In the background they were fighting fires: Pharmacists faced record drug shortages

A The survey of thousands of pharmacists has found that patients’ health is being put at risk by record drug shortages in England, leaving patients and pharmacists frustrated that they cannot get the medicines they need.

I feel the government and the NHS are not taking it seriously enough, because they were fighting fires in silence, says Reena Barai, who owns and runs a pharmacy in south-west London. They don’t realize the impact of this. Will it take patients dying without medication for them to start waking up and realizing that this is a really serious problem that needs to be solved?

Barai is far from alone. Ian Strachan, who owns four pharmacies in the North West, says: If you have an inhaler, you need that inhaler; if it’s insulin, then you need it. If patients run out of medication now, they risk exposing themselves to more complications.

I have had patients who have been hospitalized due to anxiety and stress over the uncertainty of finding their medications.

Fins McCaul, who owns an independent community pharmacy in Prestwich, Greater Manchester, agrees that we shouldn’t put patients under such stress, they are already sick. Worrying about whether their tablets will be there doesn’t help them improve.

Anil Sharma, who co-owns and runs eight pharmacies in Cambridgeshire and Suffolk with his wife, says he has never heard of anything like it. I have been a pharmacist for 25 years, but I have never experienced this level of shortage that I am seeing now. On any given day, we could have up to 10% of the medicines they were ordering unavailable.

The problem, McCaul says, is that patients are increasingly venting their frustration at pharmacies like his: in most cases, it’s yelling, swearing, punching counters, throwing things.

More rarely, it devolves into physical assault. The other day I had a patient who was so aggressive that she almost punched one of my pharmacy assistants because we didn’t have her medicine, says Sharma. The rest of the people in the queue had to hold him back.

Aggression can be very distressing for staff trying to help them. McCaul says his staff had sometimes been spat out when patients’ medications were unavailable. He leaves the team on the sidelines all day — it’s like walking on eggshells, he said. I usually have staff in tears at the end of the day because of the sheer pressure of it all.

Many pharmacists say the price the NHS is willing to pay for drugs is too low. A chunky KitKat costs around 85p in a convenience store, Sharma says. Twenty of the 100 most common medicines prescribed by GPs cost the NHS less than 85p. Other countries pay much more.

Barai says what’s needed is a dedicated task force to investigate drug shortages that would bring together manufacturers, wholesalers, pharmacists and doctors. In the meantime, a short-term solution would be to make it easier for pharmacists to switch patients to an appropriate alternative medication without having to obtain another prescription. For now, they have to get a new prescription to issue an identical medicine in liquid form if the GP had ordered tablets, or an ointment instead of a cream.

I am a pharmacist, I should be able to change a product that I know is equal in concentration, strength and medicine, she says. It’s just the wording that’s slightly different. Why can’t I change it myself? Why do I have to go back to the doctor to get a prescription? It just seems silly.

At Prestwich, McCaul says 99.9% of patients are great, and even those who are abusive realize the pharmacists are not to blame. If someone becomes violent or abusive, ban them from the store. A lot of times when someone is abusive, they’ll come back later and say, I’m so sorry, and bring a box of chocolates or something. Because they know they did wrong. They know that we were trying to help them and that if there is a problem, it is rarely our fault.