Revealed: Hospitals face ‘severe’ shortages of medical supplies ahead of winter due to Brexit and Covid

Hospitals are experiencing shortages of essential medical equipment triggered by a combination of Brexit and the impact of the pandemic on global supply chains, The Independent can reveal.

Manufacturers and suppliers of beds, lifts and life-saving defibrillators have also warned of being under “unparalleled pressure” due to the supply chain crunch this winter. NHS England boss Amanda Pritchard has warned that the winter season was already going to be “tougher” than a summer which experienced unprecedented demand.

Medical supplies are the latest casualty of widespread disruption that has left gaps on supermarket shelves and prompted panic buying at petrol stations.

Managers at London’s St George’s Hospital, one of the largest NHS trusts in England, are having weekly meetings with suppliers to stay on top of the problems and warned staff in an email leaked to The Independent that some companies were folding or exiting the UK market as a result of the pressures.

The message, sent by a procurement manager at the trust, revealed the hospital had experienced shortages of oxygen saturation monitors, slide sheets used to move patients, as well as needles for drawing up medicines.

It said: “We are having intermittent stock shortages across the [southwest London area], this includes St George’s. The core reasons are due to Brexit, Covid and companies folding from a combination of the two. There is also an added element of new UK CE marking requirements being so expensive, some European suppliers are pulling out of the UK market altogether.”

The UK is set to bring in a new post-Brexit regime for certifying the safety of products. However, ministers recently decided to postpone introduction of the extra bureaucracy to the end of 2022 in response to concerns that manufacturers and assessment centres were not ready.

“Some companies are having border issues, sterilisation issues of their product in the packaging process (staff shortages due to Covid) and production lines being crippled across the world,” the letter added.

“There is [no] pattern to the stock issues and they are quite random. Some companies like Smith Medical and BD have had more issues than others but it is quite widely spread.”

The trust said it was successfully sourcing alternative products and the problems had not impacted patient care.

But the letter revealed the daily challenge facing NHS teams with staff spending “most of their working day” trying to find alternative products. It added: “We have little to no warning of these products and as we run a just in time process we are at times left with little to no stock.

“Some key suppliers we are having weekly meetings with to resolve issues.”

On Friday, the Office for National Statistics (ONS) said the public were beginning to experience problems buying medicines or prescriptions. Nearly a quarter – 23 per cent of adults – who had tried to buy medicine or get a prescription reported differences compared to usual. These included items not being available but a replacement being found in six per cent of cases, as well as items unavailable and no replacements in 5 per cent of cases.

Four per cent of people said they had to go to more pharmacies to find what they needed. The results were based on a weighted sample of 5,000 households.

Leyla Hannbeck, CEO of the Association of Independent Multiple Pharmacies, also said there were problems with deliveries linked to the fuel crisis and a lack of HGV drivers.

She said this week: “While the situation with the fuel crisis has started to improve, we are aware that some geographical areas continue to be affected by delays to deliveries of medicines. We are watching the situation with delivery drivers and fuel crisis very closely and are liaising with the government and asking the government to ensure robust contingency plans and strategy are in place to ensure medicines supply is not affected and that we can continue caring for our patients.”

Mark Dayan, Brexit lead at the Nuffield Trust think tank, told The Independent that while preparations for exiting the EU had meant supplies of medicines overall were being managed well, there were real problems with other products.

He said: “There is clearly a problem in the medical consumables supply chain of a sort that is not normal. Medical devices and consumables are essential for a healthcare system.

“There is not a huge amount that can be done. The difficulties in the manufacturing supply chain are going to continue for a while.”

Mr Dayan said the problems were being caused by a “coming together of different factors” linked to Brexit, such as migration policy and shortages of HGV drivers, as well as the administrative burden for companies crossing the UK/EU border. He said global issues linked to Covid and its effects on manufacturing in places like China were affecting the movement of goods around the world.

Mark Roscrow, chair of the Health Care Supply Association, said there were problems in “some areas” but he was not seeing “major problems across the board yet”.

He said the pandemic has led to specific shortages, adding: “Covid has meant demand for needles used in the vaccination programmes, for example, have increased globally which will affect supply in some areas.”

Mr Roscrow said Brexit was a factor for some issues although many were “coincidental” and linked to large individual companies such as Becton Dickinson, which has had major supply issues with blood collection tubes across the NHS.

Last month, GPs were ordered to halt all non-urgent community blood testing due to a shortage of tubes. BD blamed UK border problems as one factor behind the shortages.

The British Healthcare Trade Association said suppliers of other equipment were under “unparalleled pressure” and faced “significant price inflation across various essential materials”.

The severity of healthcare supply problems “cannot be ignored” as the UK enters the winter, said Andrew Stevenson, chairman of the BHTA.

Direct Healthcare Group (DHG), a leading manufacturer of hospital beds, specialist mattresses and mobility aids, warned that it may not be able to keep up supplies through the winter.

Graham Ewart, its chief executive, said he had seen a “dramatic” reduction in the speed and quantity of supplies at its Caerphilly plant over the past month.

"I am very concerned that the catastrophic combination of the lorry driver shortage, the pandemic and Brexit is taking a severe toll on the whole healthcare system," Mr Ewart added.

DHG began having problems sourcing materials last year, with high-specification mattress foam being in particularly short supply due to surging demand for the chemicals that it is made from.

Mr Ewart said: “For our customers, the NHS and care homes, the impact has so far been mitigated by companies like us having to hold a lot more stock. Unfortunately that’s now coming to an end and we can no longer replace it because of problems with logistics and raw materials.

“My belief is that this is about to start impacting the health service’s ability to care for patients. The supply of essential medical devices simply cannot meet increased demand.”

Health services in other countries have begun stockpiling some items to avoid future shortages, further exacerbating the immediate problem, said Mr Ewart.

"You are going to potentially see a National Health Service which is running out of products. As a company, we are now coming to a point where we have to choose which healthcare provider we supply.”

A lack of microchips has meant long delays to orders of defibrillators, according to three major suppliers of the devices. Defib Shop, one of the UK’s largest sellers of defibrillators, said “manufacturers just can’t get hold of the stock”.

Brexit has meant additional paperwork partly related to the fact that defibrillators can be classed as dangerous goods if their batteries have a high lithium content.

Social care is also being impacted. Mike Lord, chief executive of Stiltz, which manufactures and installs lifts in elderly and disabled people’s homes, said “pretty much every building material” was now in short supply.

“If you can get it, it’s significantly more expensive than it was, sometimes double or more," he said.

Until now, the company has absorbed the extra costs for installation work but said it is likely it would have to raise prices next year.

Shipping costs have gone up from $2,800 (£2,000) per container to $20,000 (£14,700) and goods can be waiting in Stiltz’s Chinese factory for six or seven weeks before a container becomes available, Mr Lloyd said.

In the UK, the company has struggled to find people with general building skills to install its lifts after many labourers from EU countries left because of Brexit.

A government spokesperson said that there are currently “no reports of supply shortages within the NHS as a result of issues with freight deliveries”.