Dozens of NHS trusts across England are facing persistent shortages of essential medications, including aspirin, the painkiller co-codamol, and the blood pressure treatment ramipril. Recent data obtained by Dr. Rodolfo Catena of University College London reveals that these supply chain disruptions affect a significant portion of hospital trusts, forcing some to pay premium prices to secure stock and highlighting broader vulnerabilities in the UK’s pharmaceutical supply chain.
Extent of Aspirin, Co-Codamol, and Ramipril Shortages
Freedom of information requests submitted to 184 NHS trusts, with 60 responding, show that supply instability is widespread. Aspirin, a fundamental medication for pain relief and blood clot prevention, saw the highest disruption rate; 26 out of 42 trusts that provided data reported supply issues between December and March.
Co-codamol, a combination of paracetamol and codeine used for moderate pain, also faced significant availability gaps. Thirteen out of 42 responding trusts reported shortages. Some facilities have struggled for months, with Royal Wolverhampton NHS trust reporting difficulty accessing the drug for a 10-month period ending in August, and York and Scarborough NHS trust experiencing supply disruptions dating back to May 2025.
Ramipril, critical for managing high blood pressure, was reported as unavailable by 16% of the 43 trusts that answered inquiries on the drug. The shortage of this specific medication is particularly concerning given that more than one-third of adults in England have high blood pressure, according to recent research.
Operational and Financial Impacts on NHS Trusts
The scarcity of these generic medicines is forcing hospital trusts to adopt reactive, costly strategies. Frimley Health NHS trust, which serves patients across Surrey, Berkshire, and Buckinghamshire, opted to pay higher prices to guarantee a steady supply of ramipril rather than risk a clinical shortfall.
This trend reflects a shift in the nature of medicine shortages. While historical supply issues often centered on specialized treatments for epilepsy or ADHD, the National Pharmacy Association notes that current crises now frequently involve low-cost, high-volume generic drugs. Pharmacists have characterized the current situation as a “national crisis,” with patients occasionally unable to access their regular prescriptions for weeks.
Challenges to NHS Risk Assessment and Supply Management
Dr. Catena argues that NHS England’s classification of drug shortages as a “medium” risk—scoring 16 out of 25 on its operational risk register—does not reflect the reality on the ground. He suggests that the widespread nature of these shortages makes the NHS goal of reducing this risk score to nine by next month unlikely.
A significant hurdle in addressing these gaps is the lack of internal reporting. Data shows that 92% of responding trusts lacked contingency plans for supply disruptions, and 82% had not formally reported their scarcity issues to NHS England. Dr. Catena advocates for a policy change that would mandate NHS trusts to report impending shortages, shifting the responsibility away from drug companies alone.
Government Response and Mitigation Efforts
The Department of Health and Social Care maintains that the majority of licensed medicines remain in good supply. In response to the ramipril shortages, the department has issued “serious shortage protocols” to ensure patients can still access necessary treatments.
A spokesperson for the health department stated that they are in regular contact with clinical leads and suppliers to resolve issues regarding aspirin, co-codamol, and ramipril. The government has signaled that it is currently investing in the UK medicine manufacturing industry to improve resilience against future disruptions. Meanwhile, the Society for Acute Medicine emphasized that the priority remains timely communication and the provision of suitable clinical alternatives to prevent delays in patient care.
Causes and consequences of ongoing medicine shortages
Why are common drugs like aspirin and co-codamol in short supply?
Shortages are attributed to a combination of global conflict, trade disputes, and manufacturing problems that have rendered pharmaceutical supply chains increasingly precarious.
What happens if a hospital cannot source a necessary medicine?
Hospitals may be forced to pay higher prices to secure stock from different suppliers, or they may need to utilize serious shortage protocols issued by the government to provide alternative treatments to patients.
Are all NHS trusts facing these medicine shortages?
Data from 60 trusts suggests the issue is widespread, though the severity varies. For example, Kent community health NHS trust reported shortages of all three tracked medications—aspirin, co-codamol, and ramipril—during the study period.
Who is responsible for reporting drug supply issues?
Currently, the obligation to report impending shortages lies primarily with drug companies. Experts like Dr. Catena suggest that expanding this requirement to include NHS trusts would improve the service’s ability to respond to supply chain failures.
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