Month: January 2024

Strategies to Address Drug Shortages in the UK’s NHS

In recent years, the UK has repeatedly suffered from shortages of many key drugs. As well as creating extra work for doctors and pharmacists, these shortages are also very stressful for patients. The government has recently published details of how it might address this issue. We need effective implementation of these plans as well. In particular, we need a combination of a strong UK manufacturing base to produce the drugs the NHS needs along with secure contracts with overseas suppliers.

Developing a robust domestic manufacturing base for pharmaceuticals offer several benefits. It reduces reliance on international supply chains, which can be vulnerable to global events, trade disputes, and logistical challenges. UK manufacturing can also facilitate quicker responses to the UK’s health needs and stimulate economic growth and job creation within the UK. However, building such infrastructure requires substantial investment, time, and expertise.

While bolstering domestic production, it is also essential to maintain strong relationships with overseas drug suppliers. Diversifying the source of pharmaceuticals mitigates the risk of shortages due to domestic production issues. Secure, long-term contracts with foreign suppliers can help ensure a steady supply of essential drugs, but these agreements must be carefully managed to ensure they are resilient to global market and political fluctuations.

Relying on the “free market” and a laissez-faire attitude won’t be nearly enough to tackle the problem. Drug manufacturing and supply problems a major global health concern. The UK government should actively engage in international dialogues and collaborations to address wider challenges that impact drug availability.

Improving measles (MMR) vaccine uptake in primary care

The UKHSA has warned that the UK is seeing a surge in measles cases; putting at risk the health of children and others who are unvaccinated. What can primary care teams do to boost measles vaccine uptake in their patients and help bring the number of measles cases down?

In this post, I list some of the key steps in implementing measles (MMR) vaccination in your practice and raising vaccine uptake. This guidance can also be used by primary care providers in other countries.

1. Give one member of the practice team responsibility for leading the vaccination programme, supported by the wider practice team.

2. Ensure that all staff are informed about the programme; including who is eligible; and the benefits of vaccination for the individual patient, their family, the NHS and society. There are many free online programmes on vaccination and addressing vaccine hesitancy for health professionals. Ensure that vaccination is discussed regularly at team meetings to review progress and address challenges.

3. Prepare FAQs to common questions from patients. These are usually available on government websites such as those published by NHS England and the UKHSA. Ensure staff know where to look for these FAQs, which are essential in countering misinformation about MMR vaccination. Specific training is available in effective communication strategies to address vaccine hesitancy and misinformation during patient interactions.

4. Ensure medical records are as accurate as possible so that patients are not called for vaccination inappropriately. This is particularly important in large urban areas where population mobility is high and vaccine records may not always be up to date. Regular audits of medical records can help identify gaps in the recording of vaccine status.

5. A key time to record vaccine status and offer MMR vaccination is when patients register with a practice. Ensure that vaccine records are entered on the medical record correctly (including vaccines given overseas) and offer MMR vaccine to patients who are unvaccinated or unsure of their vaccine status.

6. Prime patients with information about MMR vaccination, including who is eligible; and the benefits of vaccination for the individual, their family and society.

7. Use multi-channel communication to inform patients. Consider using a variety of media to inform patients as well as direct contact through text messages, phone calls, emails and letters: posters, leaflets, social media, and the practice’s website. Different people prefer different methods of communication. Partnering with local schools, colleges and universities can also help in contacting patients.

8. Be culturally sensitive, particularly if your practice is located in a diverse area. Use materials that are linguistically and culturally appropriate to cater to diverse populations, especially those who may not be fluent in English or are from different cultural backgrounds. Collaborations with community organisations and voluntary groups can help practices to better reach and communicate with diverse groups of patients; including those least likely to be vaccinated.

9. Provide accessible clinics for MMR vaccination and also offer opportunistic vaccination to patients when they attend appointments at the practice for other reasons. To make it easier for working adults, consider extending clinic hours for vaccinations. Some areas may also offer mobile clinics or clinics in community centres that can further improve access to vaccination.

10. Monitor uptake in each target group. Contact those who have not come forwards for vaccination by text, email or telephone. Discuss the need for vaccination with patients in clinics. Implementing an automated system for sending reminders for upcoming vaccination appointments can be efficient and lead to increased attendance.

11. Some patients will receive MMR vaccines elsewhere in the NHS or overseas. Details of vaccinations at NHS sites should be sent to the practice automatically but this may not always be the case. Contact patients to check their vaccination status by text or email and enter vaccinations on their medical record if given elsewhere. This will improve the data the NHS uses to monitor vaccine uptake and also ensures that patients are not sent unnecessary reminders.

12. Incentivise staff to achieve targets; and work with the patient participation group and other local community groups to increase awareness of the benefits of vaccination and improve vaccine uptake.

13. Develop a way for patients to provide feedback about their vaccination experience. This could be a short survey sent by email or available at the clinic. The feedback can provide valuable insights for improving the programme in the future. Also consider a post-campaign evaluation to understand what worked well and what didn’t. This information can be also help for planning future campaigns.

14.The same principles can be applied to maximise uptake of other vaccination programmes delivered by the practice for both children and adults.