Impact of Brexit on health and social care supply: NAO report

EU and UK flags highlighting impact of Brexit on health and social care supply

The National Audit Office (NAO) has published a report exploring the impact of Brexit on health and social care supply.

It says that there is a risk of delays to supplies for health and social care if the UK leaves the EU without a deal. The Government has undertaken work to manage this risk, but the National Audit Office highlights that there is still significant work to be done. This includes improving the 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 care homes.

In its report, the NAO has reviewed the Department for Health and 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 7000 come from or via the EU.

The NAO recognises that this is a significant challenge and it 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% to 60% 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. 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 the 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.