Regulator cracks down on unsafe practice at online pharmacies

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Regulator cracks down on unsafe practice at online pharmacies Four more providers have put people at risk of harm, says CQC

Caroline White

Thursday, 06 April 2017

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The health services regulator, the Care Quality Commission (CQC), has exposed examples of poor and unsafe practice at four more online pharmacies providing medicines to the public, in a set of inspection reports published today.

Insufficient identity checks, inadequate recording of patients’ medical history, failure to clarify symptoms, inappropriate medicines prescription, and lack of communication with the patient’s GP were among the examples of potentially harmful practice the regulator found.

The CQC has suspended the registration of one of these providers, imposed conditions on two of them, and instructed the fourth to improve its practice.

Last month, CQC, alongside the GMC, the General Pharmaceutical Council, and the Medicines and Healthcare products Regulatory Agency, reminded those running these websites that they must care for people safely and effectively, and follow professional guidelines like any other provider.

At the same time, the CQC warned the public to be cautious when considering using these websites after it published the first two inspection reports on online primary care – HR Healthcare Ltd and MD Direct. The CQC suspended the registration of HR Healthcare Ltd, and MD Direct voluntarily cancelled its registration following the CQC’s inspection.

Following an internal review of all 46 online services that are registered in England, the CQC brought forward a programme of inspections prioritising those services it considered as potentially presenting a significant risk to patients.

Its latest findings concern Doctor Matt Ltd, Frosts Pharmacy Ltd, White Pharmacy Ltd, and i-GP Ltd.

• Doctor Matt Ltd (www.theonlinesurgery.co.uk) was issuing prescriptions after taking as little as 17 seconds to review patient questionnaires. The CQC has suspended the registration of this service until the end of June.
• Frosts Pharmacy Ltd (www.oxfordonlinepharmacy.co.uk) was prescribing large quantities of inhalers for asthma without checking if the patient’s condition was out of control or if a diagnosis of asthma had been confirmed. The CQC has issued the provider with warning notices.
• White Pharmacy Ltd (www.whitepharmacy.co.uk) was prescribing a high volume of opioid-based medicines with no system in place to confirm patients’ medical or prescribing histories. CQC has placed conditions on the provider to restrict its prescribing of these medicines.
• i-GP Ltd (www.i-gp.uk) was issued requirement notices instructing it to make improvements in a number of areas, including ensuring that it has a good system in place to verify the identity of its patients.

In several cases, providers took action immediately after the inspection to address some concerns. The CQC will check the impact of these changes when it returns to re-inspect.

Professor Steve Field, chief inspector of General Practice at the Care Quality Commission, said: “It is understandable that people want convenient access to advice and medicines, but it is important that providers do not compromise on patient safety. We expect the same standards of quality and safety to be met as we would see in more traditional GP settings – this is exactly what people deserve.”

He said that online providers and those working for them had a duty to protect the people seeking their services.

“They must follow relevant guidance and best practice to make sure that they know who they are communicating with, how medicines fit in with their medical history, and that their GP is made aware of any prescribing decisions,” he said.

Professor Helen Stokes-Lampard, chair of the Royal College of GPs, said: “We cannot tolerate a laissez faire attitude towards dispensing of prescription medication; they are not sweets.

“We were shocked and disappointed last month to hear about the apparent minimal security checks on some websites to ensure patients are obtaining prescription drugs appropriately. It’s concerning today to see reports that this is more widespread – and the CQC are absolutely right to take a hard line against this.”

She added: “We do understand why patients might think getting their medication online is convenient, but they also need to be confident that these services are safe and follow strict remote prescribing rules outlined by the GMC.”

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