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GPs shouldn’t have to ‘police’ online pharmacy prescribing, BMA says

Dr Andrew Green: It would be better to blacklist the online supply of high-risk drugs
Dr Andrew Green: It would be better to blacklist the online supply of high-risk drugs

It is not GPs’ job to “police” online pharmacies prescribing high-risk medication, the BMA has said in response to new guidance for distance-selling pharmacies.

The General Pharmaceutical Council (GPhC)’s guidance – issued last month – includes the safeguard that a prescriber at an online pharmacy should contact the patient’s GP in advance of issuing a prescription for medicines “which are liable to abuse, overuse or misuse, or when there is a risk of addiction”.

But Dr Andrew Green, the British Medical Association’s (BMA) GP committee's clinical and prescribing lead, said it would be better to “blacklist” the supply of such drugs through this route instead.

“The suggestion from the GPhC that GPs authorise the provision of high-risk medication before issue is inappropriate,” he said. “It is not the function of GPs to police the prescribing of others.”

“Patients must be made aware of the risks of online prescribing at the point of sale and there needs to be a robust regulatory system in place to ensure safe practice,” Dr Green added.

The association “shares the concerns” of the GPhC that distance-prescribing carries safety risks and “has been working closely with regulators, including the General Medical Council, to push for tighter regulation”.

In response to Dr Green’s comments, the GPhC said: “We have strengthened our guidance for pharmacy owners to help make sure that people can only obtain medicines from online pharmacies that are safe and clinically appropriate for them.

“This guidance was put together following a public consultation and was informed by what we heard from patients and health professionals, including concerns raised with us by medical practitioners regarding the appropriateness of some medicines being supplied to vulnerable patients.”

Do you agree with the BMA's comments?

Rachael Clarke, Superintendent Pharmacist

It's great to see both regulatory bodies working together to clamp down on those healthcare professionals falling short of the high standards of care that patients deserve. The GPhC is saying that online pharmacies working with online prescribers must involve the GP where high risk drugs are involved, the burden cannot be passed to the online prescriber. The BMA is saying online prescribing of high risk drugs is unlikely to be appropriate, hence the GP should maintain sole responsibility in this scenario. It looks to me like the regulators have taken considerable time and effort to ensure their requirements complement each other to protect patients. Well done GPhC and BMA.

Peter Smith, Student

No - the GPhC issued idiotic guidance suggesting that online prescribers must contact the patient's GP before issuing a script for some medicines (and with the kind of meds which are ordered online, this would encompass most or all medicines being requested - patients generally do not go to third-party online prescribers to order atenolol). The logistics of this are very difficult and time-consuming, which would suggest that the person issuing the guidance doesn't know what they are talking about, and that is why the BMA chose to call the advice "inappropriate". A very poor effort, yet again, from the GPhC, not sure who prompted you to post that comment but it would appear that you didn't even read the article.

Rachael Clarke, Superintendent Pharmacist

Hi Peter, thanks for your comment, I'm voicing my professional opinion, which is based on my views as both a Superintendent Pharmacist and a Lawyer. I've read both the article and the standards, I also took the time to respond to the GPhC consultation on the proposed new standards last summer. Both online pharmacy and online doctor services are seeing much greater uptake and I welcome controls that make these kinds of services safer for patients, especially vulnerable patients. Whether these controls become logistically difficult and time consuming are entirely within our gift. Of course it is inappropriate for the GP to be expected to "approve" a third party prescriber, hence why the services we design should have better mechanisms in place to avoid this being the case in the first place.


Kevin Western, Community pharmacist

how is access to a GP, and the time it takes entirely within our gift? have tyou tried to speak to a Gp recently? are you still on hold? 

Im no fan of online prescribing and the prospect of abuseable/high risk medicines being accessed this way is obviously a situation open to misuse and harm. Im happier with the no issue policy suggested by the BMA (not something I normally say!)

R A, Community pharmacist

This really put a smile on my face.

Peter Smith, Student

GPhC gets smacked down by the BMA for providing totally useless and completely ignorable "advice". Maybe if the BMA had seen some of the other total guff that has been put out by Rudkin and pals, then this article wouldn't have even been necessary, they would have just ignored it in the first place. It would be pretty funny, were it not for the fact that pharmacists are being forced to pay for the existence of the GPhC.

Greatly Pedantic and Highly Clueless, Senior Management

Well said. Good to see a student who is switched on. 

Benie I, Locum pharmacist

It is not GPs’ job to “police” online pharmacies prescribing high-risk medication




We will police online pharmacies prescribing high-risk medication if we are paid handsomely to do so.

Maybe PSNC etc.... should pay close attention to how the BMA negotiate.

Brent Cutler, Manager

Lets face it, the GPhC's April guidance is just a backside covering guidence document so that they don't need to take any real responsibility and can ultimately say we told you so. Clearly there are bad eggs out there in pharmacies and surgeries and it's this group that needs specific targeting by the BMA and GPhC and not the whole industry, who are by and large patient centric professionals.


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