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CQC cracks down on four more online pharmacies

CQC: One online pharmacy was issuing prescriptions after as little as 17 seconds
CQC: One online pharmacy was issuing prescriptions after as little as 17 seconds

The Care Quality Commission (CQC) has suspended the registration of one online pharmacy and taken action against another three for potentially putting people “at risk of harm”.

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.

Opiod-based medicines

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.

Do you have concerns about online pharmacies?

Shawn Casey, Pharmaceutical Adviser

*This comment has been deleted for breaching C+D's community principles*

James Colin, Pharmaceutical Adviser

*This comment has been deleted for breaching C+D's community principles*

John Ellis, Community pharmacist

I think many people are confusing online pharmacies qith online prescribing. They're two different things. An online pharmacy is regulated by the GPhC and the MHRA, this regulates the supply of medicines over the internet. But once an internet pharmacy, or any pharmacy for that matter, offers prescribing services, this automatically comes under the CQC, as they have a responsibility to make sure prescribing practices are safe, records are adequate and kept safely. If anybody wants to assess patients and prescribe medicines from a 'practice' whether online or not, it has to be CQC registered.

Alaish Patel, Ecommerce

Is it not the GP's who are prescribing the medication at fault? The Pharmacist is following instructions from a GP.  

Frustrated Pharmacist, Community pharmacist

The GPhC should have been on top of this long before the CQC had to get involved. Who watches the watchmen? As Val says, unfit for purpose at this stage.

Valentine Trodd, Community pharmacist

The GPhC is simply unfit for purpose anymore. All it seems to be interested in is persecuting hard working pharmacists at the coal face whilst looking the other way regarding the shenanigans of multiples and online outfits.

CAPT FX, Locum pharmacist

May I ask the question, where was our dearly loved GPHC when these online pharmacies were having a field day with patients lives. Once again we have an expose from somewhere and the GPHC reacts.
Pharmacy as a profession will continue with this headless chicken, autopilot routine till our regulator discover and understand their role. Being a patient champion is not about lining up a few black and ethnic minority registrants and showing an example out of them. I have said this before and will never tire from saying this. It is about confronting everyone including the powerful contractors and chains and publicly bringing them to book. I worked for this wonderfully powerful , influential and all conquering chain. We sold products from baskets on the floor, patient records were everywhere and anywhere and the controlled drug cabinet was dancing on the ceiling. The local inspector was informed and he said , go to the GPHC website and express your "concerns". The magnitude of this violation scared him and paralysed him. Suffice to say nothing was done and good old life goes on. With this precedent does the GPHC have any moral high ground to regulate anyone? The answer is a defeaning no!tt

ajaz akhtar, Student

Sorry guys but these online pharmacies which employs GPs are the Future. With the general public leading ever more increasingly busy lifs and waiting times of over a week at the average surgery, many will see this as a quick and convenient way to access healthcare

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

Then we are going to hell in a hardcart. if all we can look forward to is a plethora of online pharmacies (probably based ofshore) all trying to make maximum profit for minimum effort and sod the consequences. Patient care seems to be the last thing an online pharmacy thinks of.

CAPT FX, Locum pharmacist

We are practically in hell if not worse. Any profession worthy of it's name should be regulated by a strong regulatory body with a clear vision of it's mandate. The NMC for nurses and the GMC for Doctors are consistent bodies which leave no doubt about their authority. Can we say the same for the GPHC, absolutely not. This story came out after the involvement of the CQC. Last time it was a BBC expose and yet the GPHC has the Mandate for all this. The few they actually do emanate from trivial shop floor gossip or hatred. Yes , offshore online Pharmacies love it here because they can do as they please

CAPT FX, Locum pharmacist

You are absolutely right. Community Pharmacy has been so lerthagic and is always reacting to crises rather than set the pace. We have not invested in the Community Pharmacy project. When you look at the Drug tariff you will notice the Dept of Health tried to modernise us by financing computer hardware and software during the EPS roll-out, yet you find computer hardware with 252mb ram dating back to 1999 in pharmacies around the country. The mobile phones in our pockets have more RAM and storage than most pharmacy computers. I think 75 percent of the scanners don't work. As a profession we are far from being configured for speed and efficiency. We have seen business just reaping and declaring as profits, funds which were meant to modernise and improve infrastucture. In terms of automation Community Pharmacy is well behind Africa's third world and still stuck in the 19th century. Yet despite this we are always the first to moan when cuts are made. We never introspect and rectify our weaknesses. We were being paid 24k per year per Pharmacy , just for being there and we were moaning and paying our staff peanuts.
Our biggest weakness is that despite being a profession oversubscribed with qualified Pharmacist all our Managers all the way up the vital structures are not Pharmacists. This is why standards are plummeting spectacularly. We spent 23years of our formative years to be what we are and yet we are given managers without high school qualifications to run us. Most Area and Regional Managers have no managerial qualifications. Some pharmacists have postgraduate management qualifications and at times you laugh when management principles are violated and re-written every day. I always thought the UK would be better than this honestly.

O J, Community pharmacist

U r correct mussy fudge. Once private GP service becomes affordable a lot of working people with busy life will see a private GP.
Be it either over the net (Skype consultation) or a the private clinic.

People need to accept the reality that NHS may not be the same it is today in the next 15 - 20 years.

ajaz akhtar, Student

2020...I'm guessing the NHS will be privatised...remember folks we haven't really had a really cold winter...when we do have one, the system will collapse and then the MPs will get their finger out of [email protected] and be honest with the public by admitting the days of cradle to the grave healthcare is over. 

paul lisbon, GP

This whole CQC thing is all political.

1. Why did CQC launch their new guidance on the same day as the reports -

2. These online pharmacies do not even need to be CQC registered and we know hundreds that are listed on the gphc green cross scheme, offer a online consultation service but are not cqc registered like UKMEDS selling sleeping pills . So rather than name and shame the ones trying to be compliant, the message i'm getting now is just keep away from CQC and carry on as a pharmacy service. Its obvious CQC will make your life hell.


Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

Couldn't agree more! I've had CQC inspections and GPhC ones and the pharmacy inspector is like a pussycat compared to the silent assassins of the CQC

Freelance Chemist, Pre-reg Pharmacist

How often do we see GP's issuing salbutamol x2 every month with only 1 preventer in a blue moon? I think the same needs to apply to NHS GP prescribing too

Kieran Eason, Superintendent Pharmacist

Flag them up and its an easy way to get your inhaler quality payment.

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