Hospitals in England are struggling to obtain aspirin, co-codamol and ramipril: medicines used to relieve pain, reduce the risk of blood clots and treat high blood pressure. These aren’t obscure treatments. They’re among the drugs a health service needs to have ready every day.
The shortages came to light through freedom of information requests by Dr Rodolfo Catena, a specialist in global health supplies at University College London. Sixty of the 184 NHS trusts he approached responded. Of those that answered his question about aspirin, 26 out of 42 reported supply disruption between December and March. Thirteen out of 42 reported shortages of co-codamol, while seven out of 43 had been unable to get as much ramipril as they needed.
Nine trusts had problems obtaining two of the three medicines. Kent community health NHS trust ran short of all three.
The responses don’t tell us how many of England’s trusts faced shortages overall. They do show that disruption has reached ordinary medicines across multiple hospitals. At York and Scarborough NHS trust, co-codamol supplies had been disrupted since May 2025. Royal Wolverhampton NHS trust had trouble obtaining enough for the ten months from October 2025 to August this year. These weren’t single missed deliveries quickly forgotten.
Pharmacists have called medicine supply problems a “national crisis”. In some cases, patients have been unable to obtain their usual medication for weeks. For a person waiting for pain relief or treatment for high blood pressure, a shortage isn’t an abstract problem in a supply chain. It reaches them as a delay, a changed prescription or another trip to find what they need.
This is one of the contradictions of capitalist healthcare. The NHS exists to provide treatment according to need, but it has to obtain medicines through a system in which production and distribution are organised by competing firms. A hospital’s need for a drug doesn’t, by itself, ensure that the drug will be made and delivered. The health service can plan care for its patients; it can’t plan the whole chain of production on which that care depends.
That dependence becomes harder to ignore when basic, cheaper medicines are affected. Analysis by the National Pharmacy Association has found that recent shortages, once concentrated mainly in specialist drugs such as treatments for ADHD and epilepsy, now often involve generics too. A low price at the point of purchase is little comfort when the medicine isn’t available at the point of care.
Trade disputes, global conflict and manufacturing problems have all put pressure on medicine supplies in recent years. Under imperialism, production crosses borders while states and firms compete over trade, investment and control of markets. Hospitals and patients are left exposed to disruptions far beyond their control. That wider picture doesn’t establish the cause of each shortage Catena found. It does show why treating access to medicines as a routine purchasing matter is inadequate.
The cost of keeping supplies moving is also unevenly borne. Frimley Health NHS trust paid higher prices for ramipril to avoid disruption for its patients. Staff then have to deal with the practical consequences of scarcity: finding stock, considering alternatives and managing delays alongside their ordinary work. The Society for Acute Medicine warned that shortages “can disrupt treatment and create additional pressure for clinical and pharmacy teams.”
Catena argues that NHS England has understated the danger by classifying drug shortages as a “medium” risk to care. It currently scores them 16 out of 25 on its risk assessment scale and aims to bring that down to nine by next month. Yet 92 percent of the trusts that responded said they had no contingency plan for supply problems, and 82 percent said they hadn’t reported the shortages they faced to NHS England. A lower number on a risk register won’t put tablets on a ward shelf.
Catena wants trusts, as well as drug companies, required to warn the health department about impending shortages. Earlier warning could give staff more time to respond.
The Department of Health and Social Care says it is aware that ramipril is in limited supply and has issued serious shortage protocols. It says it is working with suppliers on ramipril, co-codamol and aspirin, and investing in UK medicine manufacturing. It also says the vast majority of licensed medicines remain in good supply.
That assurance offers little to patients who need one of the medicines in short supply. The NHS can negotiate, pay more and ask its workers to manage the gaps. Meanwhile, its ability to provide basic care still depends on whether a market organised outside the health service delivers what patients need.
