Medicines Supply Warning in Brexit Yellowhammer Document 

Peter Russell

September 12, 2019

Disruption to supply of medicines could last 6 months if the UK leaves the EU without a deal, a previously confidential briefing for ministers warned.

The analysis of a worst case scenario following a disorderly Brexit, codenamed 'Yellowhammer', was published last night by the Government in response to Labour demands.

Dated 2nd of August, just days after Boris Johnson became Prime Minister, the document warned of possible disruption to medicine supplies, a higher risk of disease outbreaks due to veterinary medicine supply issues, and UK citizens in the EU struggling to access healthcare from 1st November.

It also warned of a threat to older, vulnerable people in the care system if some care providers are pushed over the financial brink in the months following exit from the EU.

Michael Gove, the cabinet minister with overall responsibility for 'no-deal' planning, said revised assumptions would be published "outlining the mitigations the Government has put in place".

The British Medical Association (BMA) called the Yellowhammer document, parts of which were redacted, an "alarming" threat to patient care.

Dr David Nicholl, the consultant who was involved in the medical contingency planning, and who became embroiled in a row with Commons leader Jacob Rees-Mogg last week, repeated his call that politicians needed to be asked what level of mortality they were willing to accept if the UK left the EU without a deal.


Risks to Medicines and Medical Products

The six-page Yellowhammer document suggested that on the first day after Brexit, traffic flow on the short cross-Channel routes could be cut to 40%, with significant disruption lasting up to 6 months. "Unmitigated, this will have an impact on the supply of medicines and medical supplies."

It warned that the reliance of medicines and medical products' supply chains on the short crossings, with three quarters of medicines imported via these routes, "make them particularly vulnerable to severe extended delays".

The problem could be compounded by a highly regulated system that requires transportation meeting strict good distribution practices, including time limits, and temperature controlled conditions.

Whilst some medicines and medical products could be stockpiled, others could not because of short shelf lives. Also, it would not be practical to stockpile products to cover expected delays lasting 6 months.

However, the document acknowledged that the Department of Health and Social Care was developing "a multi layered approach" to mitigate these risks.

Risks to Social Care System

On social care, Yellowhammer envisaged no major changes to the system the day after the UK left the EU.

However, it warned that the adult social care market was already in a fragile state due to declining financial viability of providers. An increase in inflation after Brexit could increase staff and supply costs and could see some providers go out of business.

Smaller providers could be hit within 2 to 3 months of the leave date, and larger providers after 4 to 6 months.

Problems in the social care system could be compounded by a flu epidemic, severe winter weather, or transport disruption, it said.

Other issues highlighted in the Yellowhammer document were:

  • A threat to human and animal health in the event of delays to the supply of medicines for UK veterinary use that could impact food safety

  • A decrease in supplies of some fresh foods, alongside food price rises, that would disproportionately impact low-income groups

  • Uncertainty for UK pensioners, workers, travellers, and students over how to access healthcare in EU countries

'A Stark Warning'

Dr Chaand Nagpaul, BMA council chair, commented in a statement: "This alarming document reinforces the BMA's stark warnings about the devastating impact a no-deal Brexit could have, and vindicates those doctors who have had the courage to speak out on the risks that crashing out of the EU without a deal poses to the NHS, patients, and the wider health of the UK."

Commenting this morning on BBC TV, Mr Gove said: "Over the course of the last 6 weeks, this government has taken considerable steps in order to ensure that if there is a no-deal scenario, that we can leave in the safest and smoothest possible way."

Sir Keir Starmer, the Shadow Brexit Secretary, called for Parliament, which was suspended on Tuesday, to be recalled so that MPs could scrutinise the Government's contingency planning.

His comments followed a ruling by the Court of Session in Scotland on Wednesday that the Government's proroguing of Parliament was unlawful. An appeal by the UK Government against the ruling will be heard by the Supreme Court in London next week.


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