Navigating drug shortages can be stressful, but there are ways to manage them effectively, and steps pharmacists can take to help prevent further shortages in the future.
Key takeaways
- Medicine shortages occur for multiple reasons, including global or economic events, manufacturing or supply chain issues, delays in regulatory approvals, and unexpected increases in demand
- Drug shortages can cause anxiety for patients, who will be concerned about the impact on their wider treatment and long-term health
- Medication shortages can add to pharmacists’ and pharmacy teams workloads, as they need to be reported promptly, creating extra administrative work. What’s more, sourcing alternatives and dealing with frustrated patients can be time-consuming, impacting patient experience and the time pharmacy staff have available for training
- Pharmacists can play a role in helping to prevent medicine shortages by building a diverse supply chain, reporting issues promptly, and optimising their inventory management.
Medicine shortages: the current situation
UK medicine shortages are increasing, data shows. The Pharmacy Pressures Survey 2025: Medicines Supply Report from Community Pharmacy England found that more than 80% of UK pharmacy teams encounter out-of-stock medicines every day. Over a quarter (26%) of teams said supply chain issues impacted their pharmacy on a daily basis, with 61% reporting that this was an issue several times a day. As a result, three-quarters (74%) of pharmacy owners have been spending more time on medicines procurement than ever, with 39% of staff spending one or two hours a day on this task.
A recent survey conducted by UKCPA revealed the direct and real impact of medicines shortages and supply chain issues on pharmacy teams. Pharmacists described this as one of the most frustrating and time-consuming issues due to:
- Daily time spent managing shortages
- Increased risk, workload, and inefficiency
- Waste, unlicensed medicines, additional governance
- Impact on patient care and staff morale
Clear guidance is “crucial”
Commenting on figures from Pressures Survey 2025: Medicine Supply Report, Louise Ansari, Chief Executive of Healthwatch England, said: “These findings are worrying and reflect what patients tell us about the distress and frustrations that medicines shortages can cause. International supply issues will take time to fix, but the NHS can take immediate steps to reduce the impact on patients. Providing clear guidance to the public on what steps to take if their medication is unavailable is crucial.”
Drug shortage warnings on the rise
In addition, analysis of Department of Health and Social Care (DHSC) data by the National Pharmacy Association (NPA) found that pharmacists triggered 7,426 Discontinuations and Shortages Notifications to the DHSC from October 2020 to August 2025. This is the equivalent of 28 warnings a week signalling that supplies of particular medications were running low.
The NPA also analysed data relating to Medicine Supply Notifications (MSNs), which notify healthcare providers of supply issues regarding specific medications, and found that these increased by 50% in just three years. Some 130 MSNs were issued in 2024, compared to 85 in 2021.
These high levels of medication shortages are creating extra administrative, procurement and logistics work for pharmacists, impacting the time they are able to spend on patient care. It’s therefore important that all pharmacy workers are aware of the factors impacting drug shortages, and the steps that can be taken to prevent and manage these situations.
What leads to medication shortages?
There are multiple factors that can lead to medication shortages, from global supply chain issues to increases in demand. The causes of medicine shortages include:
- Manufacturing issues: factors such as raw materials or active ingredient shortages or production disruptions can lead to manufacturing delays that impact medicines supply.
- Economic factors: a competitive procurement landscape, rising costs, and low-profit margins may cause delays in production, impacting time to market.
- Regulatory issues: delays to regulatory approvals can hold up access to medications. Following Brexit, many drugs need to be approved by both the UK Medicines and Healthcare Products Regulatory Authority (MHRA) and the European Medicines Agency (EMA), requiring additional time and costs. If a batch doesn’t meet the required standards, this will lead to further delays.
- Seasonal demand: seasonal illnesses impact demand for particular medicines, which may lead to shortages, especially if this higher demand wasn’t expected.
- Global factors: global economic and political factors can impact pharmaceutical supply chains, whether it’s the increased regulatory approvals required following Brexit or the war in Ukraine impacting energy costs and the supply of some materials.
- Prescribing trends: updated NICE guidance on a specific treatment, an increase in diagnoses for a particular condition following new research, or even trends – such as the rise in the use of weight loss jabs – can impact supply and potentially lead to medicines shortages.
How to stay informed about medication shortages
Pharmacy professionals stay informed about medicine shortages via the Medicines Supply Tool, managed by the Specialist Pharmacy Service (SPS). NHS workers can access the platform to view up-to-date information on drug shortages, supply chain issues, and when these are expected to be resolved. The Medicines Supply Tool also includes clinical advice on alternative treatments that may be available.
Outside of this, simply communicating with other healthcare professionals across the NHS can provide an insight into new shortages or concerns regarding supply. The UKCPA online forums are an excellent way to do this. However, it’s important to ensure these are reported as quickly as possible via the proper channels. This data informs the MSNs that the DHSC and NHS England will send to pharmacists informing them of supply issues, and the National Patient Safety Alerts (NatPSAs) that are sent when drug shortages pose a significant threat to public health.
The impact of medicine shortages
Medicine shortages impact patients and the wider healthcare system alike. For the general public, medication shortages cause anxieties, while they create extra work for pharmacy teams.
Impact for the public
Drug shortages can be worrying for patients, and it’s important for pharmacists to recognise this to manage their concerns and provide the reassurance they need. The impact of medicine shortages on members of the public can include:
- Health impact: if medicines shortages continue long term, there could be an impact on patients’ health, with conditions potentially worsening or leading to additional complications. It’s therefore important for pharmacists to source alternatives as promptly as possible.
- Treatment delays: medicine shortages can lead to delays in patients accessing vital treatment, possibly impacting health outcomes.
- Anxieties: drug shortages cause a great deal of anxiety for patients, who will worry about what this means for their health long term. Extra stress may impact their health further, and it can increase worry for patients’ loved ones too.
- Higher costs: patients may end up paying higher costs for access to medicines from alternative sources if they are unable to receive them as usual. This can raise concerns about medication safety too, as patients may not receive safe dosage advice at the point of purchase.
Impact for healthcare professionals
Medication shortages can also cause stress for pharmacists and other healthcare professionals. The impact of shortages on pharmacists can lead to:
- Increased workload: medicines shortages can increase pharmacists’ workload, with staff required to spend more time reporting issues, creating extra administrative work. Procuring alternative treatments also takes time. All of this could leave pharmacy professionals experiencing stress that may lead to burnout.
- Patient frustrations: patients can be understandably frustrated when the medications they rely on are unavailable, and pharmacists may bear the brunt of their frustrations. This can be stressful to deal with, and requires careful management.
- Ethical dilemmas: when medicine supplies are limited, pharmacists are faced with the choice of which patients receive this stock. Senior pharmacists should collaborate with other healthcare teams on these decisions to ensure the best possible care is provided to each patient.
- Impact on patient care: as pharmacists spend more time dealing with supply chain issues or locating specific medications, they have less time to spend on providing care, impacting patient experience.
- Hinders professional development: dealing with medication shortages means pharmacy professionals have less time available to dedicate to ongoing education and training, which may impact their long-term career development.
Read more: Are operational pressures preventing NHS staff development?
What medicine shortages mean for different pharmacy settings?
Community pharmacy
- Increased operational pressure from sourcing alternatives, managing SSPs, and handling patient frustration at the point of supply
- Higher risk of fragmented care, particularly where patients receive inconsistent substitutions across different pharmacies
- Greater need for clear, confident patient communication to maintain trust and prevent unsafe self-directed sourcing of medicines
Primary care / general practice pharmacy
- Increased workload related to prescribing switches, prescription amendments, and medicines reconciliation
- Clinical responsibility to assess therapeutic equivalence, monitor for adverse effects, and ensure continuity of care
- Need for close collaboration with GPs, community pharmacy colleagues, and ICB medicines optimisation teams
Secondary care / hospital pharmacy
- Risks to treatment pathways, particularly for oncology, critical care, antimicrobials, and medicines with a narrow therapeutic index
- Requirement for formal risk assessment, governance sign-off, and MDT agreement when alternative regimens are used
- Increased pressure on procurement teams, including regional collaboration and escalation to chief pharmacist level
Across all sectors, medicine shortages reinforce the importance of clinical judgement, professional accountability, and system-wide coordination.
Governance and risk considerations during medicine shortages
When managing medicine shortages, pharmacists should ensure that appropriate governance arrangements are in place to protect patient safety and professional accountability.
Clinical governance
- Assess clinical appropriateness and therapeutic equivalence of any alternative medicine
- Identify medicines with a narrow therapeutic index, complex dosing, or monitoring requirements
- Consider cumulative risk where patients experience multiple or repeated switches
Documentation and audit
- Clearly document decisions, rationale, and any advice provided to patients or prescribers
- Record use of SSPs, local agreements, or exceptional supply arrangements
- Ensure documentation is sufficient to support audit, learning, and incident review
Communication and escalation
- Communicate changes clearly to patients, carers, and relevant healthcare professionals
- Escalate unresolved or high-risk shortages via local governance routes (e.g. chief pharmacist, ICB medicines optimisation team)
- Use national reporting systems promptly to support system-wide situational awareness
Professional accountability
- Act within scope of practice and local authorisation
- Seek senior or specialist input where clinical risk is high
- Ensure decisions align with professional standards and organisational policy
Robust governance supports safe flexibility during shortages while protecting patients, pharmacists, and organisations.
How pharmacists can help manage medicines shortages
Pharmacists, pharmacy technicians and other healthcare professionals have a key role to play in managing medicines shortages to prevent too much disruption for patients. Pharmacy staff have a duty to report supply issues promptly, collaborate with healthcare providers to source alternatives, and communicate effectively with patients to provide reassurance. The Royal Pharmaceutical Society (RPS) set out to examine the causes of medicines shortages and help tackle their impact on patients and pharmacy practice, which has culminated in the publication of Medicines shortages: Solutions for empty shelves. Some key elements that focus on solutions include:
Prompt reporting
Efficient reporting is vital for managing medication shortages. Supply issues and unexpected stock shortages need to be reported to the SPS to keep the Medicines Supply Tool up to date. If a shortage you’ve encountered isn’t listed on the SPS website, this should be reported to Community Pharmacy England.
Supplier relationship management
Working with multiple suppliers is another way to manage medicines shortages, avoiding reliance on just one company when issues occur. Building a diverse supply chain can enhance its reliability, while pharmacists have their own part to play in ensuring accurate inventory management. This means pharmacy staff can order in advance from suppliers when stocks reach a certain level, and anticipate future demand based on accurate inventory data.
Serious Shortages Protocols (SSPs)
Serious Shortage Protocols (SSPs) are an important factor in managing medicines shortages. These are issued when a serious drug shortage is identified, and they allow pharmacists to dispense a specific alternative formulation or treatment without needing to refer back to the prescriber. This ensures patients can still access medication, and streamlines the prescribing process, helping to ease anxieties.
Patient communication
Keeping patients informed is a vital part of managing medication shortages. If a patient’s usual treatment is unavailable, it’s understandable that this may cause some anxiety and concern. Take the time to explain the reason for the medication’s delay and talk to them about potential alternatives they could take.
Pharmacists need to stay informed of expected shortage resolution dates via the SPS Medicines Supply Tool to manage patients’ expectations regarding when their usual care will resume.
What action can be taken to prevent drug shortages?
Sometimes, medicine shortages cannot be anticipated or actively prevented, such as in the case of global political or economic events. However, there are steps pharmacists can take to prevent localised drug shortages from becoming a significant concern. These include:
- Report any concerns about potential shortages as soon as possible
- Collaborate with other healthcare departments for a full view of medicines availability
- Optimise inventory management to identify stock that is in high demand or at risk of running low ahead of time
- Prevent waste by ensuring medicines are dispensed well in advance of their expiration date
- Actively participate in opportunities to inform policy development to improve transparency to help prevent future shortages.
Medicine shortages: implications for policy and system leadership
Medicine shortages are not solely an operational issue — they are a system-level patient safety and resilience challenge. Pharmacists, particularly those in senior, specialist, and leadership roles, have a critical contribution to make beyond frontline management.
The issue is so concerning and detriment to patient care that it has been raised as a national priority by the House of Lords.
Key considerations for policy and system leaders include:
- Improved transparency across the supply chain, including earlier notification of potential disruptions and clearer timelines for resolution
- National horizon scanning and intelligence sharing, linking prescribing trends, regulatory changes, and manufacturing risks
- Greater alignment between clinical guidance and supply realities, to reduce unintended demand surges following guideline updates
- Stronger integration between national, regional, and local escalation routes, ensuring consistent messaging and coordinated action
- Recognition of the workforce impact, with sustained shortages contributing to burnout, moral distress, and reduced capacity for clinical development
Pharmacists bring unique expertise at the intersection of clinical care, medicines optimisation, procurement, and patient safety. Their leadership is essential in shaping sustainable, system-wide responses to ongoing and future medicines supply challenges.
Join a professional pharmacy network to stay informed
Keep informed of the latest developments across the pharmaceutical industry, from regulatory updates to emerging medicines shortages when you become a member of UKCPA. The cost of membership is less than £3 a week, and provides you with the opportunity to connect with other pharmacy professionals working across the UK to share knowledge, support, and best practice tips. Membership includes:
- Access to a paper-submitted resource library
- Forums where a wide range of topics are discussed, providing an opportunity to share tips on navigating medication shortages
- The chance to join specialist communities, dedicated to different areas of pharmacy practice
- Training opportunities to support your continuing professional development, led by experts
- A calendar of educational and networking events throughout the year
