GPhC reports rise in fitness to practise action around online prescribing

There has been an increase in fitness to practise (FtP) action being taken against pharmacist prescribers associated with certain types of online prescribing services, the GPhC has confirmed.

The pharmacy regulator told The Pharmacist that it had applied for and imposed five interim orders in the last two months and a total of seven interim orders since March this year against pharmacist prescribers associated with certain types of online prescribing services.

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The GPhC spokesperson reported a ‘large increase’ in referrals from members of the public, coroners, clinicians and inspectors around ‘unsafe prescribing practices or prescribing outside scope of practice and the level of harm caused or risk posed’, triggering an increase in FtP action.

This comes after the Pharmacists’ Defence Association (PDA) issued an urgent alert around the rise, pointing out that all the pharmacists concerned ‘are or have previously been associated with online prescribing services that are not subject to regulation by a UK regulator’.

The PDA highlighted common features underpinning the allegations including:

• Overreliance on a patient questionnaire to inform clinical decision making
• No patient-prescriber interaction
• Prescribing high risk medicines without adequate safeguards
• Inadequate systems and processes leading to inappropriate prescribing
• Very high volumes of prescriptions being authorised in short periods of time
• Prescriber-patient relationships established via an unregulated online portal

The PDA said members can get in touch for further advice on protecting their position.

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Specifically, those who issue private prescriptions via an online service or clinic setting where the patient-prescriber relationship is established or maintained via a website or third-party organisation that is not registered with either the relevant pharmacy regulator.

The GPhC has instructed an expert witness to comment on the prescribing model being utilised by a particular provider, and this evidence is being reviewed to look at the implications across wider FtP cases. The expert witness has only been instructed for one case to date.

The GPhC  issued a warning about online prescribing practice last year, and in May, published an article in which it detailed identified cases of overprescribing where up to six Salbutamol inhalers per prescription had been issued by online prescribers.

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GPhC’s Guidance for pharmacist prescribers recommends safeguards for the online prescribing of certain medicines and the organisation published further Guidance for registered pharmacies providing pharmacy services at a distance, including on the internet earlier this year, as well as guidance on providing safe and effective treatment.