Community Pharmacy NI has warned of an imminent risk to the supply of essential medicines in Northern Ireland, as MLAs and sector representatives raised escalating concerns about the resilience of the medicines supply chain and the sustainability of community pharmacy services.
At a meeting of the All Party Group (APG) on Community Pharmacy at Stormont on Tuesday 3 February, members heard that while medicines supply disruption is a UK wide issue, it is currently more acute in Northern Ireland and is now directly affecting patients.
Community pharmacy representatives briefed MLAs on growing shortages of commonly prescribed medicines, including co codamol 30/500mg, which they advised is likely to remain in short supply for several months. Members were also told of reduced availability of aspirin 75mg, used as an anti platelet medicine for patients at risk of stroke or heart attack, and propranolol, widely prescribed for long term condition management.
In Northern Ireland, approximately 50,000 packs of co codamol, equating to around five million tablets, are dispensed each month to a population of fewer than two million people. Community Pharmacy NI warned that pharmacies may be forced to ration supplies of medicines related to shortages, potentially affecting on average 50 to 100 patients per pharmacy, so that patients have some supply and do not run out of vital medicines.
When questioned by MLAs, Community Pharmacy NI confirmed that community pharmacies in Northern Ireland are typically trying to source stock for over 100 common medicine lines currently in short supply.
Impact on patients and wider health service
The APG expressed serious concern about the impact on patients and the wider health service. Where medicines cannot be sourced in the usual way, patients may face delays, may receive interim or reduced supplies, or may be referred for alternative treatments.
Members heard that this disruption is creating significant additional workload for community pharmacies and increasing pressure on GP practices, out of hours services and other parts of the system. Pharmacy teams are spending large amounts of time sourcing stock, managing patient expectations and supporting clinically appropriate alternatives when supply fails.
The APG is calling on the Department of Health to treat this as an urgent patient safety and system resilience issue and to set out, without delay, a clear plan to stabilise community pharmacy funding and cashflow so pharmacies can continue to secure medicines for patients. Members also called for faster, more practical mechanisms for switching to clinically appropriate alternatives when shortages occur, reducing the operational burden created by supply disruption.
The APG also made clear that community pharmacy is not an optional extra within the health service, but a frontline service, warning that failure to act now risks avoidable harm to patients and escalating pressure across the entire system.
Community Pharmacy NI: risk of NI becoming lower priority market
Gerard Greene, Chief Executive of Community Pharmacy NI, said the discussion highlighted the growing pressures facing pharmacy teams, including the widening gap between medicine costs and reimbursement.
“Today’s discussion made clear that community pharmacy in Northern Ireland is operating under sustained and increasing pressure. The gap between medicine costs and reimbursement is widening, and pharmacies here are also struggling to pay medicine wholesaler bills and receive sufficient supply of many common medicines to meet patient need,” he said.
“The supply issue sees community pharmacies working intensively to source medicines, often under severe constraints. We have pharmacy teams reporting back to us daily that they are seeing growing numbers of other commonly prescribed medicines also in short supply. All of this is taking place while pharmacy teams try to support patients who are understandably keen to get the medicines they need.”
Mr Greene appealed to the public to remain patient with pharmacy teams as they work to source medicines, and called on the Minister to prioritise support for the sector to ensure pharmacies can pay wholesalers.
He said this could be achieved by removing clawback which reduced the payments pharmacies received last year for medicines dispensed by £23m, stressing that this does not require new funding.
Mr Greene added that while medicines supply disruption is a UK wide issue, Northern Ireland faces additional risks due to its small market and increased logistical costs compared to Great Britain. He warned that without action there is a risk Northern Ireland could become a lower priority market for wholesalers, with serious implications for patient safety, continuity of care and health system resilience.
Community Pharmacy NI is calling on the Minister and the Northern Ireland Executive to work with the UK Government to strengthen medicines security and supply for Northern Ireland, including ensuring that medicine stock is appropriately ring fenced, so patients continue to receive the medicines they rely on.
MLA call for immediate action
Chair of the All Party Group on Community Pharmacy, Danny Donnelly MLA, said:
“Today’s warnings about a sharp deterioration in medicine availability, significant medicine price increases and pharmacies in Northern Ireland struggling to pay medicine wholesalers is very concerning.
“Medicines are such a vital part of the lives of everyone across our population and the Minister needs to do all he can to support pharmacies to be able to get the medicines patients are prescribed. It is imperative that he recognises the severity of this issue and works immediately with the local community pharmacy sector to reduce the impact and risks to patients.”
Community Pharmacy NI also advised strongly against patients self selecting alternative medicines or altering doses without professional guidance, warning this may be clinically inappropriate and in some cases harmful.
Community Pharmacies in Northern Ireland dispense millions of packs of commonly prescribed medicines each year and even relatively small interruptions in supply can have a rapid and disproportionate impact on patients, pharmacy teams and local health services.