‘We’re firefighting in the background’: the pharmacists coping with record drug shortages

A 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 they cannot get the medicines they need.

“I just feel like the government and the NHS aren’t taking this seriously enough, because we’re firefighting in the background silently,” says Reena Barai, who owns and runs a pharmacy in south-west London. “They’re not realising the impact of this. Is it going to take patients to die without medication for them to start waking up and realising that this is a really serious issue that needs solving?”

Barai is far from alone. Ian Strachan, who owns four pharmacies in the north-west, says: “If you’re on an inhaler, you need that inhaler; if it’s insulin, then you need that insulin. If patients are going without medication now, they are at risk of exposing themselves to more complications.

“I’ve had patients who have been hospitalised because of the anxiety and stress about the uncertainty of finding their medicines.”

“We should not be putting patients under this stress, they’re already ill,” agrees Fin McCaul, an independent community pharmacy owner in Prestwich, Greater Manchester. “Worrying about whether their tablets are going to be there just doesn’t help them get better.”

Anil Sharma, who co-owns and runs eight pharmacies in Cambridgeshire and Suffolk with his wife, says he’s never known anything like it. “I’ve been a pharmacist 25 years, but I’ve never ever experienced this level of shortage that I’m seeing now. Any one day, we could have up to 10% of the drugs that we’re ordering not being available.”

The problem, says McCaul, is that patients are increasingly venting their frustration on pharmacies like his: “In most cases, it’s shouting, swearing, thumping fists on to counters, throwing things about.”

More rarely, it spills over into physical assault. “I had a patient the other day who was so aggressive that she nearly punched one of my pharmacy assistants, because we didn’t have her medicine,” says Sharma. “The other people in the queue had to restrain her.”

The aggression can be very distressing for the staff trying to help them. McCaul says his staff had on occasion been spat at when patients’ medicine was not available. “It leaves the team on edge all day: it’s like walking on eggshells,” he said. “I regularly have staff members in tears by 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 drugs that are prescribed by GPs cost the NHS less than 85p.” Other countries pay much more.

Barai says what’s needed is a dedicated taskforce to look into medicine shortages which would bring together manufacturers, wholesalers, pharmacists and doctors. Meanwhile, a short-term fix would be to make it easier for pharmacists to swap patients on to suitable alternative medication without having to get another prescription. At the moment, they have to get a new prescription to issue an identical drug in liquid form if the GP had requested tablets, or an ointment instead of a cream.

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

In Prestwich, McCaul says 99.9% of patients are fantastic, and even the ones who are abusive realise pharmacists are not to blame. “If somebody becomes violent or abusive, we’ll bar them from the shop. A lot of the times when somebody is abusive, they will come back later and say, ‘I’m really sorry’, and bring a box of chocolates or something. Because they know they’ve done wrong. They know we’re trying to help them and that if there’s a problem, it’s rarely down to us.”