The General Pharmaceutical Council (GPhC) has identified that some online pharmacies have supplied high-risk medicines including opiates and sedatives to patients without appropriate steps being taken by the pharmacy owner, prescriber, responsible pharmacist or other members of the team. It has been found that check to ensure that the medicine being prescribed and dispensed was clinically appropriate for the patient were not made.
These patient safety concerns were identified during recent pharmacy inspections which looked at whether online pharmacies were meeting the standards for registered pharmacies and following updated guidance published in April this year.
The updated guidance on providing pharmacy services at a distance made clear that some categories of medicines are not suitable to be supplied online unless further safeguards have been put in place to make sure they are clinically appropriate for patients. This includes medicines liable to abuse, overuse or misuse, or when there is a risk of addiction and ongoing monitoring is important, such as opiates and sedatives.
In response, the GPhC is taking enforcement and regulatory action where appropriate against the owners of these registered pharmacies, as well as individual pharmacy professionals involved in both the prescribing and supply of medicines where their conduct may have fallen short of professional standards. The GPhC are also taking forward Fitness to Practise investigations against a number of superintendent pharmacists, pharmacist independent prescribers and responsible pharmacists.
Improvement notices and conditions on a pharmacy’s registration have been imposed; for example, conditions restricting the supply of controlled drugs by the pharmacy.
The chief executive of the GPhC, Duncan Rudkin, has this week written to the owners of online pharmacies and asked them to provide information on the actions they have taken to follow the new guidance and make sure patients access pharmacy services online safely. This information will be used to proactively prioritise the GPhC’s inspection programme.
Duncan Rudkin, Chief Executive of the GPhC said:
“I want to reassure patients and the public that we are taking robust action against the small number of online pharmacies and pharmacy professionals who through their actions have put the safety of patients at risk. I have also written to online pharmacy owners to obtain details of how they are keeping patients safe online and following our guidance.
“I have made clear that pharmacy owners need to make sure that they have the right safeguards in place to make sure all medicines they supply are clinically appropriate for their patients.
“When prescribing and supplying high-risk medicines such as opioids, it is not acceptable to rely solely on information provided by the patient via an online questionnaire; the prescriber needs to take other steps such as consulting with the patient, reviewing medical records and contacting the patient’s GP, as outlined in regulatory standards and guidance. (1)
“Patient safety is our central focus, and we are continuing to work closely with other regulators involved in regulating online primary care services, governments and other stakeholders across Great Britain to improve the quality of care for patients online.”
(1) Prescribers are expected to follow relevant regulatory standards and guidance such as the GMC’s Good Medical Practice and the GMC’s guidance on prescribing. The GPhC is currently developing prescribing guidance for pharmacist independent prescribers.