Hospitals are currently facing significant shortages of essential medications used for pain management, blood clot prevention, and hypertension treatment.
Numerous NHS trusts across England have reported difficulties in obtaining supplies of aspirin, the pain relief medication co-codamol—which is a combination of paracetamol and codeine—and ramipril, a medication for managing blood pressure.
Out of the NHS trusts surveyed, nine have struggled to secure adequate supplies of at least two of these three commonly used medications, with the Kent Community Health NHS Trust experiencing shortages of all three.
These supply challenges highlight the increasing fragility of the healthcare system’s supply chains for fundamental drugs, exacerbated by factors such as trade disagreements, international conflicts, and manufacturing issues.
Pharmacists have described the situation as a “national crisis,” with some patients unable to access their necessary medications for extended periods, sometimes lasting weeks.
The supply issues faced by hospitals came to light through freedom of information requests made by Dr. Rodolfo Catena, a specialist in global health supplies at University College London, who sought data on the stock levels of these three medications. Out of 184 trusts approached, 60 provided responses.
Aspirin was the most commonly reported shortage, with 62% of the 42 responding trusts indicating they faced disruptions in supply from December to March. Additionally, 31% of trusts reported shortages of co-codamol, which is effective for alleviating various types of pain. The York and Scarborough NHS Trust has had supply issues since May 2025, while the Royal Wolverhampton NHS Trust reported difficulties sourcing co-codamol for nearly ten months from October 2025 to August of this year.
Furthermore, 16% of the 43 trusts that responded regarding ramipril indicated they were unable to obtain sufficient quantities. Recent research suggests that over one-third of adults in England have dangerously high blood pressure, a condition that increases the likelihood of heart attacks or strokes, with 59% unaware of their condition.
To ensure a consistent supply of ramipril, the Frimley Health NHS Trust, which serves areas including Surrey, Berkshire, and Buckinghamshire, resorted to purchasing the medication at elevated prices, as highlighted by Catena.
His observations resonate with findings from the National Pharmacy Association, which noted that while recent shortages primarily affected specialized medications for conditions like ADHD and epilepsy, the current crisis frequently involves generic drugs, which are less expensive to manufacture.
Dr. Catena, who is also an associate professor in operations and supply chain management at UCL’s Global Business School for Health, criticized NHS England for categorizing drug shortages as only a “medium” risk in its operational risk register.
According to NHS England, drug shortages are rated as 16 out of 25 on their risk assessment scale. Given the widespread nature of these shortages, Catena expressed skepticism about the organization’s ability to meet its goal of reducing this score to nine by the following month.
Enhancing supply chain resilience is recognized as a crucial priority by the Department of Health and Social Care. Catena urged a revision of the existing system, where only pharmaceutical companies are required to report potential shortages, suggesting that NHS trusts should have the same obligation to ensure that service leaders are better informed about supply disruptions and can take appropriate actions to mitigate them.
Over 90% of the responding trusts reported having no contingency plans in place for managing supply shortages, and 82% admitted they had not communicated their shortages to NHS England.
A representative from the Society for Acute Medicine, which advocates for hospital physicians, commented, “Shortages in medication can hinder treatment and place additional strain on clinical and pharmacy teams. It is critical to establish resilient supply chains, ensure timely communication, and provide access to suitable alternatives to avoid delays in patient care.”
A spokesperson from the health department stated, “We maintain regular communication with NHS trusts and national clinical leaders regarding medication availability and are aware of the limited supply of ramipril. This understanding has led to the issuance of serious shortage protocols to ensure patients in the UK can still obtain their necessary medications. We are coordinating closely with suppliers to address the issues related to co-codamol and aspirin to ensure a steady supply.
“The vast majority of licensed medicines in the UK are readily available, and we have implemented strong measures to minimize disruptions for patients. This government is committed to investing in the UK medicine manufacturing sector to effectively manage supply challenges as they arise.”
