No-deal Brexit could trigger power for pharmacists to alter GP prescriptions

Pharmacists may need emergency powers to alter patients' prescriptions without their GP's permission to cope with drug shortages in the event of a no-deal Brexit, medicines distributors have warned.

Giving evidence to the House of Commons health and social care committee on the impact that a no-deal Brexit could have on the NHS, Healthcare Distributors Association (HDA) executive director Martin Sawer said a no-deal Brexit would be ‘catastrophic’ for medicine supplies.

Patients may need to have their medications swapped without their GP’s permission if the drugs they usually take are out of stock following the UK’s departure from the EU, he said.

Mr Sawer told MPs: ‘I’m not pulling any punches. We have to think of emergency powers.’

In a no-deal situation, UK ports ‘would be a challenge for some time’ and medicines that are already in the UK ‘should be managed more appropriately’.

Medicines supply

This would include ‘allowing pharmacists to substitute prescriptions [and] perhaps alternate prescriptions to medicines that [are] available’.

Pressed by committee member Ben Bradshaw MP to confirm whether this ‘could involve patients being put on different drugs to what they are used to without even consulting their GP’, Mr Sawer replied: ‘Correct’.

Mr Sawer also argued that government should relax current legislation so that pharmacies are able to ‘share and use other pharmacies’ medicines… [and] allow a local community to share medicines around’.

During evidence from health and social care secretary Matt Hancock, committee chair and former GP Dr Sarah Wollaston described from her own experience how ‘chasing round’ for alternative medicines ‘takes up an inordinate amount of clinicians’ time and pharmacists’ time’.

Workload

She added: ‘If that happens on a grand scale, for many products all at the same time, that is - I think - what concerns a lot of people.'

Mr Hancock insisted that medicine shortages are not unusual. ‘We’re trying to reduce the amount of products that [this] will happen to with all the planning work that we’re doing now,’ he said.

'It’s a standard situation that there’s a shortage of one or other piece of equipment or drug. And the response to such a shortage can be both to look for alternative supply lines and also to take a clinically-based decision on the appropriate reaction to the fact that whatever it is may not currently be as available as we would like.’

The committee also voiced concerns over the implications of a no-deal Brexit for public health. Deputy chief executive at NHS Providers Saffron Cordery told MPs: ‘One of the things that I think we probably all recognise the EU for in terms of public health is around communicable diseases and tracking the flow of communicable diseases. We know that being a member of the EU we benefit from early warning on those issues, so I don’t know what the scenario will be in terms of those networks for early warning but that is certainly one area where I think we need to be very careful.’

Professor Tamara Hervey, Jean Monnet Professor of European Union law at the University of Sheffield told the committee: ‘In the event of a no-deal Brexit the UK will be immediately excluded from the European Centre for Disease Control (ECDC)... It’s very difficult to see how the undertaking that the government has given to do no harm could be fulfilled in the event of a no-deal Brexit.’

DHSC permanent secretary Sir Chris Wormald said:  ‘If the result of exiting the union is that we are not involved in the EU systems we will have to rely more heavily on our WHO systems… So we will have exactly the same objectives for health protection but we will have to deliver them differently and use WHO membership more if we don’t have access to the EU one.’

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