A new report from the Royal Pharmaceutical Society, backed by charities and patient groups, has called on the government to create a national strategy to manage medicine shortages. It also calls for changes in legislation to allow community pharmacists to amend prescriptions when medicines are in short supply.

Medicines Shortages: solutions for empty shelves finds that supply chain vulnerabilities have combined with unplanned spikes in demand, such as shifts in prescribing practice or increased diagnosis of some conditions, to create a perfect storm of unstable supply.

The report highlights the complexity of global medicine supply chains, with shortages caused by manufacturing problems and disrupted, less resilient sources of supply. Supply chain issues are in part due to the consolidation of manufacturing outlets and cost-driven pressures, says the reports.

The government is called on to create a national strategy to both prevent and manage medicine shortages. Th strategy should streamline efforts across the NHS, reduce inefficiencies caused by duplication of effort, and ensure information and guidance for professionals and patients is available as soon as shortages occur, the RPS says.

The report also urges the government to legislate to allow community pharmacists to make minor amendments to prescriptions when medicines are in short supply, to enable a different quantity, strength or form of the medicine to be provided.

This move already has support from medical organisations such as the British Medical Association and the Royal College of GPs.

Commenting on the report, Community Pharmacy England chief executive Janet Morrison said: "It is worrying that medicines supply problems continue to affect pharmacy teams and their patients. The RPS study matches closely with our own 2024 Medicines Supply Report, which also highlighted the frustration and inconvenience caused by increasing level of medicine shortages.

"CPE contributed to this report and is fully supportive of many of its recommendations, including allowing pharmacists to make minor adjustments to prescriptions to supply alternative strengths or formulations and sharing more information about the reasons behind supply issues.”

Other recommendations in the report include:

• Improve reporting by manufacturers: prompt alert of the risk of shortages would transform the impact on patients, and those consistently failing to report should be fined.
• Build supply chain resilience: strengthen NHS procurement contracts to ensure manufacturers can meet supply demands and respond to shortages quickly.
• Improve data connectivity: Use better demand forecasting and share information across the supply chain to prevent stock issues before they happen.
• Enhance systems for life critical medicines: improve collaboration across the health service to coordinate access to specific medicines.

“Taking a new approach to medicine shortages is essential. A properly resourced UK-wide medicines shortages strategy that helps prevent and manage shortages would greatly improve the resilience of the supply chain. This would relieve stress and anxiety for patients and free up time for pharmacists to focus on patient care rather than constantly chasing down supplies,” said James Davies, RPS director for England and co-author of the report.

“Community pharmacists must be allowed to make minor changes to prescriptions during shortages. The current outdated system inconveniences patients, wastes time and causes frustration. The Health Secretary should give pharmacists the authority to act in the best interests of their patients, rather than remain subject to ‘empty shelf syndrome’.”

Sharon Brennan, director of policy and external affairs at National Voices, a coalition of 200 health and social care charities in England said: “Our members report that patients are rationing their medicines to make their supplies last, that deteriorations in health have led to job losses or dropping out of education, and that patients are buying falsified medicines from the internet.

“This is on top of many hours wasted calling round pharmacies to track down medication and the frustration, worry and anxiety felt by those that can’t access their medicines. People often don’t know where to turn for help and advice, and the situation is especially bad for those who are facing health inequalities.”

The report has been welcomed by charities including Diabetes UK, ADHD UK, the Epilepsy Society, CardiomyopathyUK, the National Rheumatoid Arthritis Society, Pancreatic Cancer UK, and Parkinson’s UK, as well as Healthwatch England and the Health and Social Care Alliance, Scotland.

Duncan Rudkin, chief executive of the GPhC, said: “Our Council shares the concerns outlined in this report, and has heard first-hand of the frustration, distress and harm that medicines shortages can cause. We fully agree with the report’s conclusion that further action is needed now.

“Although the GPhC has no direct role in medicines supply, we are determined to play our part in the next steps wherever possible, including in educating pharmacy teams about medicines shortages, and supporting them through our standards and guidance when they are facing challenging situations.”