The General Pharmaceutical Council (GPhC) has said it has identified ‘serious patient safety concerns’ around some online pharmacies and online prescribing services.

In separate letters to pharmacy owners and pharmacists, published today, it stressed that over 30% of its open fitness to practise cases relate to online pharmacy. This is ‘disproportionate to the sector of the market that online services occupy’, it added.

It warned that online pharmacy does involve ‘particular risks’ and pharmacists working for online services must ‘appropriately manage these risks to protect patient safety’.

Since March, the GPhC said it has imposed seven interim orders on pharmacists who have worked for or with online prescribing services, after identifying serious concerns with their practice. It also has several ongoing investigations into other pharmacists working for online services.

It explained that these pharmacists include those working as pharmacist independent prescribers for online services or who were dispensing medicines prescribed online. Some were the Responsible Pharmacist (RP) or the Superintendent Pharmacist (SI).

The common themes in these cases include:

  • medicines being prescribed to patients on the basis of an online questionnaire alone, with no direct interaction between the prescriber and either the patient or their GP
  • prescribing of high-risk medications or medications which require monitoring without adequate safeguards
  • prescribing of medicines outside the prescriber’s scope of practice
  • high volumes of prescriptions being issued by the prescriber in short periods of time.

In addition, it said it has taken enforcement action against over 50 online pharmacies since March 2019 after identifying patient safety issues during inspections.

Only 71% of online pharmacies the GPhC inspected from 2019-22 met all of its standards for registered pharmacies, compared to an overall benchmark of 85% for all pharmacies, it added.

It urged pharmacists to make sure they are meeting its standards for pharmacy professionals at all times and for pharmacist prescribers when prescribing. They should also ensure their employer is appropriately regulated in the UK and/or is meeting the relevant UK regulatory standards.

However, the GPhC acknowledged the ‘significant benefits for patients in using online services’ and said it supports ‘innovative approaches to the prescribing and supply of medicines’.

It also said pharmacy owners must ‘create and maintain the right environment and framework to deliver safe and effective pharmacy services’. They must also meet standards for registered pharmacies, and follow guidance for providing pharmacy services at a distance, including online.

It added that if a pharmacy is working with services that involve lawfully working with prescribers or prescribing services not regulated by UK regulators, it must make sure it sucessfully manages ‘the extra risk that this may create’.

Pharmacies should not work with ‘online providers who try to circumvent the regulatory oversight put in place within the UK to ensure patient safety’, it added.

The GPhC confirmed in July that there has been an increase in fitness to practise action being taken against pharmacist prescribers associated with certain types of online prescribing services.