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Preparing for a ‘no deal’ Brexit

RCP president Professor Andrew Goddard is meeting with Stephen Hammond, the health minister with responsibility for Brexit, in a few weeks’ time. Ahead of this we asked the minister for an update on the Department of Health and Social Care's Brexit preparations.

It is no overstatement to say that ensuring the uninterrupted supply of medicines, medical devices and consumables – whatever the outcome of Brexit – is the number one priority of the Department of Health and Social Care (DHSC) right now.

Concerns about the impact a ‘no deal’ Brexit could have on the health and care system are understandable, and I do not want to discount those worries out-of-hand. That is why I want to update you, as colleagues on the frontline, on the extensive work the DHSC is doing together with the NHS and our partners to prepare for every eventuality as the UK exits the EU.

Making sure patients continue to have access to the medicines they need is paramount, which is why the government has undertaken a comprehensive assessment of medicines whose supply involves the EU or wider European Economic Area. We are working extremely closely with industry to make sure there are significant supplies of these drugs in the UK.

The majority of pharmaceutical companies are already actively stockpiling the minimum 6 weeks’ supply of medicines – over their existing stocks – which we requested of them, and we are engaging closely with the others to encourage their compliance.

Stephen Hammond, health minister with responsibility for Brexit

The majority of pharmaceutical companies are already actively stockpiling the minimum 6 weeks’ supply of medicines – over their existing stocks – which we requested of them, and we are engaging closely with the others to encourage their compliance. Warehouse space for these stockpiles has been secured, which will be fully equipped to handle medicines that require either ambient, refrigerated or controlled storage.

Complementing this stockpiling are plans for alternative transport routes designed to deliver an uninterrupted supply of medicines into the UK in a worst-case ‘no deal’ scenario. In a demonstration of the importance of continued supply to the health and care system, the government has confirmed medicines and medical products will be prioritised on these routes. 

In addition, Public Health England is working closely with vaccine suppliers to ensure continued replenishment of their significant existing stockpile of vaccines, while medicines used specifically for medical trials will likewise be prioritised on alternative import routes. 

It’s worth remembering that drug shortages are not uncommon and at any one time we and our partners are managing and mitigating a small number of shortages. In fact, we have well established processes in place to ensure the impact of any shortages are minimised, whether by working with manufacturers to increase supply or find alternative sources, with the Medicines and Healthcare products Regulatory Agency (MHRA) to take any regulatory action necessary or with the NHS to provide additional clinical advice.

The government is also introducing legislation that, in exceptional circumstances, will allow pharmacists to provide alternative medications to patients if a shortage is deemed serious enough by ministers on the advice of senior clinicians. This could include, where appropriate, a differing quantity, strength or form of medicine. Though this protocol is not directly linked to a ‘no deal’ EU exit, it will be a useful tool in mitigating any unforeseen medicine supply issues that may arise.

I would also like to take this opportunity to reinforce the vital message that hospitals, pharmacies, GP surgeries and patients should not stockpile medicines at any point during this process. Doing so risks shortages for other patients. If everyone does what they are supposed to, we are confident the supply of medicines will continue uninterrupted whatever the Brexit outcome. 

I want everyone who provides care, whether in hospitals or in the community or elsewhere, to feel reassured that the extensive preparations we are taking will allow you to continue to provide the same high-quality care that you always have.

Stephen Hammond, minister of state for health (responsible for Brexit at the Department of Health and Social Care)

The RCP’s response to the potential of a ‘no deal’ Brexit

Over the last few weeks we have seen a renewed focus on the potential impact of a 'no deal' Brexit on the NHS and patients. We know that medicine shortages are a real concern for many doctors, pharmacists and most importantly patients. The RCP along with others has continued to highlight the challenges facing the current and future supply of devices and medicines with the Department of Health and Social Care, NHS England and parliamentarians. The RCP is aware that a number of specialist societies have yet to be asked for their clinical input and we are following this up with the relevant senior responsible officers at NHS England.