When a medicine runs short, the pressure lands on the people at the counter, on the phone and in the consulting room. Patients ring three pharmacies before lunch. Prescribers send queries about alternatives. A weight-loss medicine trends on social media and demand doubles in a week. Staff end up absorbing frustration for a supply problem they did not cause and cannot fix alone.
Use the official supply information, agree one team message for patients, and send clinical decisions about alternatives back to the prescriber unless a Serious Shortage Protocol applies. In England, the SPS Medicines Supply Tool lists current shortages, alternatives and expected resupply dates. Regulators expect you to be able to account for your decisions during a shortage.
Key facts
- Medicine Supply Notifications
- Issued for significant shortages with the expected duration, clinical advice and suggested alternatives
- Medicines Supply Tool
- Run by the Specialist Pharmacy Service (SPS), with content from DHSC and NHS England
- National Patient Safety Alerts
- Used for the most serious supply problems, sent through the MHRA Central Alerting System with deadlines for action
- Serious Shortage Protocols
- Let a community pharmacist supply a specified alternative or quantity without going back to the prescriber. In England they are published on the NHSBSA website.
- Regulators' joint statement
- GPhC, GMC, NMC, HCPC and PSNI statement on meeting standards during shortages, updated 17 January 2024
Where official supply information comes from
DHSC and NHS England, working with clinical specialists and the Specialist Pharmacy Service, publish guidance on shortages. Medicine Supply Notifications go to primary and secondary care when a shortage needs action, with advice on managing patients and suggested alternatives. The SPS Medicines Supply Tool brings these together with lower-impact problems, so you have one place to check. The most serious problems come as National Patient Safety Alerts, which set deadlines for action.
GLP-1 medicines show how this works. A National Patient Safety Alert on the shortage of GLP-1 receptor agonists was issued in July 2023 and replaced by a new alert in January 2024. At the same time, the GPhC, GMC, NMC, HCPC and PSNI updated a joint statement on meeting regulatory standards during shortages. The statement says professionals must be able to account for their decisions. Our guide to GLP-1 safety conversations covers the clinical side.
What a pharmacy team can and cannot change
A pharmacist cannot swap a prescribed medicine for a different one on their own judgement alone. The options are to contact the prescriber for a new prescription, to supply under an active Serious Shortage Protocol, or to owe the patient the balance and source stock. A Serious Shortage Protocol names the medicine, the permitted alternative or quantity, and the dates. Check the protocol covers your nation and the patient before you use the protocol, and record the supply.
A shared plan for the team
- Pick one person per shift to check the Medicines Supply Tool, alerts and wholesaler updates, and brief the team.
- Agree a short script for patients: what is short, what the pharmacy is doing, and when to check back. Avoid promising a date or a product you have not confirmed.
- Keep a shared list of affected patients and the action taken for each, inside your clinical system.
- Agree how queries reach prescribers, such as one batched message per day to each surgery, so staff do not chase the same answer five times.
- Flag patients at clinical risk from a gap in treatment, such as people on epilepsy medicines or insulin, for a pharmacist to review the same day.
- Review workload weekly. If shortages add hours of phone calls, tell the owner or manager and ask for cover. GPhC guidance asks pharmacy owners to review staffing in line with changing workload.
When frustration turns into abuse
Shortages raise tempers. Staff do not have to accept threats or abuse. Follow the workplace safety policy, record incidents, and read our guide to patient aggression for the steps to ask your employer for. If a shortage affects a medicine a patient bought online, direct the patient back to the prescribing service, not to your stock.
Notice the weight you are carrying
Saying "we don't have the medicine" fifty times a day wears people down, especially when a patient's health depends on the answer. Name the strain at the team huddle. A short debrief at the end of a hard day helps more than staying silent.
Support for staff under supply pressure
Pharmacists, trainees and pharmacy students can contact Pharmacist Support. The services below support doctors, nurses and specialist groups.
BMA wellbeing services
Counselling and peer support for doctors and medical students.
The main wellbeing services have their own access rules. Additional member services may require membership.
RCN member support
A starting point for nursing members seeking advice and support.
Membership and service-specific criteria apply. Read the current service information.
Psychiatrists' Support Service
Peer support for psychiatrists facing personal or work-related difficulties.
For psychiatrists. Read the provider's confidentiality policy and professional safety exceptions.
GLADD
A community representing LGBTQ+ doctors, dentists and medical and dental students.
Check membership and event information. The organisation does not provide medical or dental advice.
Common questions
Where can I check which medicines are in short supply?
In England, the SPS Medicines Supply Tool lists current supply problems, alternatives and expected resupply dates. National Patient Safety Alerts for serious shortages arrive through the MHRA Central Alerting System.
What is a Serious Shortage Protocol?
A Serious Shortage Protocol lets a community pharmacist supply a specified alternative medicine, strength or quantity without contacting the prescriber. Each protocol has its own conditions and end date, and the pharmacist must follow them exactly.
Can a pharmacist give a different strength during a shortage?
Only under an active Serious Shortage Protocol which allows the change, or with a new prescription from the prescriber. Otherwise the pharmacist contacts the prescriber or owes the balance.
How should I tell a patient their medicine is out of stock?
Say what is short, what you are doing about the shortage and when to check back. Do not promise a date or an alternative until a prescriber or a protocol has confirmed one.