The health regulator found that online prescribing service Doctor Matt Ltd was issuing prescriptions after taking “as little as 17 seconds” to review patient questionnaires.
CQC has suspended the business's registration until the end of June, it announced in a report today (April 6).
"Risks to patients were not appropriately assessed or managed," CQC said in its report. "We found patients being prescribed large quantities of inhalers for the treatment of respiratory disease, but there was a lack of monitoring for these patients, whose condition could put them at serious risk of harm."
Community pharmacy business Frosts Pharmacy Ltd – which trades under the name Oxford Online Pharmacy – was found to be prescribing "large quantities of asthma inhalers without checking if the patient's condition was out of control or if a diagnosis had been confirmed".
However, the regulator also highlighted that the pharmacy business was providing "caring and responsive services" in accordance with the relevant regulations.
It issued Frosts Pharmacy with a warning notice, and told it to ensure prescribing decisions were documented and made appropriately, based on a thorough medical history.
Inhaler service suspended
Frosts Pharmacy told C+D it had "responded immediately" to CQC's report, and has suspended its asthma inhaler service for the time being.
Stuart Gale, owner and chief pharmacist at Frosts Pharmacy, said the group "absolutely welcomes" CQC’s focus on online pharmacies, "since patient care is at stake".
"Patient safety is our number one priority and we will continue to internally audit our performance," Mr Gale added.
CQC also “placed conditions” on online pharmacy White Pharmacy Ltd to restrict their prescribing of opioid-based medicines, after it found patient verification was not carried out for every customer, and not all medical questionnaires were evidence based.
The regulator found that one clinician working for White Pharmacy was not registered with the General Medical Council, it added.
It instructed White Pharmacy to carry out a comprehensive review of all medical questionnaires it uses to ensure they are evidence-based.
Meanwhile, online prescription service i-GP Ltd was instructed to “make improvements” in a number of areas, including ensuring it has a “robust system” to identify patients’ identity.
In conclusion, CQC said in a “number of cases” providers took action “immediately after the inspection” to address some of its concerns, but added it would check the impact of the changes on re-inspection.
Last month, CQC published two inspection reports on online pharmacies – HR Healthcare Ltd and MD Direct – neither of which are currently providing prescriptions in England, it said.
A duty to protect
Steve Field, chief inspector of general practice at CQC, said online companies have a duty to protect the people seeking their support.
“This might be a new way of working, but the risks and responsibilities need to be understood and action taken in response,” Professor Field said.
The Royal Pharmaceutical Society (RPS) told C+D it expects consistency in the regulation of online pharmacy services and for healthcare regulatory bodies to work together to ensure the regulations are “robust and effective”.
A General Pharmaceutical Council spokesperson reaffirmed to C+D that it is carrying out inspections to ensure that pharmacies linked to online prescribers are meeting standards.