There is a risk of delays to supplies for health and social care if
the UK leaves the EU without a deal. Government has done an
enormous amount to manage this risk, but the National Audit Office
(NAO) highlights that there is still significant work to be done.
This includes improving government’s understanding of preparedness
across the supplier base, putting in place sufficient freight
capacity to carry priority goods, and improving the readiness of
the social care sector, including nursing homes.
In its report, published today, the NAO has reviewed the
Department for Health & Social Care’s (DHSC’s) preparations
to make sure the UK has a steady flow of supplies for the health
and social care sector when it leaves the EU. Of the 12,300
medicines used in the UK, DHSC estimates that around 7,000 come
from or via the EU.
The NAO recognises that this is a significant challenge and it is
is not possible for anyone to know exactly what will happen at
the border if the UK leaves without a deal.
Government’s own “reasonable worst case” assumption is that the
flow of goods across the Channel could be reduced to 40-60 per
cent of current levels on day one. This assumption underpins
DHSC’s preparations to try to avoid disruption. It has identified
high risk areas and taken steps to respond. It has taken a
multi-layered approach, focusing on three areas.
Building up stockpiles and obtaining space in
warehouses
- DHSC has encouraged suppliers, including pharmaceutical
companies, to build up stockpiles of medicines and other supplies
but it has incomplete information about the level of stockpiles
in place. It has also secured additional warehouses for companies
to use.
- DHSC has created its own stockpile of six-weeks’ worth of
equipment and supplies that the NHS gets through at high volume,
such as gloves and syringes. Its stockpile was 88% complete as of
20 September.
- Supplies of goods other than medicines for social care
providers have not been similarly
stockpiled.1 DHSC has asked providers of care
in nursing homes and domestically to put in place robust
contingency plans for the possible implications of a ‘no deal’ EU
Exit. DHSC does not yet know how many providers have followed its
advice, what preparations have been made and whether needs will
be met.
Re-routing supplies to avoid busy crossings, procuring
additional freight capacity and preparing suppliers
- Suppliers of medicines and other priority clinical supplies
will be able to use freight capacity bought for government-wide
use. DHSC expects to use 91% of government’s total freight
capacity.
- The Department for Transport (DfT)-led procurement of freight
capacity is underway but the time available to put capacity in
place for 31 October is extremely limited and it might not now be
possible to have all the freight capacity available on that date.
DfT’s aim is to have as much of the freight capacity for priority
goods as possible in place by 31 October, and all of it by 30
November at the latest.
- DHSC has started procurement of its own dedicated courier
service which can pick up urgent medicines and supplies direct
from manufacturers in Europe and deliver them to where they are
needed in the UK. This will provide capacity for 50 pallets and
an additional 35m³ of urgent or specialist goods to be
transported each day.
- Despite recent efforts across government, there is a risk
that traders, including medicine suppliers, will not be ready for
new border processes by 31 October.
Increasing DHSC’s ability to monitor the situation and
respond.
- DHSC is putting in place contingency plans to address any
shortages in supplies. It is strengthening its ability to monitor
the situation and respond quickly. It will get regular reports
from local bodies about the situation in their area and it has
set up a command centre to address getting supplies to places
with potential shortage.
Notes for Editors
Key facts
7,000 out of 12,300
the number of prescription-only and over-the-counter medicines
that come from or via the EU
40-60%
the assumed capacity on the first day at ports serving the
short Channel crossings compared with current flows, under the
government’s reasonable worst-case scenario
2,326
number of heavy goods vehicle spaces per week that the
Department of Health & Social Care has asked the Department
for Transport for, as part of the government-secured freight
capacity.
450,000-500,000
number of types of medical devices and clinical consumables
-such as needles, syringes and stethoscopes - available to the
NHS each year
£95 million
value of planned additional stockpile of high-volume clinical
consumables, £85 million of which was in place by 20 September
91%
proportion of government secured additional freight capacity
earmarked for priority supplies to the health and social care
sectors
25%
percentage of medicine product lines for which suppliers had
reported to the Department of Health & Social Care (by 20
September) that they had secured freight capacity away from the
short Channel crossings.
72%
percentage of medicine product lines for which suppliers had
reported to the Department by 20 September that they held at
least 6 weeks’ stock.
- The NHS supplies medicines for people in social care, but
social care providers also rely on non-medicine supplies that
are not usually bought via the NHS.
- Press notices and reports are available from the date of
publication on the NAO website. Hard
copies can be obtained by using the relevant links on our
website.
- Our EU exit hub draws together all of our work on
departments’ performance on EU exit to-date. It is updated as
we publish work and report to Parliament on risks to
preparedness. Available here: https://www.nao.org.uk/exiting-the-eu/
- The National Audit Office (NAO) helps Parliament hold
government to account for the way it spends public money. It is
independent of government and the civil service. The
Comptroller and Auditor General (C&AG), , is an Officer of
the House of Commons and leads the NAO. The C&AG
certifies the accounts of all government departments and many
other public sector bodies. He has statutory authority
to examine and report to Parliament on whether government is
delivering value for money on behalf of the public,
concluding on whether resources have been used efficiently,
effectively and with economy. The NAO identifies ways that
government can make better use of public money to improve
people's lives. It measures this impact annually. In 2018 the
NAO's work led to a positive financial impact through reduced
costs, improved service delivery, or other benefits to
citizens, of £539 million.
