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Online pharmacy cuts antibiotics supply after CQC 'concerns'

An online pharmacy has scrapped the prescribing of antibiotics following its suspension by health regulator the Care Quality Commission (CQC).

After an inspection in November 2016, the CQC said it was “concerned” at some of the prescribing decisions made by staff at HR Healthcare Ltd – operating through the website Treated.com.

Incidents highlighted by the regulator included one patient being prescribed four seven-day courses of antibiotics to treat a urinary tract infection and another being prescribed 12 asthma reliever inhalers over a four-month period.

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

Treated.com was initially suspended for three months from December 2, 2016, “to protect patients”. But HR Healthcare asked to extend the suspension to six months so it could “carry out a comprehensive and wide-ranging reassessment” of its systems and implement measures to meet the Health and Social Care Act regulations, it claimed.

In its follow-up inspection on July 17, the CQC found that HR Healthcare had met all the legal requirements and “additional improvements” had also been made at the online pharmacy since its initial inspection (see below for the CQC’s key findings from the follow-up inspection).

The CQC highlighted that after reviewing the medicines and treatments available to patients, the online pharmacy had removed the higher-risk treatments and "was no longer providing antibiotics, or medicines for the treatment of long-term conditions such as high blood pressure and asthma."

“The service had also introduced restrictions on the quantity of medicines available for clinicians to prescribe,” the CQC said.

Following the second inspection, Treated.com services are no longer suspended and it is able to operate, it concluded.

Getting "straight to work"

Riaz Vali, registered manager for HR Healthcare, said the company got “straight to work” following the inspection in November 2016.

The provider implemented a “range of new measures”, including overhauling the consultation process, remodelling the patient questionnaires, and upgrading the website to “provide a simpler and smoother patient experience”, Mr Vali said.

“We consider the introduction of the CQC’s new guidelines for online prescribers to be a welcome development for online healthcare as a whole,” he added.

The CQC’s key findings from the follow-up inspection

  • There is now an effective system in place for recording and reporting significant events
  • A system is in place to receive and act upon patient safety and medicine alerts
  • The clinical system has been updated, so clinical staff can now easily access patient records from previous consultations
  • There is now a clear leadership structure in place
  • There is now a system in place for quality improvements and clinical audits
  • There is now an effective system in place to deal with emergency situations
  • Staff are aware of safeguarding procedures and a policy is in place
  • Information about making complaints is now clearly stated on the provider’s website
  • Policies and procedures are now easily accessible to staff on the intranet
  • The business continuity plan has now been updated to include relocation details
  • There is a policy in place to cover data security, protection, destruction and disposing of sensitive data.

Source: HR Healthcare Ltd follow up inspection report, August 16, 2017

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