The health department has told social care providers that some medicines may take up to five times as long to be delivered as they do now in the event of a no-deal Brexit, with guidance suggesting the government may be expecting greater disruption to supplies than it was earlier this year.
Guidance published this week by the Department for Health and Social Care – just days before the department said its contingency arrangements would ensure medicines would be transported without disruption – warns adult social care providers that medical supplies they are used to ordering from EU suppliers with a day or two’s notice could take up to five days to arrive if the UK crashes out without a deal.
Providers had previously been told to allow “around three days” for these deliveries, in a letter from then-health minister Caroline Dinenage in February, to prepare for a potential no-deal Brexit on 29 March.
And in an announcement today, health minister Chris Skidmore said DHSC was making arrangements to ensure "supply of medical goods remains uninterrupted as we leave the EU". DHSC opened bids for a £25m "express freight services" contract to transport medicines in a no-deal Brexit last month, and the department said today the deal would ensure medical supplies were delivered "within one to four days".
But social care organisations that rely on short-term deliveries from the EU have separately been told to allow more time for deliveries in the event of a no-deal Brexit on 31 October “to help address any local supply issues”.
This week's guidance also instructs social care providers to ensure they are prepared to receive stock deliveries of medicines outside normal hours.
Providers are also expected to have contingency plans in place that address “risks and issues associated with” the supply of non-clinical goods and services, which include IT service agreements and infrastructure, food and laundry services, it said.
Nadra Ahmed, chair of the National Care Association, told CSW that the guidance was not wholly unexpected but that "it's not comfortable, it's not easy".
Ahmed said providers would be able to give pharmacies extra notice when ordering regular medicines from pharmacies. She added that DHSC has so far indicated it is confident its contingency planning will work as intended and that any delays will be "short-lived and short".
However, she said it was impossible to predict exactly what would happen on 1 November in a no-deal scenario.
"Delays could have a fundamental impact on the wellbeing of an individual or service. We’ll only know when it starts to happen... what concerns us is if that five days turns into 10," she said.
She added that the Care Quality Commission, which regulates care providers, will measure their performance against the service they provide. "There is no leeway for us so it is imperative that providers have what they’re required to have at the time that they’re required to have it," she said.
She also said there was some uncertainty about the arrangements for delivering drugs needed at short notice or for medicines with a short shelf life, such as insulin. She said providers were working on the assumption that these medicines would be deliered more quickly using the express freight service.
DHSC has urged providers not to stockpile medicines, medical devices or clinical consumables. Pharmaceutical companies have been asked to build up buffer stocks, but individual care providers doing so “could cause shortages in other areas and put other service users at risk”, the guidance said.
“You should also tell service users not to store additional medicines, medical devices or clinical consumables at home,” it added.
Social care and healthcare providers have been told to report problems to the National Supply Disruption Response, a unit set up by DHSC as part of its Brexit contingency planning.
“The NSDR can help with disruption to the supply of medicines and vaccines, medical devices and clinical consumables that normal procedures can’t resolve,” the guidance stated.
The guidance was one of several documents DHSC published this week to help health and social care providers prepare for no deal.
Another sets out arrangements for charging EU nationals who do not live in the UK for NHS services.
The guidance confirms that EU and EEA nationals who live in the UK will continue to access free healthcare, whether or not they have settled status. It confirms that requirements for all patients to provide proof of residence, such as a tenancy agreement or utility bill, will stay in place. Urgent treatment will be exempt so GP services and A&E and maternity departments will be expected to deliver services without this evidence and investigate patients' residential status later, it says.
NHS staff are being told to use an eight-page “toolkit” to determine whether patients are entitled to free healthcare. The document lists questions designed to demonstrate residency, including whether people can prove they have a UK address or bank account, or that they are working or have family in the UK.