Hospitals across England are experiencing shortages of several commonly prescribed medications, including aspirin, co-codamol, and ramipril, underscoring ongoing challenges within the National Health Service (NHS) supply chains. The shortages affect dozens of NHS trusts and have raised concerns among healthcare professionals about patient care and supply resilience.
A recent survey conducted through freedom of information requests to 184 trusts by Dr. Rodolfo Catena, an expert in global health supplies, revealed that 60 trusts responded regarding stock levels of the three drugs. Among those, 26 out of 42 trusts (62%) reported disruptions in aspirin supplies between December and March. Aspirin is widely used to manage pain and reduce the risk of blood clots. Co-codamol, a pain relief tablet combining paracetamol and codeine, faced shortages in 13 of 42 trusts (31%), with York and Scarborough NHS trust reporting ongoing disruption since May 2025. Meanwhile, seven out of 43 trusts (16%) had difficulties obtaining ramipril, a blood pressure medication crucial for preventing heart attacks and strokes.
Kent Community Health NHS trust uniquely reported shortages of all three medications. Frimley Health NHS trust – which serves parts of Surrey, Berkshire, and Buckinghamshire – has resorted to paying higher prices for ramipril to maintain a steady supply amid shortages.
These disruptions have taken place against a backdrop of complex factors affecting drug availability, including trade disputes, geopolitical instability, and manufacturing delays. The National Pharmacy Association has noted a shift from shortages primarily involving specialist drugs in recent years to now also include generic medicines, which are generally cheaper and simpler to produce but remain vulnerable to supply chain problems.
Dr. Catena highlighted the discrepancy between NHS England’s risk assessment of medicine shortages and the realities reflected in the data. While NHS England rates drug shortages as a "medium" risk to care provision, scoring 16 out of 25 on its risk scale, Catena warned that the widespread nature of these shortages makes it unlikely this risk level will improve as planned. He called for systemic changes to improve supply chain resilience, including expanding the obligation to report impending shortages beyond drug manufacturers to NHS trusts themselves. According to his findings, almost all trusts surveyed lacked contingency plans, and the majority had not formally reported shortages to NHS England.
Representatives from the Society for Acute Medicine emphasized that medicine shortages disrupt patient treatment and increase pressure on clinical and pharmacy teams. They stressed the importance of resilient supply chains and timely communication to prevent care delays.
A spokesperson from the Department of Health and Social Care (DHSC) acknowledged the supply challenges, particularly with ramipril, co-codamol, and aspirin. The department has issued serious shortage protocols to ensure patients continue to receive necessary medications and stated it is collaborating with suppliers to address and resolve these issues.