medication shortages, healthcare professionals, regulators, and policymakers can work towards implementing effective solutions and mitigating the impact on the healthcare system and patient outcomes.

References:

• Emergency prescriptions – NHS
• Request or view prescriptions – NHS App help and support – NHS
• Record number of drugs hit by supply problems, trade body warns | The BMJ