By Content Producer Elisa Menendez
Pharmacists across the UK say they are facing a rise in abuse amid what they describe as government "denial" and "misinformation" over medicine supply shortages.
ITV News has been told of pharmacists who have been stalked and have suffered racial and physical attacks from patients.
One "traumatised" pharmacist said he feels unsafe at work after being punched and put in a headlock by a patient, while another pharmacy shared footage of an incident in which a man appeared to repeatedly smash the shop's window.
A man was arrested and charged following an incident at Knights Taibach Pharmacy in South Wales
It comes as pharmacists continue to report shortages of common medicines for colds and flu including cough mixtures, throat lozenges, and some pain killers such as liquid paracetamol and ibuprofen.
Pharmacists say the reasons behind the rise in abuse are "multi-faceted" but put much of it down to the "mixed messaging" from the government over the supply issues, compounded by long GP waits.
The Department of Health and Social Care (DHSC) says cold and flu drug shortages are "temporary and localised" - but pharmacists say the issues are more widespread. Some say they now regularly struggle to buy in stocks for a range of drugs.
Before Christmas, pharmacists were sounding the alarm for weeks over a shortage of antibiotics amid a sharp rise in Strep A infections and what health officials described as a flu and Covid "twindemic", while last year they struggled with HRT drug shortages.
Dr Leyla Hannbeck, chief executive of the Association of Independent Multiple Pharmacies (AIMP) which represents around 4,000 pharmacies, described the situation for "burnt out" pharmacists as "chaos" as she hit out at the Department of Health for a continuous lack of planning and denying supply issues.
"We've had some serious cases of violence and abuse - some related to medicine shortages. It's been very demoralising. People are just fed up," she said.
Greater Manchester pharmacist Safwaan Chhipa told ITV News how he has been left "shaken up" after a patient attacked him because they didn't have his medication in stock.
Mr Chhipa, manager of Rigby & Higginson Pharmacy in Bolton, said the patient had come in the week before asking for diabetes medication but the pharmacy didn't have it because they were struggling to get it from a wholesaler.
They suggested the patient either leave it with them until they get hold of supplies, try another pharmacy, or go back to his GP and ask for an alternative medication.
The week after, on the morning of December 20, the patient came back and asked to speak to the pharmacist in private, so Mr Chhipa took him to the consultation room where he asked for his medication. Mr Chhipa checked stocks but informed him that they still didn't have it.
"I could see his hands tensing up and he was saying 'I'm not moving until I get it'," recounted the pharmacist. "He started shouting and saying 'I need it right now'."
Mr Chhipa said he apologised and explained there was nothing more he could do, but concerned the patient was growing more upset, he went to open the door.
"As soon as I opened the door, he punched me in the back and put me in a headlock," he said.
After struggling to break free for a few moments, Mr Chhipa said the patient eventually let go but he continued to demand that his prescription was fulfilled and sat down to wait.
Police arrived several minutes later after colleagues pressed the panic button - but the patient had already left.
Greater Manchester Police said they were called to "a report of an assault taking place at a business on Church Street in Westhoughton in Bolton".
"A 55-year-old man was arrested on suspicion of common assault and battery. He has been released under investigation whilst enquiries continue," said GMP.
"I don't want to go to work feeling unsafe"
Mr Chhipa, who is still suffering back pain following the incident, took a few days off but said the experience left him "in shock" and nervous to go to work.
"It leaves us traumatised," he said of the growing incidents of abuse.
"Every time I go to work, or I go into the consultation room it brings back the memories. In any job, you don't want to go into work feeling unsafe," he said.
Mr Chhipa said staff at the community pharmacy, which he described as family-orientated, "never used" to experience aggression from customers who were mostly understanding if they didn't have items in stock.
But now, he said, they regularly suffer abuse, adding: "There's more shouting, customers are becoming more irate."
When asked what was behind it, Mr Chhipa replied: "The drug shortage that's happening I think is putting a lot of stress on patients.
"And a lot of our patients can't get GP appointments. They get diverted to 111, who then refer them back to us. We deal with a lot of stuff but we can't prescribe the medication they need.
"The pharmacy is the only place they can actually walk in and talk to someone. At the GP they can't get past reception a lot of the time, or it's a phone consultation.
"I think they just vent out in the pharmacy because it's often the only person they get to talk to face-to-face.
"As healthcare workers, it's just sad that stuff like this happens. It's something that's out of our control and we're getting abuse for it."
A report conducted by the Pharmaceutical Services Negotiating Committee (PSNC) in early January last year found two-thirds (75%) of pharmacy staff in England have experienced aggression from patients amid medicine supply chain issues.
The vast majority of pharmacies (83%) said they had experienced a significant increase in medicine delivery issues, with more than half (51%) of respondents saying drug shortages are a daily occurrence.
"Pharmacy abuse is rife and becoming normalised"
Mohammed Kolia, superintendent of Knights Pharmacy which has 96 pharmacies across the UK, said he is concerned about the racial, physical and verbal abuse staff suffer on a weekly basis.
He told ITV News that in the last month alone, there have been three physical attacks on staff members.
When he started in his role seven years ago, he said it was "unheard of" to hear of patients attacking pharmacists but it is now becoming "normalised".
He shared footage of one of the most recent incidents, in which a man appeared to smash up the window of a pharmacy in Port Talbot, South Wales, on December 19.
South Wales Police said officers were called to "a report of criminal damage at a doctors’ surgery and a pharmacy in Taibach, Neath Port Talbot", in which "officers deployed taser to safely arrest the culprit".
"Jonathan Keegan, 51, from Swansea was later charged with assault, criminal damage and possession of controlled drugs. He has been remanded in custody," it added.
"This was just one incident and while it looks extremely graphic, it is really a reflection of daily life in community pharmacies," added Mr Kolia.
"That same day, we had a patient follow a staff member home. That was over a simple issue where a staff member said they can't skip the queue.
"Just a week before, a till was thrown at a staff member. They literally pulled it out - and our tills are very heavy - but they luckily missed. That was over a stock availability issue."
"And we had another incident on Friday where a pharmacist was head butted in Rugby," he added.
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The issues around why pharmacy abuse is "rife" is multi-faceted, he said.
"But most of the time, certainly recently, it has been down to the issue around stock availability, which of course pharmacies don't have much impact on because we are at the bottom of the chain," added Mr Kolia.
"What doesn't help is the constant mixed messaging from the Department of Health. And it seems to be continuing. I would've thought the government would've learnt their lesson."
He said the department's "constant" sharing of "misinformation needs to stop".
Mr Kolia pointed to the recent antibiotic shortage during which pharmacists laid bare the lengths they were going to keep patients safe, with some waking up at 4am to obtain stock, while one told ITV News how a young girl with Strep A collapsed in front of him after her family had driven for hours between pharmacies to try and get antibiotics.
Ministers, including Prime Minister Rishi Sunak, maintained there was no shortage and that antibiotics were readily available.
"What happened was patients obviously expected there to be antibiotics in pharmacies," said Mr Kolia. "When they found pharmacies that didn't have them, they blamed pharmacy staff and took it out on them."
The government later issued a "Serious Shortage Protocol" granting pharmacists the power to supply alternatives to penicillin where stocks were low.
"But the mixed messaging still continues with cold and flu products now," he added, pointing to the DHSC's comment. "Completely false information yet again."
Mr Kolia said he is concerned there is a "silent pandemic of mental health issues among community pharmacy workforces" and believes many workers are suffering with some level of acute mental health concerns due to the abuse and pressures faced in the industry.
He said on top of the shortage concerns, wholesale prices are increasing and the current "not fit for purpose" funding structure is "crippling" community pharmacies, with many operating at a loss.
The pharmacy director has previously had to get security guards in one pharmacy and put in place a support guardian to take care of the mental health and wellbeing of staff.
Dr Leyla Hannbeck of the AIMP also raised concerns about pharmacists' mental health and said she has been trying for months to get round the table with the Department of Health to discuss supply issues. She said she finally had "constructive discussions" with health minister Will Quince this week.
A Department of Health and Social Care spokesperson said: “We are aware of reports of issues with the availability of some branded cold and flu medicines – these appear to be temporary and localised.
“Supply of over-the-counter medicines is not controlled by central government but we are engaging with suppliers to investigate and help ensure that over-the-counter cold and flu medicines remain available.”