The ongoing conflict in Iran has placed the NHS on high alert, with concerns over rising costs and potential shortages of medicines and medical supplies such as syringes, intravenous bags, and gloves. Much of modern healthcare relies on petrochemicals now disrupted by the Gulf shipping standstill, affecting active pharmaceutical ingredients and the production of sterile single-use items like PPE, catheters, and diagnostic device casings.
The NHS, one of the world's largest healthcare bulk buyers, spends £8bn annually on equipment and consumables, with a medicines bill of £21.6bn in 2024-25. While temporary shortages have occurred since Brexit and during the Covid-19 pandemic, the Iran war threatens to widen and deepen these issues globally, pushing up costs and triggering competition for supplies.
Jim Mackey, chief executive of NHS England, has expressed being “very worried” about supply chain challenges, warning that extra government funding will be needed if price increases cause a “huge shock”. In response, NHS England has increased purchases of drugs and devices to build buffers, though no shortages exist yet due to its purchasing power. However, prolonged conflict could change this, especially with potential damage to energy infrastructure and mines in the Strait of Hormuz.
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. 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, are affected, compounding logistics issues.
Richard Sullivan, professor of cancer and global health at King’s College London, notes that supply chains for many cancer drugs are thin, often relying on single suppliers. He highlights waste within the NHS and suggests shortages could force more sensible use of single-use items. At Gloucestershire Hospitals trust, a campaign in 2024 to reduce overuse of synthetic rubber gloves—67,653 boxes annually—may see stricter enforcement of usage rules.
The average price of a box of 1,000 synthetic rubber gloves has risen 40% to $29 (£21.50) since the war began, according to Oong Chun Sung of CIMB Securities. Liz Breen, professor of health service operations at Bradford University, warns that shortages of small items like catheters and gloves could collectively cause significant problems for patient care.
