Rachel Warren, a senior associate at law firm Charles Russell Speechlys, said the Care Quality Commission (CQC) has "said it anticipates getting future powers for regulating digital healthcare providers", which could include the introduction of a new rating system.

The rating system could be similar to the one currently used in care homes, with online pharmacies graded 'outstanding', 'good', 'requires improvement' or 'inadequate', Ms Warren said in March, in comments published by C+D to coincide with its feature on pharmacy inspections.

The CQC only regulates online pharmacies if they are providing a prescribing service through a doctor, Ms Warren explained.

At the moment, there is no rating system for these businesses. Instead, the CQC summarises the results of its inspections under categories that consider whether the business is “safe” and “well-led”, among others.

Thorough CQC inspections

Speaking at Charles Russell Speechley's pharmacy conference on March 23, Ms Warren said her firm had helped a number of online pharmacies which had been visited by the CQC, and its experience was that the regulator carries out a “really thorough” investigation.

Online pharmacies could expect to be scrutinised by the CQC for “five or six hours”, with multiple inspectors – including GPs, she told delegates.

The regulator will then send a letter to the contractor around a week later explaining any concerns, she said. The pharmacy is usually given a “really short time period, perhaps over a weekend, to give a detailed response setting out how these issues are going to be addressed”, she added.

• Over-prescribing of a number of different medicines
• No system for identifying patients who might have duplicate accounts
• Inadequate clinical governance
• Out-of-date policies and procedures
• Issues relating to the security of patients' medical records.

Last month, the CQC announced it had suspended the registration of one online pharmacy and brought action against another three for potentially putting people “at risk of harm”. It was the latest effort in the regulator's new focus on online primary care services.