Letter to pharmacists says plans will ‘maximise the ability for supply to continue unimpeded’

Plans have been drawn up for the use of alternative transport routes and prioritisation of medicines as part of contingency planning for a no-deal Brexit, pharmacists have been told by the NHS.

The government has been reviewing transport routes for all medicines “to maximise the ability for supply to continue unimpeded” after 29 March, according to a letter seen by the Guardian that was was sent out on Thursday.

“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,” the letter reads.

Details of the correspondence emerged after the Guardian reported that top doctors have urged ministers to reveal the extent of national drug stocks, amid growing evidence patients are stockpiling medication in preparation for a no-deal Brexit.

That issue is also referred to in the letter from Dr Keith Ridge, NHS England’s chief pharmaceutical officer, who states: “Crucially I want to reiterate, it is not helpful or appropriate for anyone to stockpile medicines locally.

“Registered pharmacy professionals must always consider the consequences for patients of their actions. As we know from managing normal medicines shortages, instances of individual organisations stockpiling can risk additional pressure on the availability of medicines for patients in other areas of the country.”

There is also a warning: “To ensure we manage supply effectively across the NHS, any incidences involving the over-ordering of medicines will be investigated and followed up with the relevant chief or responsible pharmacist directly. I am expecting senior pharmacy leaders to ensure local collaboration to meet patient needs wherever necessary.”

The letter also appraises pharmacists of Serious Shortage Protocols (SSPs), which are governed by draft legislation which came before parliament on Friday.

The protocols, which will only be issued in exceptional circumstances, will allow ministers to permit a pharmacist to provide an alternative to the item prescribed on a medicine-by-medicine basis.

In addition, the letter gives details on other areas of contingency planning, adding that the Department of Health and Social Care 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.

It states that the department has also secured contract agreements for additional warehouse space for stockpiled medicines, including ambient, refrigerated and controlled drug storage.

It also advises that participation in clinical research including trials should continue as normal “unless specific instructions from an individual sponsor or formal communications are received”.

Investigational medicinal products, which are used in such trials, have been prioritised on alternative routes to ensure that the flow of all these products continues unimpeded after 29 March 2019, it adds.

Simon Dukes, the chief executive of the Pharmaceutical Services Negotiating Committee (PSNC), said that there was “continued pressure on the medicines supply chain” and that the body was working with other organisations and the government to minimise any impact.

A Department of Health and Social Care spokesperson said: “We are working closely with pharmaceutical companies to ensure patients can continue to receive the medicines they need, including asking many of them to ensure a minimum of six weeks additional supply of medicine over and above usual buffer stocks in place by 29 March.”