Duncan Rudkin, Chief Executive of the General Pharmaceutical Council, explains why the pharmacy regulator has strengthened its guidance for owners of online pharmacies on supplying medicines online.

Searches for online medicines have increased hugely in recent years and there is no doubt many people value the convenience which online offers. Research by YouGov (1) commissioned by the GPhC found that 25% of people say they are likely to use online pharmacies in the future, but 50% of those unlikely to do so have concerns about the safety of online medicines sales.

Ensuring patients receive safe care

We are aware of situations where people have experienced serious harm after accessing medicines online that were not appropriate for them, through concerns raised with us (including by doctors) and through our work with other regulators.

Regulating healthcare services on the internet is complex, with different organisations and agencies responsible for different parts of the service. We have been working closely with other regulators with a role to play, including the GMC, to help make sure patients receive safe and effective care at each stage, from when they first visit an online primary care service to when they receive their medicines from a pharmacy.

Strengthening our guidance

As the pharmacy regulator for Great Britain, it is our responsibility to regulate the online pharmacies and the pharmacists and pharmacy technicians working for them. We have strengthened our guidance for pharmacy owners providing pharmacy services at a distance, to help make sure that people can only obtain medicines from online pharmacies that are safe and clinically appropriate for them.

This guidance was developed following a public consultation and was informed by what we heard from patients and health professionals. It introduces a number of new safeguards, including in relation to how pharmacy owners work with prescribers and prescribing services, and so has implications for any doctors working for online prescribing services.

The safeguards include:

  • Making sure medicines are clinically appropriate for patients – pharmacy owners will have to make sure that the pharmacy team can carry out robust identity checks on people obtaining medicines and can identify requests for medicines that are inappropriate. The pharmacy websites should also not allow a patient to choose a prescription-only medicine and its quantity before there has been an appropriate consultation with a prescriber.
  • Further safeguards for certain categories of prescription-only medicines – further safeguards will have to be in place before supplying certain categories of medicines, including; antimicrobials, medicines liable to abuse, overuse or misuse or where there is a risk of addiction, and non-surgical cosmetic medicinal products, to make sure that they are clinically appropriate. Online pharmacies have an important responsibility to help improve communication between online services and GPs, which we see as essential in patients’ interests.
  • Transparency and patient choice  pharmacy owners will have to supply more details about where the service and health professionals involved in prescribing and supplying the medicine are based and how they are regulated, so people have enough information to make an informed decision about using the service and can raise concerns about the service if they need to.
  • Regulatory oversight  pharmacy owners working with prescribers or prescribing services operating outside the UK must take steps to successfully manage the additional risks that this may create, including assuring themselves that the prescriber is working within national prescribing guidelines for the UK.

During pharmacy inspections, our inspectors will be looking for evidence that the guidance is being followed, or that there is a plan in place for how the pharmacy is working towards this.

We hope this guidance, alongside guidance and resources from the GMC and other regulators, will help to make sure that providers and health professionals are clear on their responsibilities to protect people who use their services and deliver safe, high quality care.

We will also continue to work closely with the GMC and the other regulators involved to share intelligence where we have concerns and to take action where necessary to protect patients.

(1) All figures, unless otherwise stated, are from YouGov Plc. Total sample size was 2040 adults. Fieldwork was undertaken between 8th – 9th August 2018. The survey was carried out online. The figures have been weighted and are representative of all GB adults (aged 18+).