NAO highlights 'significant' gaps in government's no-deal Brexit plans for NHS

'Significant work' remains to be done to prepare the NHS for a no-deal Brexit, the National Audit Office (NAO) has warned - highlighting that the government expects scores of drugs to become unavailable.

Downing Street (Photo: Dan Kitwood/Getty Images)
Downing Street (Photo: Dan Kitwood/Getty Images)

In a report examining the government’s plans for supplying the health and social care sectors should the UK crash out of the EU without a deal, the NAO confirmed the DHSC had set up a ‘medicine shortage response group’ and strengthened its communication routes to general practices and community pharmacists.

The paper added that the government estimated that 100 medicines were likely to be short supply at any given time and that it had expanded its team to manage this, recruiting additional pharmacist advisors.

Earlier this week, GPonline’s sister website MIMS reported on its free drugs shortages tracker that a total of 106 products prescribed in primary care were unavailable. However, the true figure could be higher, with the list not being exhaustive.

Drug shortages

GP leaders have said patients are being forced to 'chop and change' between medicines as commonly-prescribed drugs go out of stock, with availability changing 'almost by the week'.

Despite acknowledging that the government had done ‘an enormous amount to manage’ risks around supply delays, the NAO said there was ‘still significant work to be done’, specifically highlighting efforts around stockpiling.

The NAO said the DHSC had encouraged suppliers, including pharmaceutical companies, to build up stockpiles of medicines and other supplies, but found it had ‘incomplete information’ about the level of stockpiles in place.

Ahead of Brexit, the DHSC has relied on suppliers building up their stocks at their own expense - although it can advise suppliers to build up stocks, it cannot instruct them to do so.

Medicine stockpile

As at 20 September, suppliers reported that 72% of medicine product lines had at least six weeks’ worth of supplies stockpiled, the report said, with the government receiving responses from 69% of medicines suppliers in scope for the Continuity of Supply Programme - around 90% of the market.

The report also highlighted a lack of preparedness around plans to ensure the smooth transport of supplies across the Channel in the event of a no deal Brexit.

The NAO said there was a risk that traders, including medicine suppliers, would not be ready for new border processes by 31 October, due to a lack of understanding of the new processes for transport.

In a House of Commons debate on Wednesday, cabinet minister Michael Gove stressed it was important that providers knew about the new systems, saying they would play an essential part in guaranteeing the smooth transport of goods, such as medical supplies and medicines.

Transport

‘If traders ensure their goods have the appropriate transit accompanying documents or movement reference number barcode, they will smooth their passage through Calais without needing to go into any car park at all,’ he said. He also assured that the government was doing everything [it] could to ensure that the UK had ‘a free flow of medical products through the short straits’.

However, the NAO reported that trade bodies operating in the pharmaceutical sector informed them in September that their members had ‘continuing concerns’ about the quality of practical information from government on the precise border processes that will operate after 31 October. This was despite the government launching a communications campaign to support individuals and businesses to prepare.

If businesses, including pharmaceutical companies, fail to prepare for the new processes for moving across the Channel, there could be delays in transporting goods, meaning practices could be left waiting on drugs left sitting in the docks of Calais.

Meg Hillier MP, chair of the committee of public accounts said: 'The independent NAO report is deeply concerning and highlights the real risks of a no deal exit on 31 October.

'The DHSC still doesn’t know whether all stockpiles are in place, it has no idea whether social care providers are ready and it is still not certain whether all the freight capacity government needs will be in place on time. If government gets this wrong, it could have the gravest of consequences.'

A DHSC spokesperson said: 'We want to reassure patients we are doing everything necessary to make sure they can access the medicines they need after Brexit on 31 October, whatever the circumstances.

'As the NAO recognises, the DHSC, pharmaceutical companies and medical device manufacturers have mounted an unprecedented response in preparing for Brexit, with substantial stockpiles of medicines, which are increasing by the day. Combined with other measures, including new transport routes coming online shortly, we can help ensure patients continue to receive the highest quality of care in the same way they do now.'

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