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Online pharmacy closes over 'incompetent' clinical advice

One online pharmacy has ceased trading over "incompetent" clinical advice identified by health regulator the Care Quality Commission (CQC), while another has been suspended.

MD Direct, which traded through the website, voluntarily stopped providing services to patients after a CQC inspection in December 2016 identified a number of failings that put patients at risk.

The CQC said “ineffective” staff training had led to "some non-clinical staff with no formal training assessing patients’ needs". 

“The clinician was working outside of her scope of practice and told us they were not competent to carry out the role,” the CQC said.

The inspection revealed that did not have the “experience, capacity and capability” to provide online healthcare.

"For example, we found patients being prescribed large quantities of inhalers, but there was a lack of monitoring or follow up for these patients, whose condition could put them at serious risk of harm."

Another online pharmacy suspended

A BBC Radio 5 Live investigation prompted a CQC inspection into another registered online pharmacy – HR Healthcare Ltd, operating through the website – and its sales of antibiotics.

The CQC said it was “concerned” at some of the prescribing decisions made by staff at, including an incident of one patient being prescribed four seven-day courses of antibiotics to treat a urinary tract infection.

“Prescribing was not in accordance with best clinical practice and national guidance,” the regulator concluded.

"Another patient was prescribed 12 asthma reliever inhalers over a four-month period," it added.

Patients were not always aware if the medicine they were prescribed was unlicensed, and there were “few” procedures in place for monitoring and managing risks to patient and staff safety, the inspection found.

However, the regulator also "observed that members of staff were courteous and very helpful to patients when speaking to them on the telephone". 

The CQC said it would suspend the provider for three months from December 2, 2016, “to protect patients”.

Further inspections

From an internal review of all 43 registered “digital healthcare providers” in the UK, the CQC found incidents of patients being able to obtain prescription-only medicines with "minimal" identity and safety checks.

As a result, it announced a “programme of inspections” which will “prioritise those services it considers as potentially presenting a significant risk to patients”.

General Pharmaceutical Council chief executive Duncan Rudkin said pharmacies linked to the online services being inspected by the CQC will be subject to “further inspections” from the pharmacy regulator "where necessary".

“[We will] assess whether they are meeting our standards and appropriately addressing the issues and risks linked with online prescribing and dispensing,” he added.

“Scant regard” for patients

The Royal Pharmaceutical Society (RPS) said it is “fully supportive” of the “shutting down of online primary care services that offer scant regard for patient care”.

“Although technology – such as the use of Skype or telehealth consultations for diagnosis – can help with access to healthcare in general, there are risks to increasing access to antibiotics specifically,” RPS English pharmacy board chair Sandra Gidley said.

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