CQC cracks down on websites bypassing GPs to offer prescription medicines

The CQC has clamped down on online pharmacists that provide prescription medicines, warning they must inform patients' GPs and adhere to traditional primary care quality standards.

Pharmacy (Photo: Simon Barber)
Pharmacy (Photo: Simon Barber)

Four websites that sell prescription medicines have been subject to CQC action for failing to meet safety and quality standards – with one having its registration suspended while it makes improvements.

The watchdog warned that they must make more effort to confirm the identities and clinical histories of patients – and must inform their GP – before granting prescription medicines to patients.

Patients should expect ‘the same standards of quality and safety’ as traditional GP settings from these services, it added.

The CQC employed ‘urgent enforcement powers’ to suspend registration of Dr Matt Ltd (theonlinesurgery.co.uk) until the end of June after finding that it issued medicines after ‘as little as 17 seconds’ reviewing patient questionnaires.

Another provider, which runs the White Pharmacy, had conditions placed on its registration for prescribing a high volume of opioid-based medicines while having no system in place to confirm patients’ medical or prescribing histories.

The Oxford Online Pharmacy was given a warning message for prescribing ‘large quantities’ of asthma inhalers without checking whether the patient’s condition was out of control – or if they had a confirmed diagnosis.

A fourth, i-GP, was also given a warning that it must make improvements including ensuring it has better systems in place to verify patients’ identities.

Map: GP CQC ratings

The crackdown comes a month after the CQC – alongside the GMC, General Pharmaceutical Society and the Medicines and Healthcare products Regulation Agency – warned the public to be cautious when using online prescription services.

The latest reports are the second batch released by the CQC for web-based primary care providers, after it suspended registration for two others in March.

A total of 46 online services are registered in England. The CQC said it was prioritising inspections in those considered to pose the greatest risk to patients.

Professor Steve Field, CQC chief inspector of general practice, 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.

‘Online companies, and the people working for them, have a duty to protect the people seeking their support. 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.

‘This might be a new way of working but the risks and responsibilities need to be understood and action taken in response. As the regulator of health and social care, we will continue to play our part in guaranteeing this.’

Online services

RCGP chair Professor Helen Stokes-Lampard 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.

'GPs and other prescribers in the community are highly trained to take into account physical, psychological and social factors when treating a patient, and will only prescribe drugs if it suits the unique health needs of the person sitting in front of them. We are also careful to ensure that the drugs work safely in combination with other medications that the patient may be using and to consider any previous history of allergies.'

GPonline approached all four providers for comment.

A spokeswoman for Dr Matt Ltd, which runs The Online Surgery, said: ‘Patient safety has always been our priority, and every consultation is overseen by a qualified and experienced GP. Our first CQC inspection in 2014 was successful across all criteria.’

Stuart Gale, owner and chief pharmacist at the Frosts Pharmacy Group, which runs the Oxford Online Pharmacy, said: ‘We absolutely welcome the CQC’s focus on online pharmacies, since patient care is at stake.

‘The CQC has flagged some areas for improving further the services that we provide. We have responded immediately, even suspending our asthma inhaler service for the time being, so that we can ensure we are operating to the highest standards, before this service is reintroduced.’

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