The General Pharmaceutical Council (GPhC) is currently undertaking work to update its guidance to provide more clarity for pharmacy professionals working in online settings, it has told The Pharmacist.

This follows calls from the Pharmacists’ Defence Association (PDA) for the regulator to issue ‘unambiguous guidance’ about what it expects of prescribers using questionnaire-based or asynchronous models to provide online prescribing services.

And it comes after the PDA revealed that an expert report commissioned by the GPhC, which is not publicly available, is currently being used to prosecute ‘significant numbers’ of pharmacist prescribers who use online questionnaires.

The GPhC-commissioned report conflicts with recently released Digital Clinical Excellence (DiCE) guidance about how to provide an asynchronous weight management service, the PDA suggested, warning pharmacists not to rely on the DiCE guidance.

The PDA said in a statement published on its website on Friday that the DiCE guidance ‘promotes a questionnaire-based prescribing model’ which is ‘described as unsuitable’ in a GPhC-commissioned report that is currently being used in a ‘significant number’ of fitness to practise prosecutions against pharmacists prescribing other medications in online settings.

According to the PDA, the GPhC-commissioned report stated that, in the opinion of its expert author, ‘weight loss medications should not be prescribed from an online questionnaire’.

The author added that asynchronous prescribing, without a face-to-face consultation, ‘is not and cannot be in a patient’s best interests as the prescriber does not have a full and complete clinical picture of the patient, only self-reported information’, said the PDA.

‘Therefore, the prescriber cannot assess the patient clinically, assess their emotional and mental health, or have any kind of meaningful therapeutic dialogue with them,’ the expert author added.

PDA director of defence services Mark Pitt told The Pharmacist that with online weight-loss medication a growing field, the association wanted to warn its members about the potential consequences of using online questionnaires as a basis for prescribing.

And he called on the GPhC ‘to be clearer about what their view is on online prescribing using a questionnaire-based model’.

‘[The report is] not publicly available, it's being used as the basis of the prosecution of these pharmacists,' said Mr Pitt.

‘And if the GPhC are going to be taking that approach in fitness to practise proceedings to online prescribing using a questionnaire-based model, I think they've got a responsibility to be clear about what their expectations are, because it's a very widespread form of prescribing.’

The GPhC told The Pharmacist that it was unable to share the expert report, but its chief pharmacy officer and deputy registrar Roz Gittins said that the regulator was ‘undertaking work’ to update its guidance ‘to provide more clarity for pharmacy professionals working in online settings’.

‘This will continue to emphasise that pharmacist prescribers must satisfy themselves that they have sufficient information on which to base their prescribing decisions,’ she added.

And she highlighted that the DiCE documents were ‘industry produced’ and ‘should not be regarded as being endorsed by any professional body or regulator’.

‘The only statutory standards that must be adhered to are those produced by the UK healthcare regulators and that established national guidance such as those produced by NICE, SIGN or other statutory bodies must be followed,' Ms Gittins added.

‘Ultimately pharmacy professionals need to work in accordance with GPhC standards.'