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.
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.
The UK and EU have now agreed an extension of the Article 50 period until 31st January 2020. If the government’s withdrawal agreement is ratified by both the UK and European parliaments, the UK will leave with a deal, but if this has not happened by 31st January the legal default is that we would leave the EU without a deal. Current advice to the NHS and medicines industry is that all no-deal plans should be maintained.
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 (DHSC) and NHS England.
Recently, 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, 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.
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.
***In line with Cabinet Office guidance for civil servants in the pre-election period we will not be holding any meetings with the Department of Health and Social Care from 6 November to w/c 16 December (after the general election). This guidance is in place to maintain the impartiality of the Civil Service as the general election has a number of implications for the work of the department and civil servants.
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.
A continuity of supply FAQ for healthcare professionals has also been published.
Roadshows were undertaken in September and October, with all 500 NHS organisations, commercial health providers and healthcare professional groups to help prepare them for a no-deal exit.
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 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.
What is the situation in Scotland?
In April, 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 should prepare for possible changes to how you access healthcare, if the UK leaves the EU without a deal.
The government has been undertaking technical discussions with member states in order to reach reciprocal healthcare arrangements.
Healthcare access in Spain will remain the same after exit day, whatever the Brexit scenario. This is because the UK and Spain have each taken steps to ensure that people living in each country can continue to access healthcare as they do now until at least 31 December 2020.
The specific arrangements and advice may also vary depending on the country. The latest information for UK nationals travelling to the EEA is available on nhs.uk
If you have an EHIC, this will be valid until the exit day but may not be accepted after this, if the UK leaves the EU without a deal.
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 concerns you have with us you can call us on 0345 123 2399. Our lines are open 9am-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.