Brexit and Diabetes – how could a no-deal Brexit affect people with diabetes?

From blogs.diabetes.org.uk

If you’re living with or affected by diabetes, we know you might be worried about how Brexit might affect things like your diabetes medicines, in particular insulin. 
In this blog, we cover the potential impact of a no-deal Brexit, what’s happening across England, Scotland, Wales and Northern Ireland, and how here at Diabetes UK we’re getting your voice heard.  
We will keep updating you as events develop in the next two months. But we want to hear from you – use our online form to ask us more questions.

What has Diabetes UK been doing?

Earlier this year, following a series of letters and public statements, along with JDRF, we had a meeting with senior officials with expertise in logistics and supplies of medicines and consumables at the Department of Health and Social Care and NHS England.
Recently we have been raising your concerns directly with officials in various meetings. Most recently, we attended a meeting with senior officials within DHSC and NHS England with responsibility for ensuring supply of medicines in the event of a no-deal Brexit continuation of supply of medicines.

At this meeting we were further assured about being prepared for the possibility of a no-deal Brexit, including the supply of insulin.
Following the appointment of the new Prime Minister, we’ve written to seek his assurances on continued, uninterrupted access to insulin in the event of a no-deal Brexit.
We’ve been clear that, alongside assurances to date, the government should continue to make sure that information about progress of its plans is made available to the public.
We will continue to engage with senior officials to ensure we are able to share up-to-date information with you as 31st October approaches.

What have the government said about its plans and preparations?

The UK Government intends to leave the EU on the 31st October 2019. While leaving the EU with a deal remains its priority, they are planning for every eventuality, including ‘no-deal’. But what does this really mean and how might it affect you?
The government has said that the capacity that is available for importing goods will be prioritised, to make sure people have access to the medicines they need.
Recent announcements from the government have outlined that they are preparing by:

.     Putting plans in place that include additional stocks of medicines, strengthening the process and resources used to deal with shortages if they happen,

Securing freight capacity. The Department for Transport are leading a procurement exercise that will set up a framework to access secure additional ‘roll-on, roll-off’ freight capacity. The aim is to support supplier contingency plans to re-route their supply chains away from the Channel short straits. Medicines and medical products will be prioritised on any further capacity gained through this process.

The Department of Health and Social Care (DHSC) is setting up a ‘Dedicated Health Channel’. This will be an express freight service that will be able to bring medicines and medical products into the UK within 24 to 72 hours if needed after 31st October. This is designed to support the uninterrupted supply of medicines and medical products where there is an urgent need or where a suppliers’ own plans are disrupted or delayed. This service will be able to refrigerate products, and so would be able to import insulin in the event of shortages.

Health ministers are regularly attending an EU Exit Operations committee, which discusses operational issues in preparation for Brexit such as continuity of supply of medicines. The DHSC is also centrally coordinating contingency measures to mitigate risks to supply. They say this removes the need for any stockpiling at local level which could cause medicine shortages and put patient care at risk.

Working closely with all suppliers of medicines and devices to ensure uninterrupted supply in the event of a no-deal Brexit.

You can find all of the EU Exit-related publications from the DHSC at GOV.UK

What is the situation in Scotland?

In April, our colleagues in Scotland met with the Principle Pharmaceutical Officer, Prof Alison Strath, and the lead civil servant for provision of medicines and were reassured that contingency plans were in place at that time.  With the fresh focus on the possibility of a no-deal Brexit in recent weeks, Diabetes Scotland has been back in contact with Prof Strath and the Scottish Government to seek an update. The Scottish Government has now established a NHS Scotland Medicines Shortages Response Group to ensure that UK wide plans are carried out effectively in Scotland.
Get more information at gov.scot

What is the situation in Wales?

Diabetes UK Cymru has been working with the Welsh NHS Policy Confederation to raise issues with the Welsh Government as a result of a no-deal Brexit.
We’ve raised concerns about potential post-Brexit scenarios with the ABPI (Association of the British Pharmaceutical Industry) representative in Wales and the Welsh Government’s Cabinet Secretary for Health, Social Care and Sport.

What is the situation in Northern Ireland?

The Department of Health in Northern Ireland has published more information about the EU exit. This includes guidance from the Department, as well as links to letters issued by the department to GPs, pharmacists, opthalmologists and other healthcare professionals.

What impact will there be on insulin supplies specifically?

Earlier this year we wrote to the three main insulin manufacturers – Lilly, Novo Nordisk and Sanofi – to understand what contingencies and additional stocks they planned to have in place. This month we wrote back to them to check the situation again.
All three have confirmed that these are still in place, and the manufacturers tell us they have gone beyond the recommendations made by the government – they are keeping at least 16 weeks of additional stock. People should continue to get prescriptions and use their medicines in the normal way.

What about my diabetes tech?

The government have said they are in contact with key medical technology companies. We are seeking assurances about supplies and stocks of key pieces of technology and diabetes equipment. We have asked the government to clarify that their work includes having regular discussions with all the major companies who provide continuous glucose monitors (CGM), flash glucose monitors (we call it Flash for short), insulin pumps and blood glucose monitoring technology. When we have received a response we will update this blog.

What if I’m travelling out of the UK after Brexit?

The government has said that access to healthcare in EU countries will change if there is a no-deal Brexit, as European Health Insurance Cards may not be valid. Anyone travelling to the EU, EEA or Switzerland should get health insurance to cover this. UK nationals who live in EU countries will also have new arrangements.
The advice may also vary depending on the country – find out more from the NHS website.

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