UK pharmacies in dark about ministers’ plan to maintain drug supplies

[helvella]

The headline might be a bit overdone but, as you read, it is clear that we simply do not know what is happening. Nor what will happen.

This follows at least one post about delays in getting Teva levothyroxine - which must be one of the most common thyroid medicines.

UK pharmacies in dark about ministers’ plan to maintain drug supplies

Chemists wait for details of measures to ensure driver shortages do not adversely affect deliveries of prescription drugs

Pharmacists are waiting for details from the government about what measures are in place to deal with any delays to deliveries of drug supplies as a result of van driver shortages.

If the situation worsens, pharmacists have suggested that one fall-back could involve the use of a “serious shortage protocol”, which the government had originally prepared, against the backdrop of hard Brexit concerns, to cater for drugs with known supply problems. This would enable pharmacists to supply alternate forms and strengths of medicines without the need to contact the prescriber.

The National Pharmacists Association (NPA) said on Sunday that it was aware that deliveries to some pharmacies had been reduced and that its members worked together and with local GPs to get medicines that were needed when problems occurred.

Rest of article accessible here:

theguardian.com/business/20...

This is intended as a warning of the possible situation - not political.

ADDING - this basic story is across many media - not just the Guardian:

Pharmacies warn of drugs delay: Lack of van drivers sees 'reduced' deliveries with prescriptions 'not arriving' - amid fears situation will get worse at winter

Pharmacists reportedly facing disruption to deliveries up to 'three times a week'

They warn the issue could get worse due to an increase in demand in the winter

The delivery issue is said to be caused by a shortage of van drivers across the UK

Changes to the IR35, a shortage of labour and self-isolation due to Covid blamed

dailymail.co.uk/news/articl...

Patients face delays on prescriptions as van driver shortage hits pharmacies

Supply chain crisis begins to bite chemists across Britain as pharmacists warn medicines are either arriving late or not all

telegraph.co.uk/news/2021/0...

Driver shortage: Now pharmacies complain medicine deliveries are being delayed

lbc.co.uk/news/driver-short...

[jimh111]

I think we should wait and see. I’ve seen this story before and what confuses me is that all my local pharmacies get their stock delivered by small vans not HGVs. So, I don’t see a problem. There’s no shortage of “white van man” - in spite of all my voodoo efforts!

[helvella Administrator in reply to jimh111]

Vans don't deliver from manufacturers to pharmacies. But from warehouses and depots to pharmacies.

There is a network of around ten distributors (and I don't know how many sites) and the manufacturers do need to use HGVs to deliver in bulk to them.

And Teva and Aristo levothyroxine (to look at just one relevant medicine) are manufactured on the other side of the water.

And even UK-manufactured products need deliveries of active ingredients and (probably more of a problem) excipients, packaging, etc.

[bantam12 in reply to helvella]

So now people will be panic ordering and buying meds and creating an issue that may not come to anything 🤦🏻‍♀️

[helvella Administrator in reply to bantam12]

For prescription medicines, we in the UK probably don't have much option to panic buy.

[jimh111 in reply to helvella]

Yes to wholesalers, but you get a lot of tablets in a juggernaut.

[helvella Administrator in reply to jimh111]

A few jottings on the delivery issues. At around three million packs of levothyroxine per month in England… Assume a typical pack dimensions:

10 cm

5 cm

0.5 cm

Each pack is about 25 cm3

3,000,000 packs per month

75,000,000 cm3

75 cubic metres

A particular trailer holds 33 Euro pallets or 26 UK pallets with a volume capacity of 90 m³. (Assuming most palettes are full.)

That would pretty much fill a trailer with just one medicine. How many medicines are there? And if they have to multi-drop around ten locations…

A Transit typically starts around six cubic metres. So one fifteenth of a trailer.

The scale of change is much larger than it might initially appear. And not just any Transits, but ones with proper air-conditioned loading areas. (I think they need recording devices.)

[jimh111 in reply to helvella]

I wouldn’t worry about it. This situation has existed for over a year and we are coming out of COVID, with vaccinations fewer drivers will be off sick, certainly better than last winter. It makes sense to try and keep a couple of months stock of thyroid hormone (if you can) as there have been interruptions to supply in the past.

[TSH110 in reply to jimh111]

But we are 100k short of drivers. It is worrying.

[jimh111 in reply to TSH110]

Is causing some problems but medicines have been OK so hopefully they will continue to be OK. I don’t like turkey so that’s no problem and it’s not related to thyroid anyway.

[Outandabout in reply to TSH110]

I was talking to an HGV driver in a cafe last week and he says this is not new, it has been an issue for years. It just happens to be the centre of media attention right now - for whatever reason - best known to the media. I am more annoyed about the media frenzy making petrol shortage claims leading to panic buying by idiots. Leaving ambulances, DPD drivers, taxis etc etc unable to obtain fuel to keep the services running.

[TSH110 in reply to Outandabout]

It’s a complete mess and agree there’s long term problems that haven’t been addressed. I think the hideous facilities or total lack of them, no family life, sleeping at the side of the road in a cab for starters must put people off doing it as a job. I understand lorry drivers in France have much better facilities. I don’t know if there’s a big problem on the continent too but it doesn’t sound like it.

[TSH110]

But what of millions of pounds worth of food rotting, animals slaughtered that have got too big to enter our food supply chain because of this transportation issue? It’s all going wrong and seems to be getting worse, even ambulances can’t fill up and people are stock piling it making it even worsé not to mention the fire danger residential properties stuffed with petrol might pose - we are so reliant on transport for our very survival in our developed society it’s a bit more serious than a few seasonal turkeys. I hope you are right and medicines are not affected and the measures taken are effective in righting things I imagine driving a lorry to be a stressful and unpleasant and I am not very confident the long term problems with recruitment will be resolved or the quick fix will be effective either. I know that we probably have far too much choice but I couldnt even buy something as basic as a mop the other day, and my local pharmacy was shut all day Saturday because there was no pharmacist to man the place. It’s not just medicines getting there, it’s people reaching their work place too to dish the things out.

[helvella Administrator in reply to TSH110]

I was trying to keep the discussion to thyroid-related issues!

Though it is difficult to draw a line so will leave that response.

[TSH110 in reply to helvella]

Sorry will try and stick to the main subject in future.

[DippyDame]

Ultimately our biggest challenge may be panic!

[Horsey07 in reply to DippyDame]

Excellent point. It’s panic buying that will cause most of the problems. One only has to look at the ridiculous behaviour at petrol stations, or the shortage of toilet rolls at the start of the first lockdown. Why people thought toilet paper would be so essential in large quantities baffled me. Pharmacies are run by intelligent, well-trained people. I’m sure they’ll be taking the necessary precautions.

[helvella Administrator in reply to Horsey07]

Pharmacies are run by intelligent, well-trained people. I’m sure they’ll be taking the necessary precautions.

And it is they who are raising the issue saying they do not know what to do.

They cannot decide whether to apply the serious shortage protocol.

[Horsey07 in reply to helvella]

Are they, or is it the press as usual? Honestly, all this scaremongering in the press is the cause of half the issues.

[helvella Administrator in reply to Horsey07]

You can look further up the chain than general media and individual pharmacists. For example, from 14 days ago:

Phoenix pauses OTC orders and Trident delays deliveries due to staff shortages

In an email to pharmacy contractors – seen by C+D – sent last week (September 10), Phoenix’s supply chain director Alan Fairfield said: “All OTC orders will be suspended as of today until the end of next week.

“This is necessary in order to process a backlog of orders which has arisen due to staff shortages outside of our control resulting from COVID-19 test and trace self-isolation; rising COVID-19 infection rates; and Brexit restrictions concerning who is eligible to work in the UK including depot staff and drivers,” he explained.

The supply of prescription-only medicines (POMs) is not affected, Phoenix stressed.

“Like many other sectors across the UK, the whole of the medicines supply chain is suffering from chronic labour market shortages,” Mr Fairfield said.

As well as redeploying head office staff to work in the depots, a spokesperson for Phoenix told C+D it is “continuing with [its] intensive recruitment campaign” in the hopes of “returning to business as usual as soon as possible”.

chemistanddruggist.co.uk/CD...

[Horsey07 in reply to helvella]

So the key thing there, which the press seem not to be mentioning, is that those controls apply to over the counter medicines, not prescriptions - ‘The supply of prescription-only medicines (POMs) is not affected, Phoenix stressed.’ It’s a jolly good job we have a totally impartial press that doesn’t need to make money selling copy!

[helvella Administrator in reply to Horsey07]

No - that is that one company which seems to handle OTC and POM and has been able to protect POM (as I read it). POMs are being affected with, for example, Alliance unable to offer their usual next-day deliveries.

[Outandabout in reply to helvella]

Yes, but I remember carers saying the same thing about covid - now that's a group of people who pought to know. Worrying.

[helvella Administrator in reply to Outandabout]

Yes - I agree there is concern.

And many people require OTC medicines just as much as they require POM medicines. The classification is an entirely separate issue to the patient need.

The company seems to have decided that POM are somehow more important than OTC.

[TSH110 in reply to Horsey07]

If you need petrol to get to work and there may not be any - panic might be a possible reaction to your situation, including buying as much as you can while you can. I don’t approve of it but I do understand why it’s happening. I don’t drive myself. Not being able to get prescriptions like I experienced the other day with my local pharmacy closed with a sign saying no pharmacist available is a worry and I can’t see how all this can be blamed on individuals ensuring they can get to work it just doesn’t add up, its not the real cause it’s scapegoating.

[Horsey07]

Thank you for passing on the information. I’ve not experienced any problems since the start of the first lockdown when my usual pharmacy couldn’t supply the controlled drug I need for pain relief. My GPs pharmacy was fantastic and got the drug for me within two days. These headlines are at best unhelpful as they cause unnecessary anxiety, but at least people can make sure they order repeat prescriptions in plenty of time.Fortunately, unlike fuel, it won’t be possible to ‘panic buy’ prescription medication. I don’t recall ever seeing drugs delivered to pharmacies by hgv, although I imagine it’s possible that firms like Boots and Lloyds might have theirs delivered that way along with other store supplies.