Experts have warned that the ongoing conflict in Iran is exposing the NHS's heavy dependency on petrochemicals, potentially leading to shortages and rising costs for essential medical items such as syringes, intravenous bags, and gloves. The war has disrupted shipping in the Gulf, affecting the supply of petrochemicals that are crucial for producing active pharmaceutical ingredients and sterile single-use items like personal protective equipment (PPE), catheters, and diagnostic-device casings.
NHS Supply Chain Under Pressure
The NHS, one of the world's largest healthcare bulk buyers, spends approximately £8 billion annually on equipment and consumables, from latex gloves to prosthetic hips, and a further £21.6 billion on medicines. While temporary shortages of certain drugs and equipment have become more common since Brexit and during the Covid-19 pandemic, the Iran war now threatens to exacerbate these issues globally, pushing up costs and intensifying competition for supplies.
Chief Executive's Concerns
Jim Mackey, chief executive of NHS England, has expressed deep concern over supply chain challenges, warning that additional government funding may be required if the war leads to a significant price shock. In response, NHS England has increased purchases of drugs and devices to build buffer stocks. However, damage to energy infrastructure and mines in the Strait of Hormuz could prolong disruptions.
Central Procurement Body's Response
NHS Supply Chain, the central procurement body managing over 620,000 products, has increased stocks where appropriate and is engaging with suppliers on continuity plans and logistics. Tom Brailsford, head of resilience, confirmed these measures.
Air Freight Disruptions
Airports in the Middle East remain disrupted, with airlines cutting flights due to jet fuel concerns. Dubai and Doha, key hubs for medicine air freight from India—known as the world's pharmacy—are affected. Professor Richard Sullivan of King's College London highlighted the dual problem of airspace issues and logistic chain disruptions, noting that supply chains for cancer drugs are often thin, relying on single suppliers.
Impact on Hospital Operations
At Gloucestershire Hospitals trust, doctors and nurses use over 6 million synthetic rubber gloves annually, costing nearly £330,000. A 2024 campaign to reduce overuse may now be enforced more strictly. Professor Liz Breen of Bradford University emphasised that items like catheters and gloves are fundamental to patient care, and shortages could cause significant problems.
Waste Reduction Opportunities
Professor Sullivan suggested that shortages could force the NHS to adopt more sensible use of single-use items and prepare drugs only when needed, reducing waste. He noted that many single-use instruments are opened unnecessarily and must be discarded if unused.
Cost Surges and Price Gouging
The cost of common medical items has jumped since the war began. The average price of a box of 1,000 synthetic rubber gloves has risen 40% to $29 (£21.50), according to Oong Chun Sung of CIMB Securities. Sustained disruption could lead to glove shortages by late May. Naphtha prices, a key petrochemical feedstock, have soared from $560 to over $900 per tonne in Europe.
London-based Polyco Healthline, a major NHS contractor, raised prices by 10.3% to 26.3% from April 1, signalling further rises. Malaysian condom-maker Karex, also an NHS supplier, is increasing prices by 20% to 30%, and Top Glove, the largest manufacturer, has passed on cost increases of 50% due to higher nitrile latex prices.
Price Gouging Allegations
Professor Sullivan accused some suppliers of price gouging, warning that components for surgical robots could become scarce. The NHS pays some of the lowest prices globally, but manufacturers may prioritise higher-paying countries, leading to shortages.
Buffer Stocks and Just-in-Time Supply Chains
Drugmakers hold eight weeks of medicines, and equipment makers have buffer stocks, but markets for items like IV bags are dominated by few suppliers. Scott Lehmann of Sphera noted that volatility is a feature of the system, but healthcare cannot pause due to shortages. The UK's "just in time" supply chains may face challenges, and Sullivan urged investment in domestic manufacturing.
A Department of Health and Social Care spokesperson stated that robust measures are in place to manage disruption, including buffer stocks and alternative products, with most of the UK's 14,000 licensed medicines in good supply.
