As members are no doubt aware, the national realisation that one of the impacts will be a worsening medicines shortage situation which could be highly damaging to the health and wellbeing of the population is beginning to attract more attention, as the Brexit crisis deepens.
The Government recently started to participate in a Pharmacy Brexit forum and in the last few months, the PDA alongside all the relevant pharmacy organisations has been regularly meeting with Government representatives to discuss these matters particularly against the backcloth of a possible ‘no deal’ Brexit.
A number of ideas have been agreed and the government are making some changes to the legislation to enable pharmacists to take proactive steps to try and make the best of a critical shortage situation. That the government has focussed upon maintaining the supply of medicines is important and unsurprising. However, the PDA is disappointed that the PDA’s proposal to allow pharmacists across all sectors of pharmacy to work directly with patients to also reduce the demand for medicines, through pharmaceutical care using processes like de-prescribing did not gain the support of the government. This is a wasted opportunity.
The main proposals of the government to deal with the medicines supply in the event of a ‘no deal’ Brexit are described by a number of communications, the most informative which we enclose.
Dr Keith Ridge, Chief Pharmaceutical Officer at NHS England, has provided an update on the Government’s contingency preparations for a no-deal EU exit.
PSNC newsletter https://psnc.org.uk/our-news/serious-shortage-protocols-draft-legislation-laid/
Whilst pharmacists are of course concerned to ensure that patients can continue to receive their medicines and that the whole health service can deliver the care patients need, the PDA as a trade union, is also concerned about the impact on pharmacists at work.
It will be front-line pharmacists that face patients and their carers and families and have to spend the time explaining what alternative options exist in the event of a medicines shortage crisis. Employers need to make sure pharmacists are given the extra time, clearly agreed processes and appropriate supporting communications. They must protect their employees and locums from any aggressive behaviour that could come from frustrated and concerned members of the public. The government has the responsibility to support employers in this, but if the government fails to do so, this in no way removes the obligation on employers to look after each employee or locum for whom they are responsible.
Pharmacists in secondary care may face additional different problems; those associated with a reduction of EU healthcare personnel upon which hospitals are very reliant. Pharmacists working together as part of multi-disciplinary teams will need to be supported by employers as they face the direct consequences of under staffing.
The PDA also appeals to wholesalers to act responsibly and not seek to take advantage of the shortage situation through an aggressive pricing policy or by favouring certain of their larger pharmacy customers.
Throughout the Brexit process, the PDA has remained impartial, recognising that members have various views on the subject. However as Brexit is fast approaching and more information is becoming available (and in this regard the Brexit Forum meetings with the government have provided many more insights), it is important to recognise that the potential effects of a no deal Brexit would be disastrous for both patients and for the pharmacists who look after their medicines-related needs.
We believe a no deal Brexit would exacerbate problems with medicines supply and pharmaceutical care in a way that would put patient safety at risk. We would be against a no deal Brexit on grounds of patient safety and we are extremely concerned about what that would mean if it went ahead.
Similarly, we believe that any agreed deal for Brexit must also provide cast iron protections for employment rights for our members, these must not fall behind those enjoyed by pharmacists across the continent. Employment rights were not given this protection in the deal recently rejected by parliament and it is important that any future plan honours the government’s prior commitment to retain UK workers’ rights.
We understand that members may have very different views on Brexit and that is why we have focussed upon medicines and employment rights; issues that bind all pharmacists, whatever their views may be.
This is the most important decision for our country in generations and we expect, and welcome, an increased focus on pharmacy in the next few weeks as the life or death nature of health care and the reality of what Brexit could mean for supply of medicines is realised by the media and general public. We encourage all pharmacy organisations to be honest and open about this issue and ask all pharmacy employers to support their coal face pharmacists in the difficult decisions that they may need to make under the bad circumstances that they and their patients have found themselves in.