This is the real cost of pharmacy shortages to type one diabetics

The system needs urgent attention – but pharmacists say they aren’t being listened to when they raise the issue with government

James Moore
Sunday 16 April 2023 06:05 EDT
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Doctor on strike reveals eye-watering number of people on NHS waiting lists

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It was after a run of Tesco being unable to fulfil my prescription that I realised something was going badly wrong. And not with Tesco.

This week, The Independent reported that pharmacy leaders have raised concerns about patients coming to harm as a result of medicine supply issues.

A Pharmaceutical Services Negotiating Committee (PSNC) survey of pharmacy owners and teams across England found almost all (97 per cent) reporting significant increases in wholesaler and medicine supply issues.

Worse still, 71 per cent said that this was leading to delays in prescriptions being issued.

And as I read, I was tempted to say, “catch up”.

The PSNC, that is, not my esteemed colleague Ella Pickover, whom I cheered when I read her piece because it might help to give the issue some air. It surely needs that because as someone requiring medication to stay alive, this is getting scary.

It was a few months ago, after a run of unfulfilled prescriptions, that I started to raise the issue of drug shortages with various organisations; charities, trade bodies and what have you. I asked if this was something they were hearing about too? When I got a reply at all, it tended to be something like: “We’re not aware of anything, but we can have a look if you want.” It’s not a reassuring response.

I’ve had type 1 diabetes, an autoimmune disorder that cannot be cured by diet and lifestyle changes like type two sometimes can, for decades now. So I’ve got used to the occasional hiccup. It’s uncommon to find medication of one kind or another is out of stock, and to have to wait or go to another chemist’s if you’re really short.

This is one of the small irritations that are part of life when you have health issues. But the frequency with which it has been happening has moved it into the “serious, spine-tinglingly scary concern” bracket, not least because it’s no longer just a matter of waiting a few extra days. Instead, I find myself having to ring around local independent outlets in the hope they have what I need. Yes, this has happened to me with Tesco.

Another PSNC finding was that 84 per cent of its respondents said they had experienced aggression from patients due to medicine supply issues.

Now, I understand why that is a problem. No one should have to put up with aggression when they go to work. And pharmacists are already under pressure. They are increasingly finding themselves asked to plug the yawning gaps that have opened up in the NHS.

On the other hand, I also understand what it’s like to be told your prescription can’t be fulfilled. It is an awful feeling. Your stomach lurches. Lurid scenarios start to play out in your head.

Type 1 diabetics have the potential complications drilled into them from a young age. It’s a constant mantra. I remember an ad for what was then the British Diabetic Association, and is now Diabetes UK, when I was young. “Susan lives under the shadow of diabetes,” it read, before listing all the horrible things that came with the condition: heart disease, kidney disease, amputations, blindness, and so on. It was designed to solicit donations, but it was also a reminder of how bad things can get without medication.

Sometimes you’ll hear people urging patients to order in good time to avoid getting caught in a jam. But the NHS takes a dim view of what it describes as “stockpiling” (and what you or I might describe as “prudence”).

I’ve noticed that on my online repeat forms, the GP sometimes sets a date for when I can next order which is uncomfortably close to the date at which I run dry. The surgery has sometimes declined prescription requests when I’ve put them in a day or two early. So it isn’t always possible to be prudent.

Sparks are inevitably going to fly when tired and stressed pharmacists collide with frightened patients in dire need of medication. The patient goes home in tears, wondering if and when their drugs will arrive and what might happen in the meantime. So does the pharmacist, having been left to deal with the fallout from a problem that they didn’t create.

Leyla Hannbeck, pharmacist and president of the Association of Independent Multiple Pharmacies, tweeted that her organisation has been asking for talks with the Department of Health & Social Care to “suggest solutions and plan better” for months now without getting anywhere.

“Why?” she asked. Yes indeed: why? Because Ms Hannbeck’s members, and we patients, are actually on the same side. Or at least we should be.

High-profile shortages have included certain antibiotics during the Strep A outbreak, a drug used in the treatment of Type 2 diabetes; some hormone replacement therapy meds to help relieve menopause symptoms; even run-of-the-mill cough and cold medicines. And they are just the high-profile ones.

That the DHSC appears to be sticking its fingers in its ears in the face of this is unconscionable.

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