• NHS England and MHRA looking at importing feed from other countries
  • Hundreds of patients are suffering delays in vital IV feed supplies
  • Patient safety director warns problem will last longer than expected

The shortage of intravenous feed supplies affecting hundreds of patients across the country has been declared a national emergency incident by NHS leaders.

The situation is so serious the NHS is considering importing supplies from other countries to meet the needs of patients who depend on the feed for survival.

Patients whose bodies can no longer digest normal food are reliant on intravenous feed known as total parenteral nutrition, or TPN. Some are already enduring long waits for deliveries of their prescriptions.

HSJ has spoken with some patients who have gone several days with no feed at all after restrictions were imposed on the manufacturer, Calea, by the Medicines and Healthcare products Regulatory Agency last month. Several patients, including one child, have been admitted to hospital because they were effectively being starved of vital nutrients.

Hospitals have been asked to review all their patients receiving IV feed to ensure only those deemed at high risk are allocated scarce supplies. These are being allocated to NHS trusts by a national incident management team on a “non-negotiable” basis.

Hundreds of other patients are being moved to what are known as ‘off the shelf’ bags of feed which could lead to patients needing hospital admission because the bags lack essential vitamins and minerals and may not meet their specific requirements, which varies between patients.

National patient safety director Aidan Fowler has written to all NHS trusts, clinicians and affected patients warning the disruption is likely to last longer than expected.

In the letters, shared proactively with HSJ by NHS England, Dr Fowler said a national incident management team had been set up and the issue had been “formally designated” an emergency incident under the Civil Contingencies Act “at the highest level in view of the risk within NHSE/I.”

He added: “Calea has already written to you explaining that this shortage is likely to last for four weeks, however, having worked closely with Calea on this matter, it appears likely that the issues will last longer than initially anticipated.”

HSJ asked NHS England for clarity as to how long the shortage was expected to last but it did not reply before publication.

The problems started last month after the Medicines and Healthcare products Regulatory Agency imposed overnight restrictions on Calea following an inspection of its production plant in Runcorn.

Dr Fowler said that, while there was no risk to patients, the changes insisted on by MHRA were “immediate and essential”. He added a national group including clinicians, experts and officials from NHSE/I and the Department of Health and Social Care were working with suppliers to increase the national capacity for TPN production.

He said the group had been working with other suppliers to try and increase the national capacity for TPN feed adding the NHS was “working with the MHRA to expedite regulatory processes required including those required to import stock from global markets.

“We are doing absolutely everything we can to resolve this situation as quickly and as safely as possible.”

In a letter to clinicians, Dr Fowler said the market for TPN feed was “fragile and complex” with limited extra capacity.

The MHRA has been forced to defend its actions amid criticism from clinicians that it had created an unnecessary crisis.