Pharmacists have raised concerns about the supply of antibiotics and demanded that the Government gives more direction to healthcare professionals and takes action to resolve the crisis.
The Department of Health and Social Care (DHSC) previously said that it was not aware of any supply issues of amoxicillin, adding today that 'there is no supplier shortage of antibiotics' but that 'we sometimes have surges for products and increased demand means some pharmacies are having difficulties obtaining certain antibiotics'.
However, the Pharmaceutical Services Negotiating Committee (PSNC) said it had heard anecdotal reports of supply issues with Amoxicillin (capsules and suspension) and phenoxymethylpenicillin (Pen V), (tablets and liquid), with limited stock showing at wholesalers.
PSNC also said that following UKHSA advice for GPs to have a ‘low threshold’ to prescribe antibiotics for symptoms of Group A strep, prescribers may now be issuing more prescriptions for these lines, increasing demand and driving up prices and possibly affecting supply too, amid concern over high levels of infections and the deaths of nine children from strep A since September.
Dr Leyla Hannbeck, chief executive of the Association of Independent Multiple Pharmacies (AIMp), said that supply of antibiotics was ‘patchy’.
‘You put your order in, and [the system] says it's not in, in London, and somebody puts it in in Manchester and it says yes, it’s in. But then the next day somebody puts it in in another part of the country and it's not in – it's just all over the place’, she explained.
‘If they [DHSC] say there is enough stock, they need to stick to their word and make sure there is enough stock’, she added. ‘Medicines are important. We don't want to turn patients away, or to turn parents away.’
GP pharmacist Siddiqur Rahman said his GP colleagues have been asking him for updates about the supply situation in community pharmacy, but without any updates from DHSC, he said healthcare teams have been ‘left in limbo’.
He called on DHSC to acknowledge a national antibiotics shortage, to give directions to healthcare teams about what the next steps if supply were to be completely exhausted, and to take action to resolve the crisis – for instance, by buying antibiotics supplies from other countries.
‘Because we're not hearing any of these type of preventive measures happening at the moment, we're in the darkness as much as the public’, he said.
He added that there was extra concern about the situation because Strep A is particularly dangerous for children if untreated, which might cause GPs to prescribe antibiotics more regularly.
A spokesperson for DHSC said that it was 'working urgently with manufactures and wholesalers' to 'explore what can be done to expedite deliveries and bring forward stock they have to help ensure it gets to where it’s needed, to meet demand as quickly as possible and support access to these vital medicines.”
It added that DHSC will look to utilise all possible tools to ensure stock is available for patients who require treatment with antibiotics for Strep A.
Ade Williams, a community pharmacist in Bristol, said that earlier this week he had to keep his pharmacy open late to supply antibiotics to a parent who had called several pharmacies in the area to find one that could fulfil her prescription.
He added that while community pharmacies and GP practices could work together to amend prescriptions when necessary, a longer-term solution would be to give pharmacists access to clinical notes and the power to change a prescription, within their area of competence, to ensure that a patient could access medicines that were in stock.
Dr Kieran Sharrock, BMA England GP committee acting chair, said: ‘While the Government insists there are sufficient supplies of antibiotics nationally, this will be of little comfort to pharmacists, GPs and patients who are experiencing shortages locally’.
He also argued that ‘those responsible for supply chains must double down on efforts to ensure there are enough medicines to meet demand.’
Clear and effective public health messaging on Strep A was ‘crucial’ to ‘ensure that patients and parents and guardians know where to go if they do need help and to reassure the vast majority of people who will not go on to become seriously unwell,’ Dr Sharrock added.
The Department of Health and Social Care (DHSC) previously said that it was not aware of any supply issues of amoxicillin, despite pharmacists sharing screenshots on Twitter showing where it was out of stock.
Today it said that it was aware of a short-term issue with sugar containing amoxicillin 250mg/5mL oral suspension but added that the sugar-free product is able to support a full uplift in demand, and that amoxicillin oral suspensions and capsules remain available.
It said that supplies of phenoxymethylpenicillin (penicillin V) an as oral suspension and as tablets were currently available, but that due to a particularly sharp increase in demand over the past week, stocks in wholesalers have been depleted very quickly and replenishments haven’t kept in step with demand, which remains higher than usual.
It added that DHSC is engaging with manufacturers and wholesalers to understand availability of stocks and explore what can be done to expedite deliveries, and bring forward more stock for the UK market as soon as possible.
PSNC said that it was awaiting an update from the DHSC Supply Team regarding the wider situation. ‘We rely on reports from pharmacies for our information but don’t have the same access to market information that the Department do’, its spokesperson added.
Community pharmacists have been reporting rising prices and difficulties obtaining medicines for several months, last month saying that the issue was now impacting ‘bread and butter lines’.
This article has been updated to include a response from the Department of Health and Social Care.
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