Source · Select Committees · Home Affairs Committee
Recommendation 50
50
Rejected
Paragraph: 175
Ensure sustainable supply of prescribed diamorphine for patients facing shortages.
Recommendation
We are concerned by reported shortages of prescribed diamorphine, particularly because of the serious impact they may have on the health and lives of patients. As prescribed diamorphine is a viable form of treatment in England, the Government must work with suppliers to ensure that a sustainable supply is available to patients whom clinicians deem suitable for it.
Government Response Summary
The government rejected the recommendation to ensure a sustainable supply of prescribed diamorphine, stating ongoing manufacturing issues, clinical advice to use morphine as a first-line alternative due to no clinical advantages of diamorphine, and reduced NHS usage.
Paragraph Reference:
175
Government Response
Rejected
HM Government
Rejected
The Government does not accept this recommendation. There are two UK suppliers of diamorphine, and both have experienced repeated manufacturing issues over the past five years due to the complexities of the manufacturing process. In response to the ongoing supply issues, following expert input, advice was issued to the NHS in February 2020 that morphine should be considered a first line treatment option. The UK is the only country that uses diamorphine for medicinal analgesic purposes. Diamorphine is metabolised to morphine and, in terms of analgesic efficacy and effect on mood, it has no clinical advantages over morphine by oral or subcutaneous/intramuscular routes. This advice has subsequently been reiterated to respond to further supply issues and usage of diamorphine has reduced in the NHS. We are in contact with both suppliers when there are supply issues and continue to update the NHS if there are any changes to the availability of diamorphine injections.