Brexit and diabetes – how could a no-deal Brexit affect people with diabetes?
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 few months. But we want to hear from you – use our online form to ask us more questions.
Following the general election, the Withdrawal Agreement Bill was introduced to Parliament and a majority of MPs voted in favour of it. The passage of this bill will continue in January. After it has been passed by Parliament it will go to the EU. We will now be leaving the EU on the 31 January and then the implementation period starts. The implementation period will last up to 12 months and means that there will be no changes in regulatory and customs procedures, while in 2020 the UK negotiates permanent trading arrangements with the EU.
What has Diabetes UK been doing?
Early in 2019, 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 (DHSC) and NHS England.
Throughout 2019, we have been raising your concerns directly with officials and regularly attending meetings with senior officials within DHSC and NHS England with responsibility for ensuring continuation of supply of medicines in the event of a no-deal Brexit.
At these meetings we were assured about preparations for the possibility of a no-deal Brexit, including the supply of insulin.
Back in the summer of 2019, following the appointment of the new Prime Minister, we wrote to seek his assurances on continued, uninterrupted access to insulin in the event of a no-deal Brexit. A reply to this letter from the health minister stated that the DHSC’s plans should ensure that the supply of medicines and medical products remains uninterrupted.
In December 2019, the Withdrawal Agreement Bill was introduced to Parliament and a majority of MPs voted in favour of it. The passage of this bill will continue in January. We will continue to have discussions with the government during the 2020 implementation period, which will last up to 12 months, as the UK negotiates permanent trading arrangements with the EU.
What has the government said about its plans and preparations?
The DHSC has been working closely with the NHS, trade associations, pharmaceutical companies, suppliers of medical devices, and many others to help ensure medicines and medical products continue to be available after the UK leaves the EU.
The government has put in place a multi-layered approach to no-deal planning which includes:
- improving trader readiness for new border arrangements
- building up buffer stocks
- procuring extra warehouse space for stockpiled medicines
- securing freight capacity for all medicines, not just those included in the stockpiling.
This will be done in two ways:
- Freight capacity contracts that will help ensure vital medicines continue to enter the UK after Brexit are in place. The firms will operate on routes which have been assessed as less likely to face any potential disruption, if the UK leaves the EU without a deal. Three companies have been awarded contracts for Express Freight Service to deliver medicines and medical products within 24 to 48 hours. This service will help ensure supply of vital medicines and medical products, including radioisotopes. This will mean the NHS will have access to next day delivery on small consignments, including temperature controlled or hazardous products, 48-hour delivery for larger loads, and access to specialist services, including hand delivered courier services if needed.
- DHSC has been working with suppliers to ensure that they have alternative transport routes in place if disruption occurs. The Government has made changes to, or clarifications of, certain regulatory requirements so that companies can continue to sell their products in the UK even if we leave without a deal. Statutory instruments, covering the regulation of human medicines, medical devices and clinical trials were considered and approved by Parliament.
You can find all of the EU Exit-related publications from the DHSC at GOV.UK
On 17 September the NHS published information for medicines supply in case of a no-deal Brexit. Please note that this is generic information about all medicines and not specific to diabetes.
Following the vote in December to pass the government’s Withdrawal Agreement, the government has been clear that the UK will now leave the EU on the 31 January – this means that no-deal preparations are now being stepped down.
The implementation period will last up to 12 months and means that there will be no changes in regulatory and customs procedures, while in 2020 the UK negotiates permanent trading arrangements with the EU. The default position should this not be achieved by the end of 2020 would be a no-deal Brexit.
What impact will there be on insulin supplies specifically?
Earlier in 2019 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.
During the implementation period, the UK will continue to stay aligned to EU law, and existing regulatory and customs procedures will remain in place. The government expect supplies, including medicines and medical goods, will continue to flow as usual.
What about my diabetes tech?
The government have said they are in contact with key medical technology companies and have confirmed 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. The majority of tech companies have confirmed to the DHSC that they have alternative transport routes in place if disruption occurs and have built up buffer stocks.
Again, during the implementation period, the UK will continue to stay aligned to EU law, and existing regulatory and customs procedures will remain in place. The government expect supplies, including technologies, will continue to flow as usual.
What is the situation in Scotland?
In April 2019, our colleagues in Scotland met with the Principal 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 if I’m travelling out of the UK after Brexit?
If you are a UK national travelling to the EEA or Switzerland , you can continue to access healthcare as you do now until at least the end of the implementation period at the end of December 2020.
The latest information for UK nationals travelling to the EEA is available on gov.uk
If you have an EHIC, this will be valid until the end of the implementation period.
The government always advises UK citizens to take out comprehensive travel insurance when going overseas, to both EU and non-EU destinations. They say you should make sure your insurance has the necessary healthcare cover to ensure you can get any treatment you might need, for example if you have any pre-existing conditions such as diabetes.
Do you have more questions or concerns?
If you would like to discuss any questions or concerns, call us on 0345 123 2399. Our lines are open 9am to 6pm Monday to Friday.
We want this blog to be as useful a resource as possible, so please let us know your questions using our online form. We will do our best to find answers to them through our contact with the government.