LONDON, 27 Sep (APM) - The UK government cannot be sure of the total number of medicines companies have stockpiled in preparation for a no-deal Brexit, according to a report published on Friday.
The National Audit Office (NAO) has reviewed the Department for Health and Social Care (DHSC)'s preparations to make sure the UK has a flow of supplies for the health and social care sector when it leaves the EU, which is currently set to happen on 31 October.
Border delays are likely if no deal is made. According to the government’s own "reasonable worst case" assumptions, it is assumed is that the flow of goods across the Channel could be reduced to 40-60% of current levels on day one, says the report. Flow of goods would improve to 50%-70% of current flow after three months and return to close to current levels within 12 months.
The limited flow would be particularly damaging for healthcare. According to the report, 7,000 out of 12,300 prescription and over-the-counter medicines used in the UK come from or via the EU.
As part of its preparations, the DHSC has encouraged suppliers of healthcare products to build up at least six weeks' worth of stockpiles of medicines and other supplies considering the likelihood of border delays if the UK exits the EU without a deal.
However, the NAO's statement says it has "incomplete information" about the level of stockpiles in place having surveyed relevant companies.
As of 20 September, it had received responses from 69% of medicines suppliers, which it estimates represents 90% of the market. The responses confirmed that at that point stockpiles of at least six weeks were in place for 72% of medicine product lines.
These efforts have seen the DHSC sign 12-month contracts with three specialist providers of storage space to provide additional storage capacity for 58,850 pallets, of which 5,000 could be used for refrigeration and 850 for temperature-controlled drugs, although this was in prepartion for the original Brexit date of 29 March.
The new assessment has led to a lower requirement - a maximum of 48,000 pallet spaces- meaning the DHSC terminated one of the contracts. The total cost of the contracts is expected to be £10.9 million, of which the DHSC had paid out £8.2 million by the end of August 2019.
Since 2018, the DHSC estimates it has spent £50.1 million on the entire continuity of supply programme and has committed to spend a further £37.2 million by 31 March 2020.
Freight capacity
Suppliers also reported that they had secured freight capacity away from the short Channel crossings for 25% of medicine product lines. The Department for Transport is procuring, on behalf of government, this freight capacity to carry priority goods, including for products with a short shelf-life or where production constraints mean stockpiling is not possible, for example radioisotopes.The DHSC expects to use 91% of the total freight capacity, requesting 2,326 heavy goods vehicle spaces per week. The largest suppliers, responsible for at least 80% of radioisotope doses, have confirmed to the DHSC that they have plans in place to air freight stock into the UK after 31 October.
Time is limited, however, says the NAO, noting that "it might not now be possible to have all the freight capacity available" by 31 October.
With this in mind, the DHSC has started procurement of its own dedicated courier service which can pick up urgent medicines and supplies direct from manufacturers in Europe and deliver them to where they are needed in the UK. This will provide capacity for 50 pallets and an additional 35m³ of urgent or specialist goods to be transported each day.
However, the NAO confirmed: "Despite recent efforts across government, there is a risk that traders, including medicine suppliers, will not be ready for new border processes by 31 October."
Other medical supplies
Outside of medicines, the DHSC has created its own stockpile of six-weeks’ worth of equipment and supplies that the National Health Service (NHS) gets through at high volume, such as gloves and syringes. Its stockpile was 88% complete as of 20 September, says the NAO.There is a greater level of uncertainty over stockpiling of products for social care due to the fragmentation of the service and the fact that providers rely on non-medicines suppliers that are not usually bought via the NHS.
The DHSC has advised social care providers not to stockpile medical devices or clinical consumables, for example rubber gloves, but instead ensure they are ready to deal with any disruption.
However, the NAO report says the DHSC "does not currently know what proportion of social care providers have followed its advice, what preparations providers have made with their suppliers and whether suppliers will meet their priority needs".
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