No-deal Brexit preparations: NHS England update

No-deal Brexit preparations: NHS England update

January 18, 2019

Dr Keith Ridge, NHS England’s Chief Pharmaceutical Officer, has today (January 18th 2019) written to community pharmacies to update them on the continuity of supply of medicines as part of the Government’s contingency preparations for a no-deal exit from the European Union (EU).

Read the letter from Dr Keith Ridge here:

The letter reiterates that it is ‘not helpful or appropriate for anyone to be stockpiling medicines locally’, due to the risk of placing additional pressure on the availability of medicines for patients in other areas of the country, and Dr Ridge writes that ‘any incidences involving the over-ordering of medicines will be investigated and followed up with the relevant Chief or Responsible Pharmacist directly’.

The main body of the letter consists of a summary of the work currently underway across Government and the NHS as part of contingency preparations for a possible no-deal Brexit scenario.

Contractors should particularly note the Operational Readiness Guidance which sets out the actions that contractors should take to prepare for a no-deal exit from the EU and can be found here. PSNC has provided a summary of the key actions for contractors: PSNC Briefing 005/19: Key actions for pharmacy contractors to prepare for a no-deal exit from the EU

Further information included in the letter is:

  • Medicine Supply Assessment: The government has undertaken a comprehensive assessment of medicines supply to identify products that have a manufacturing touch point in the EU or wider European Economic Area (EEA) countries.
  • Six Week Stockpile: DHSC has received very good engagement from industry on developing a six-week stockpile of prescription only medicines and pharmacy medicines to ensure supply for patients is maintained across the NHS. DHSC has also secured contract agreements for additional warehouse space for stockpiled medicines, including ambient, refrigerated and controlled drug storage.
  • Alternative Transport Routes: Government has reviewed transport routes for all medicines and plans are being developed with industry for re-routing where necessary. The government has agreed that medicines and medical products will be prioritised on alternative routes to maximise the ability for supply to continue unimpeded after 29 March 2019. In the event of a ‘no deal’ scenario this additional transport capacity and prioritisation includes prescription only medicines and pharmacy medicines, general sales list medicines and unlicensed medicines, including specials and investigational medicinal products used in clinical trials and vaccines.
  • Vaccines: Public Health England manages significant stockpiles of vaccine for the national immunisation programme and in addition is working closely with vaccine suppliers to ensure replenishment of stockpiles continues in the event of supply disruption in the UK. In addition, DHSC is leading separate contingency plans outlined above, which includes locally procured vaccines
  • Clinical Research including Trials: Participation of and recruitment into clinical research including trials should continue as normal unless specific instructions from an individual sponsor or formal communications are received. Investigational medicinal products (IMPs) have been prioritised on alternative routes to ensure that the flow of all these products continues unimpeded after 29 March 2019.
  • Unlicensed Medicines: DHSC have met all key unlicensed and specials suppliers and asked them to ensure that by March 2019 they have a minimum of six weeks additional supply in the UK in case of a ‘no deal’ scenario. In addition, unlicensed medicines and specials manufactures to ensure sufficient ingredients in the UK to ensure continuity of supply.
  • Operational Guidance: National operational guidance for the NHS has been produced in December 2018 by DHSC, with support from NHS England and NHS Improvement.
  • Serious Shortage Protocol: The government has also put in place legislation to enable Ministers to issue protocols that, where appropriate, enable community pharmacies to dispense against a protocol instead of a prescription without going back to the prescriber first. Any protocol will be developed with input from clinicians and could cover dispensing a different quantity, pharmaceutical form, strength or a generic or therapeutic equivalent.

PSNC Chief Executive, Simon Dukes, said: 

‘This letter from the Chief Pharmaceutical Officer repeats the Government’s request for anyone, other than manufacturers, to avoid stockpiling and it sets out some of the contingency planning that is being done to prepare for a possible no-deal Brexit. Much of this work, and particularly the preparation for the introduction of Serious Shortage Protocols, is complex, and PSNC will continue to work to represent community pharmacies’ interests in the ongoing dialogue. As uncertainty over Brexit continues we can expect to see continued pressure on the medicines supply chain, and we will work closely with LPCs, other national pharmacy organisations and the Government to try to ensure that the impact on pharmacies and their patients is minimised.’


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