The new report, published today (May 9), said that the worsening situation with medicine shortages has led to patients taking their frustrations out on pharmacy staff, including spitting at them and leaving them breaking down “in tears” or anxiously “walking on eggshells” for the rest of the day.

Some 84% of pharmacy staff questioned by CPE said patients had become “aggressive” when informed about delays or incomplete prescriptions due to medicine shortages.

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“We have had patients being annoyed and angry, and occasions of people spitting at us,” one independent pharmacy owner Fin McCaul said. “Even if this only happens once it leaves the team on edge all day, it’s like walking on eggshells.”

“Because we have a constant queue of people in the pharmacy you can feel very overwhelmed. I regularly have staff in tears because of the sheer pressure of it all,” McCaul added.

Anil Sharma, another community pharmacy owner, said that with “hundreds of medicines affected all the time, the stress is never-ending.”

 

“Always on my mind”

 

The research formed part of CPE’s 2024 pharmacy pressures survey, which questioned the owners or head office representatives of 6,100 pharmacy premises in England and 2,000 pharmacy team members between early March and early April this year.

Six in ten (60%) respondents said they were contacting GPs on a “daily” basis over supply chain issues.

And 91% of pharmacy owners pointed to a “significant increase” in supply chain “issues” over the last 12 months, with 72% of pharmacy team members saying medicine shortages were creating “multiple” issues a day.

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“Sometimes the GPs will ask us to recommend an alternative medication based on what we do have in stock,” one anonymous pharmacist told CPE.

“If this is possible and simple, such as switching from tablets to liquid, then we will do so. But we don’t have access to the full patient record and sometimes we are not able to make a suggestion. That puts a lot of pressure on my team,” they added.

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The constant shortages are “always on my mind”, Sharma said. “When I arrive at the pharmacy, the first thing I do is to check the list of outstanding prescriptions to see how many patients are waiting for which medicines.

“We are constantly checking if we can get them or chasing around trying to sort out an alternative. We now use eight suppliers to give ourselves the best chance of getting hold of everything.”

 

Concession numbers up 1,763% in a decade

 

CPE chief executive Janet Morrison said the report was “distressing reading” and offered a “stark warning” as to the increasing severity of medicine shortages.

The report called for a review of the medicines supply market, the introduction of short-term measures to alleviate supply issues and a “full review” of medicines margin that “may lead to developments such as benefit sharing and relief mechanisms”.

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As an indication of the worsening state of affairs, it pointed to concession prices introduced when a medicine is affected by a pricing issue, which is often related to supply.

In 2013, it said there was an average of eight concessions per month, but by 2021 that had risen to 49 concessions a month and by 2023 it stood at 149 – a 1,763% increase in a decade.

CPE also said it had received an average of 90,000 pharmacy reports per month of purchases over listed drug tariff prices over the last 12 months.

 

“Alarming”

 

Company Chemists’ Association (CCA) chief executive Malcolm Harrison said the research was “alarming” and joined the call for a “wholesale review of the medicines supply market to ensure it is fit for purpose”.

“We also need an uplift in retained margin, which has not been reviewed since 2014/15 despite significant increases in the volume and price of medicines procured,” he added. “Ultimately, without action, medicine shortages will continue to rise.”

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A spokesperson for Healthwatch England said the shortages were an “ongoing issue” that “continues to wreak havoc” on patients.

“Our polling showed one in four members of the public experienced shortages in the last 12 months,” they added. “We hear about how shortages can lead to rationing and desperate instances of ‘pharmacy bingo’, where patients must travel from pharmacy to pharmacy looking for stock.”

 

Extreme concern over pharmacy finances

 

Meanwhile, pharmacy business owners responding to the survey listed their “top three highest worries”, which CPE said was topped by “finances” with 73% of respondents “extremely concerned” about their financial situation.

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Medicine supply came next, with 69% “extremely concerned”, followed by team well-being, where 45% were “extremely concerned”.

CPE said it is “imperative” to review pharmacy funding arrangements to prevent further closures.

The next funding deal was due in March but is currently delayed. Negotiations continue between CPE and the government, with no official timetable in place for when an announcement can be expected.