The stock shortage saga: where are we now?
Pharmacists were quick to warn last week that Department of Health guidance suggesting medicines should be supplied within 24 hours was just not good enough (C+D February 12, p6). And it seems their fears have been confirmed, as evidence now suggests that not only is the 24-hour target far from being hit, but stock shortages are in fact getting worse.
An audit by Devon LPC saw local pharmacists recording supply issues they had with branded medicines over two weeks in November 2010. The results, revealed exclusively to C+D this week (p5), show where there were supply issues, patients had to wait a staggering 4.4 days on average to receive their medicines.
The 70 Devon pharmacies encountered an average of 7.7 supply issues each over the two weeks – this figure was just 4.7 when a similar audit was carried out in April 2009. Pharmacists spent 20 minutes resolving each issue, with 95 emergency orders being placed with manufacturers. Patient care suffered, with 6 per cent of those affected experiencing moderate harm and 14 per cent low harm.
‘Outrageous' situation
The situation was condemned by everyone from wholesalers to the Patients Association, with AAH calling the findings "very disturbing" and Numark branding the delays to patients "outrageous". Boots and Lloydspharmacy confirmed their pharmacists were still having stock problems, and a C+D survey found 83 per cent of respondents were experiencing worse shortages than ever before.
PSNC chief executive Sue Sharpe summed up the mood, commenting: "There is clearly no improvement in the supply problems pharmacies are experiencing, and the sorts of waiting times this survey shows are manifestly unacceptable."
There have been efforts to tackle shortages, such as the ministerial summit in March 2010, but clearly these are yet to deliver. As Andy Murdock, pharmacy director at Lloydspharmacy, puts it: "Shortages are still very much an issue yet despite the scale of the problem the industry has not yet addressed the situation."
For him and many observers, the onus is now on the DH to take action, and the latest guidance was not enough. "The Department of Health needs to address the situation across the whole supply chain with a review of UK supply demands," Mr Murdock said.
Richard Barker, director general of the Association of the British Pharmaceutical Industry (ABPI), joined the debate, saying: "We need government action to tackle the root causes." And the British Association of Pharmaceutical Wholesalers (BAPW) executive director Martin Sawer reiterated his calls for public service obligations to be placed on the supply chain and for wholesaler dealers licensing regimes to be tightened up.
Contentious issue
But while all concerned agree on the need for action, the root cause remains a contentious issue. "This is a big problem caused by a small minority of people downstream from the manufacturers who sell medicines intended for UK patients overseas because they can make more money," says the ABPI's Mr Barker. Meanwhile, Avicenna CEO Salim Jetha maintains: "Most of our members blame manufacturers for these shortage issues", with others still suggesting restricted distribution deals could be to blame.
We've got very used to no-one accepting responsibility for the shortages. But pharmacists remain on the frontline of patient care and are regularly dealing with the consequences of medicine delays.
As Mr Murdock says: "Pharmacists are at the interface in trying to pacify patients who can become anxious and distressed when faced with a delay in receiving their medication."
In light of this alone, the DH should take action. Avicenna suggests leaflets explaining the stock situation to affected patients could be helpful. And PSNC is pushing for the 24-hour target to be enforced, warning it "will accomplish little if it is not backed by a capacity for enforcement".
It's unclear how much longer pharmacists will continue to experience problems associated with shortages nor how bad they could get. But it's clear that an already failing supply chain could continue to deteriorate if no action is taken.
DH assurances that it "will continue to review the situation and take appropriate action as necessary to help ensure patients receive the medicines they need" are unlikely to bring much comfort.
But pharmacists must hope that it is somehow able to make its supply guidelines a reality before it's too late for one patient, or more.
