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Short report
Best practice standards for managing medicines shortages in hospitals
  1. David Stead
  1. Correspondence to Mr David Stead, Pharmacy Department, Bristol Royal Infirmary, Marlborough Street Bristol BS2 8HW, UK; David.Stead{at}

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Medicines shortages can adversely affect ideal drug therapy, delay medical procedures and result in medication errors. Managing drug product shortages can be extremely complex and pharmacy procurement and clinical staff are increasingly challenged in managing the effects of shortages.

The University College Hospitals ‘Solutions’ website (now no longer operational) regularly reported between 120 and 150 current shortages.

Information from the American Society of Heath Systems Pharmacists Shortages website, run by the University of Utah Hospital indicates monitoring around 250 shortages on a regular basis.

Recent data from Guys and St Thomas's National Health Service (NHS) Trust indicates an average of 150 lines per month not delivered when expected, all of which had to be followed up by pharmacy staff.

In 2011 a poll of a number of NHS hospitals indicated that the cost of pharmacy staff time in resolving shortages was around £3–5 million/year. This short report provides readers with guidance that has been issued in the UK. It may provide a model for other economies who are facing a similar problem with shortages. The guidance document is published with the permission of the sponsoring authorities.

Best practice standards for managing medicines shortages in secondary care in England—jointly published by the NHS and Royal Pharmaceutical Society


Medicines shortages are occurring more frequently in the UK and globally for a variety of reasons. Although some of these have simple solutions, an increasingly large number have the potential to cause serious risk to patients. There is currently no national guidance to the NHS on how to manage shortages at a local level.

These standards are designed to provide advice to NHS …

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  • Competing interests None.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • i While this document is not meant to be prescriptive, Chief Pharmacists will need to consider all the processes outlined below and ensure that they meet the needs of the organisation and the risk to patients generated by each shortage.

  • ii If hospitals work collaboratively within a ‘region’ then this assessment may not need to be carried out at each hospital.

  • iii Working collaboratively (eg, within a region), limited stocks can be shared based on clinical need.

  • iv This work should be supported by regional and/or national Quality Assurance advice and additional clinical information on alternative products should be obtained from regional/national Medicines Information services.