The reliable supply of drugs is fundamental to any healthcare system, yet shortages remain a persistent problem.

Disruptions arise from a range of causes: manufacturing failures, fluctuating demand, regulatory changes and wars. Around 60% of drug shortages are linked to manufacturing bottlenecks, while insufficient reserves of both finished products and raw ingredients continue to leave health systems like the NHS exposed.

The seriousness of the issue has prompted intervention at the highest levels. In the UK, a recent House of Lords report called for more strategic leadership on medicine supply, warning of inadequate oversight and a failure to treat shortages as a matter of national security, despite the clear risks to public health.

Existing government measures – including the National Supply Disruption Response protocol
– aim to mitigate the effect of these drug shortages. Pharmacists and GPs are allowed to dispense alternative medicines where appropriate, and doctors may avoid initiating new patients on drugs in short supply. These measures, however, manage scarcity rather than prevent it.

Compounding the problem is the reality that many patients remain on prescriptions they may no longer need. Under pressure, NHS services often lack the capacity to review and safely reduce medications. Such “de-prescribing” must be gradual to avoid withdrawal effects, meaning this potential reserve of medicines cannot be mobilised quickly enough to address shortages.

The UK’s reliance on overseas manufacturing, adds a further layer of vulnerability. A significant proportion of essential medicines are made abroad, often concentrated in a handful of countries such as India, Israel and Ireland. This lack of diversity leaves supply chains fragile, particularly in times of global disruption.

Recent shortages have affected a wide range of treatments, including Ritalin (methylphenidate), used to treat ADHD, propranolol used to treat angina, heart arrhythmia, high blood pressure and anxiety, and medicines used in hormone replacement therapy, diabetes and epilepsy. There are about 120 drugs in short supply in the UK today.

Using equivalent drugs is not straightforward

GPs and pharmacists are empowered to use alternative medicines in a shortage. Some are structurally similar to the missing version. However, differences in how they are produced and how they are delivered in the body mean they aren’t necessarily equivalent.

For example, immediate-release versions of drugs produce sharper peaks and are cleared quickly by the body, leading to a rapid decrease in drug concentration levels in the blood. This creates gaps in symptom control, particularly overnight.

Extended-release versions, by contrast, provide more stable and consistent coverage. Although the total dose may be similar, differences in how the drug is absorbed can affect both how well the drug works and side-effects.

Patients are often on medicines for a long time – sometimes for life – and adapt to them specifically. Adding even a slightly different version is not necessarily tolerated and the patient may be faced with withdrawal or side-effects.

GPs and pharmacists need better information about which medicines can be used when supplies run short. They should discuss these options with patients so they understand what to expect.

Side-effects are easier to manage when patients know they are caused by the medicine, not by their condition getting worse or a new illness. Ideally, patients would receive an identical replacement, but this is not always possible.

Fixing drug shortages will take sustained investment in domestic manufacturing and genuine political will to treat the problem as a long-term priority. Where UK production isn’t viable, the NHS must urgently diversify their overseas suppliers.

In the meantime, frontline staff need the resources to navigate shortages confidently – and patients deserve clear, honest information about any changes to medication.

Located in the heart of Ancoats on Jersey Street Manchester, I was joined by six other participants on a Saturday afternoon, ready to get hands on and enhance my skillset.

(Image: Shutterstock)

Upon arrival, we were greeted by Gloria, a member of the COOK! team, who showed us to the kitchen area and offered us a complimentary drink.  I was immediately impressed with the bright, open space lined with individual workstations and well-stocked shelves lined with cookery books and crockery. 

Again, as someone who cooks a fair bit for myself and my wider family at home, I had never actually attempted Sri Lankan food before. I was intrigued – and admittedly slightly intimidated – by the recipes on the agenda for our three-hour session with tutor, Maz.

They included a rich pairing of Idiyappam (string hoppers) with Kiri Hodi (turmeric coconut gravy) and Pol Sambol, Kos Maluwa (jackfruit and cashew curry) and Vegetable Kottu Roti (a much‑loved Sri Lankan street-food favourite consisting of onions, carrots, cabbage, eggs, chopped roti, spices and aromatics).

Once we’d gone through the housekeeping rules and introductions, we pinned on our name badges, washed our hands, tied our aprons and took to our workspaces, which were well equipped with everything needed to whip up our dishes.

(Image: The Vegetarian Society)

Maz talked us through what to expect during the half-day session and the background of the recipes before we headed straight into mise en place, chopping and prepping our fresh vegetables, alongside other sundries which the team had already portioned out for us in advance.

The room began to fill with a heady mix of toasted spices as we eagerly began cooking.

Along with a tablet on our stations showcasing the full recipes and cooking instructions, Maz gave us regular demonstrations throughout as we cooked along in real time and her extensive knowledge really shone through.

We also learned a little more about the Vegetarian Society’s fascinating roots in the North West, how the team are helping to influence policy and how its mission has evolved from a Victorian campaigning group into a modern charity promoting sustainable, plant-based eating, giving the whole afternoon an added sense of place and purpose.

Making idiyappam – delicate rice flour string hoppers – was a particular highlight for me. After a few failed attempts before Maz kindly stepped in to help me, there was a quiet satisfaction in seeing neat coils of noodles appear in the steaming basket.

(Image: The Vegetarian Society)

It was fiddly but exactly the sort of thing I would never have attempted at home without someone there to show me how to balance the dough and use new equipment.

During the fast-paced class, I felt that Maz struck a good balance between demonstrating key techniques at the front and letting us get on with things at our own benches, providing a real sense of shared achievement.

Sitting down together to eat what we’d made was where the day really came together for me. Around the table, we compared notes on our favourite dishes and which recipes we’d make again.

As a vegetarian myself, the class felt like a rare chance to move beyond the usual rota of pasta bakes and bean chilli and really celebrate meat-free cooking in a different way.

I’m used to scanning menus when dining out and settling for the lone meat-free or vegan option, so standing in a kitchen where every pan, every recipe and every conversation started from a vegetarian or vegan perspective was genuinely refreshing.

It also reminded me why I chose this way of eating in the first place: not just for ethical or environmental reasons but because when it is done well, vegan and vegetarian food can be colourful, healthy and full of flavour – which is exactly what this class delivered.

(Image: The Vegetarian Society)

Knowing that the cookery school is part of the Vegetarian Society’s wider work – and that the fees help fund education and outreach to support people eating more plant-based food – made the experience feel just a little bit more meaningful than a standard cookery class.

It also reinforced the emphasis on accessibility throughout the day: alternatives were offered for people who were vegan (or those like me with minor health issues and wary of adding too much chilli) without making anyone feel awkward.

We were provided with recipes, along with leftovers, to take home and recreate the magic in our own kitchens, but I felt I’d gained more than just a few new dishes.

I’d learned how to handle ingredients that I’d never come across before, picked up practical tips I can use in everyday cooking – from toasting spice and flour to resisting the urge to constantly stir my curry rather than leaving it to slowly simmer – and had a enjoyable day out that would work just as well for a solo treat as it would for a birthday gift or date day.

They also offer an impressive range of other classes, from evening supper clubs and knife skills to street food offerings from around the word.

For anyone looking to broaden their cooking horizons – whether vegetarian, vegan or just veg-curious – this class offers an engaging, hands-on way to do it, with the bonus of supporting a long-standing local charity that has been championing plant-based food for generations.

COOK! with the Vegetarian Society, 15 Jersey Street, Ancoats, Manchester, M4 6EZ

Tel: 0161 925 2000

Email: COOK!@vegsoc.org

Website: vegsoc.org/cook

The story of how this Jewish, Liverpudlian record-shop manager discovered and shaped the band that changed the world, and how they arguably abandoned him, is sketchily but over-literally reiterated by Wright. In the first scene, Brian explains to his fusty father that this new-fangled rock ‘n’ roll, epitomised by Elvis Presley, is “what’s happening, dad”. An angsty Teddy Boy arrives claiming Brian seduced him and demanding blackmail money. Right, yes, homosexuality is illegal. Got it.