LONDON — The majority of U.K. hospitals have yet to make plans for a no-deal Brexit, according to data provided under Britains Freedom of Information Act.
A survey of NHS trusts carried out by POLITICO suggests that almost no formal contingency planning for a no-deal scenario has begun at the local level. Of 38 trusts in England that responded to a Freedom of Information request to disclose documents relating to preparations and impact assessments on different Brexit scenarios, 35 said they hold no such documents.
Conservative MP and chair of the House of Commons health committee Sarah Wollaston said NHS organizations urgently need to be told their responsibilities and what action is being taken by national bodies to avoid medicines and equipment shortages in the event of a no-deal Brexit.
The former family doctor said an absence of planning for a cliff-edge departure from the EU in March next year could be “completely paralyzing” for the NHS.
“If youre talking about stockpiling, actually building a refrigerated warehouse doesnt happen in two weeks. [We need to know] the sheer scale of this, what products it actually affects, and who is actually doing it,” she said, adding that the government needs to provide granular detail — down to plans for the supply of individual medicines — in its technical notes on no-deal preparations, which are due to be published in batches.
“There are some medicines, devices … that we cant make in this country” — Sarah Wollaston MP
Health and pharmaceuticals are two of the topics that will be covered by the first wave of technical notes, due Thursday, the Department for Health and Social Care (DHSC) confirmed. NHS trusts are expected to receive information directly following the publication of the documents.
The technical notes are expected to outline how the government has consulted with nearly 100 suppliers, including pharmaceutical companies and storage firms, with all human medicines subjected to a review of their supply chain this year. The department tested the contingency plans during a series of meetings with industry bodies.
The U.K.s health and social care secretary, Matt Hancock, told the House of Commons health committee last month that the government is actively “working with industry to prepare for the potential need for stockpiling.” A dedicated operational team with specialist industry knowledge will advise on how to achieve the required capacity for key medicines, he said.
Wollaston said that certain products would be particularly vulnerable to shortages.
Matt Hancock, the U.K.s health and social care secretary | Niklas Hallen/AFP via Getty Images
“There are some medicines, devices … that we cant make in this country,” she said. “There is not a drop of insulin [which is required daily by many diabetics, including Prime Minister Theresa May] produced in this country … We cant source plasma in this country because of the leftover concerns about CJD [Creutzfeldt-Jakob disease, know colloquially as mad cow disease] for example. Its all imported. If people dont get their plasma products that will have very major knock-on implications for people having certain kinds of surgery and certain kinds of treatments.”
Wollaston also cited the need for a contingency plan for the supply of radio isotopes, which cannot be effectively stockpiled and which are used in 700,000 diagnostic procedures, notably for cancer patients, every year in the U.K.
Citing her work as a family doctor, she added: “When I was in practice on a very occasional basis there would be, say, a fire in a warehouse somewhere or a problem with a particular batch of medicine. Suddenly youd be wasting a whole afternoon trying to source a drug for somebody. Imagine that on a grand scale. It would be completely paralyzing.”
Long list of concerns
One of the 150 NHS trusts in England surveyed, the Christie NHS Foundation Trust in Manchester disclosed an email it sent to the government tax agency — Her Majestys Revenue and Customs — in July, in response to an inquiry about Brexit “business concerns.” The Christie trust listed “availability of drugs from European suppliers,” “price of drugs from EU locations,” “drugs approval processes,” “availability of EU workers” and “timely supply of medical supplies” among its concerns.
“A significant proportion of our drugs are manufactured and shipped from EU locations. Supply chains are on a just in time basis and any delay in supplies could have a direct impact on patient treatments,” the email said.
Another trust, the East Suffolk and North Essex NHS Foundation Trust, said it is “awaiting guidance from relevant national bodies” — a message echoed in a leaked letter reported by the BBC on Tuesday, in which the NHS Providers organization, which represents hospitals and other frontline providers, expressed concern that there has been “no formal communications” from national planning organizations NHS England or NHS Improvement on preparations for a no-deal Brexit.
“The risk to public services is real and we need appropriate national contingency planning” — Chris Hopson, chief executive of NHS Providers
The NHS Providers letter, written by Chief Executive Chris Hopson, said the risk of a no-deal Brexit is “growing.” It said that NHS England and NHS Improvement appeared to consider Brexit planning the responsibility of central government and local trusts, and noted a “nervousness about communicating with trusts because of political sensitivities and what might appear in the media.”
“We are cognisant of the political and commercial sensitivities here, but the risk to public services is real and we need appropriate national contingency planning,” Hopson wrote.
A DHSC spokesperson said: “The government is confident of reaching a deal with the EU that benefits patients and the NHS.
“As the public would expect we have been planning for all situations, speaking directly to industry across the medical supply chain, from pharmaceutical trade bodies to storage providers, so patients continue to get medicine in exactly the same way they do now in the event of there being no deal.
“On Thursday the government will begin setting out its plans, including publishing guidance to industry and the health and care system on preparing for a no-deal scenario.”