mEdition shortages in the UK have regularly hit newspaper front pages in recent years. As a doctor on the front line, I see how this instability in our medicine supply chain play on the ground.
I work in a large city hospital and am used to meeting disgruntled patients who have had to wait hours in the clinic to receive treatment. But just imagine their concern when I have to explain to them that the medication we would normally treat them with is not available, and that as a result they will have to take an alternative or stay in the hospital even longer.
Over the past year, I have often seen patients go without medication for common conditions such as attention deficit hyperactivity disorder (ADHD), diabetes and even acne that would otherwise be easily managed, or be forced to take less suitable alternatives. And new EU plans for its members to work together to stock key medicines will only worsen the shortages in the UK.
Patients tell me that they feel others receive better treatment than them. And they are right, in some ways. What am I supposed to tell them? Health care workers are put in a difficult situation to explain why we make compromises in their care. I am concerned that this will further increase negativity and abuse towards NHS staff, which was on the rise in recent years. This all contributes to the feeling among patients and healthcare professionals that the health service is not working for the most vulnerable.
Seeing the tangible outcome of shortages of certain types of medication is alarming. Some patients who rely on medication to manage their ADHD go weeks without it, despite it being essential to their mental health during what has already been a difficult winter. For some of them, this means that they are unable to continue living their lives in a functional way, unable to work and even carry out basic day-to-day tasks until their medication is at the pharmacy does not arrive
The situation is similar for some anti-epileptic drugs, the shortages of which can be incredibly dangerous. Patients not on the right medication can develop seizures that require them to be placed in an induced coma, which can have life-changing implications. Fortunately, I have yet to hear of a case due to shortages, but this is something doctors like myself worry could happen if the supply crisis is not addressed.
The insecticide permethrin, used to treat scabies infection, is another medication in short supply. Scabies is on the rise in Britain and the shortage of permethrin could mean the condition cannot be treated before it can spread. Some patients with suspected scabies are told to isolate in the hospital, which does not kill the parasite and potentially exposes others to infection. It also means a longer stay in hospital for those affected.
With the NHS already in desperate need of beds during the winter months, treating patients in hospital when they would normally be sent home with medication comes at a cost – both to the NHS and the communities they serve.
There has recently been a shortage of a tablet known as Sando-K, which is very often prescribed in hospital to treat low potassium levels. Doctors in some parts of the country should instead prescribe a bag of liquid potassium chloride, which is administered intravenously and elderly patients with comorbidities are at greater risk of complications.
Different issues have been suggested as the main cause for the supply shortages, from Brexit to increased taxes on pharmaceutical companies, to manufacturing issues. But, whatever the ultimate cause, it becomes crystal clear to me that political inaction is making the situation worse. Recent figures suggest so since 2022has nearly doubled the number of medication shortages, and it is of no benefit to health care professionals or patients for the government to regurgitate the same excuses every time it happens.
We have weathered this storm for too long, so why are our leaders so afraid to act? It should be an absolute scandal that in 21st century Britain our supply of medicines is so unstable that doctors have to compromise in order to treat patients appropriately.
Patients need to know that it is not the staff who often work 60-hour weeks or more to care for them who are at fault. As doctors, our most important job – caring for our communities – is becoming increasingly difficult. Our politicians must take action now to address this situation before more lives are hurt.
