New concerns about post-Brexit medicine shortages in Scotland

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The letter also sets out support that will be available if issues arise with importing medicines.

They say that if the UK leaves the EU without a deal, new controls on the entry of goods from the EU into the UK will need to be introduced and this is likely to cause delays at ports of entry and a slow-down in the flow of medicines and medicine supplies into the UK.

"Shortages may occur, but the NHS will manage the situation and if necessary provide advice on suitable alternatives or other treatment options while supply is restored to normal levels," said the letter.

"Advice will be issued to prescribers and pharmacists about any steps needed to respond to shortages."

Commenting on the letter, health secretary Jeanne Freeman said: “Brexit is a crisis created by the UK Government, made worse by their refusal to rule out a disastrous ‘no deal’ exit. 

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"The reality is the supply of medicines and medical devices to Scotland will be impacted if the UK leaves the EU without a deal, meaning there is a risk of shortages.

“As a responsible government we are doing all we can to prepare as much as possible for the consequences of ‘no deal’. The joint letter from our Chief Medical Officer and Chief Pharmaceutical Officer sets out clearly what preparations have been made to mitigate as best we can and provides our health and social care professionals with as much reassurance as possible.

“If the UK leaves the EU without a deal and some shortages occur, the NHS will manage the situation and, if necessary, provide advice on suitable alternatives or other treatment options while supply is restored to normal levels.”

The letter says steps have been taken to build "stockholdings" of medicines, medical devices and clinical consumables in the UK. Pharmaceutical companies supplying medicines that enter the UK from the EU have been asked to increase their UK stock holding to ensure a minimum of an additional six weeks’ of supply on top of normal levels. 

The officers say that reports from the UK Government and from companies suggest "high levels of compliance" with this request.

The UK government was also making arrangements for alternative transport services to be in place if the UK leaves the EU in a 'no deal' situation, and will "give priority to supplies of “category 1 products”, which include medicines, medical devices and clinical consumables. 

"The UK Government plans that these services, which will likely take the form of roll-on roll-off ferries, will be in place during October 2019," the letter states.  "There is also planned to be a commercial 'express freight' service that will be available to transport packages and pallets into the UK at short notice. The UK Government has further encouraged suppliers to ensure that they are ready for the new checks that will be in place at the UK Border."

Arrangements have also been put in place by suppliers to transport into the UK by air, items that cannot be stockpiled, including radioisotopes.

They said Public Health England has built its stockholdings of vaccines on behalf of all the UK countries and seasonal flu vaccines, which are procured by NHS Scotland, have already been delivered and are being distributed across Scotland.

The likelihood of a no-deal Brexit has looked less likely in recent days, with reports emerging on Wednesday that the Prime Minister is set to write a letter to the EU asking for a deadline extension if a deal is not reached.

The Benn Act has also been passed at Westminster which aims to avoid a no-deal by forcing the Government to try and extend the process if any agreement is not forthcoming.