The year 2020 will see continued pressures on the UK’s medicines supply chain – they have become the ‘new normal’. The immediate no-deal Brexit shadow of uncertainty hanging over us may have eased, but there are more deep-seated strategic issues at play in the global supply of medicines. The UK, shortly to be outside the EU, will need to be aware of them and work hard for its voice to be heard.

The last 18 months have demonstrated the best of the UK’s medicines supply chain partners. By working together and analysing possible threats posed by Brexit to patients, businesses in the supply chain have worked constructively with the government, the Department of Health and Social Care and the NHS. They ensured that levers and solutions were in place, or regulations adopted, to prepare everyone as much as possible for whatever the outcome of Brexit.

These structures and new decision-making processes will stand us in good stead for the next deadline at the end of this year. Patients and public health have always been put first. By understanding and building on existing procedures and developing workarounds, there has been less disruption than might have been the case. We should thank those who have listened.

2020 will see the focus move from tackling and handling downstream symptoms to a more fundamental debate about the global supply of medicines. With other countries in Europe now facing issues of availability, and some governments planning to ask manufacturers to build national stockpiles, global medicines supply could come under pressure like never before.

As the UK leaves the EU, we must not miss out on initiatives that the European Medicines Agency and the European Commission will be working on this year to align EU member states in dealing with these problems. For example, the recent call by the generics manufacturing sector for more medicines production to take place in Europe can only be applauded as a way of providing more certainty of supply for us all. This year will also bring continual shifts in how healthcare is delivered, as technology and efficiencies are driven into the system to get the best clinical value for the patient and the taxpayer.

Contained in the imminent Medicines and Medical Devices Bill will be provisions that enable third-party hub-and-spoke dispensing to deliver to independent pharmacies, and for the UK to set its own online pharmacy regulations, perhaps tougher than EU rules. This legislation may provide more scope for innovation and speedier adoption of new treatments – initiatives that could affect the nature of delivery to patients.

Given increasing concern about the diversion of medicines out of the legitimate supply chain, and an increase in physical thefts of medicines for the same criminal reasons, we can expect the UK authorities to look long and hard at the integrity of medicines supply to patients. We all must engage with this process in 2020. What will happen to the Falsified Medicines Directive and the Medical Devices Regulations, for example?

All the HDA asks is that our member companies can operate on a level playing field, and that the different channels of distribution and delivery can compete under a balanced and proportionate regulatory and incentivised regime. As well as supply chain business partners working together, we also hope that in 2020 the regulators and policy makers continue to strengthen their joint understandings.

They should work with all the different businesses to enhance a system that can keep up with the technological and clinical changes and, most importantly of all, deliver for all UK patients.

Martin Sawer is executive director of Healthcare Distribution Association (HDA), which represents the UK's largest medicine wholesalers