Abbas Ul Hassan Samnani, registration number 2084418, has been suspended for 12 months for issuing or approving over 70,600 online prescriptions without “adequate safety-netting in place”.
At hearings held from March 12 to 27, the General Pharmaceutical Council’s (GPhC) fitness-to-practise (FtP) committee heard that “approximately 4,876” of the prescriptions were for “high-risk medicines” and those requiring ongoing monitoring.
Read more: Suspended pharmacist made £50k selling medicines on eBay
According to the hearing document, Samnani “routinely” prescribed drugs without obtaining “adequate information” about patients’ health and while relying “principally” on information received in online questionnaires.
It said Samnani also approved a prescription for 100 codeine tablets to a patient “with a history of poor mental health and opioid dependence” when he “knew or should have known” that the patient “had made previous orders for the same medicine from UK Meds”.
And it added that he “continued to work for UK Meds” in a period when the pharmacy “was not registered with the GPhC”.
Read more: ‘Every 21 seconds’: Rapid-fire online prescriber struck off after patient death
The regulator recognised the “impressive levels of remediation demonstrated” within the evidence and reflective statements provided by Samnani.
But it stressed that the extent to which Samnani “fell short of expected standards” was “both serious and deplorable” - and that he “failed to utilise his enhanced status” as clinical lead (CL) at UK Meds to protect patients.
“Systemic weaknesses”
The committee heard that the misconduct took place between October 23, 2019 and August 24, 2022, while Samnani was working as a PIP at UK Meds. In July 2020, Samnani was promoted to joint CL, sharing this role with another person until September 2021.
The GPhC said he was “an independent contractor rather than an employee” and that his pay “was not contingent on whether he approved a prescription or refused it”.
It added that prescribing data provided by UK Meds showed that Samnani had “prescribed on 70,618 occasions” during his time working for the company.
Read more: ‘Cavalier’ online pharmacy owner suspended after patient death
“These prescribing decisions could cover more than one medication and included medication designated as high-risk or requiring ongoing monitoring on 4,442 occasions,” it said.
The regulator noted that UK Meds received two statutory improvement notices in 2019, as well as a number of GPhC inspections.
It said inspectors found “systemic weaknesses such as inadequate risk assessments for high-risk medicines, over-reliance on patient questionnaires, minimal GP interaction and lack of routine consults or patient advice”.
Read more: Indemnity: Pharmacist suspended again over ‘dishonest’ claims
By November 2019, it added, the pharmacy had not met the requirements set out by the GPhC and was “subsequently prohibited from supplying Schedule 1-5 controlled drugs and modafinil”.
And during the Covid pandemic in 2020, another GPhC inspection “revealed ongoing deficiencies in managing online medicine supply risks”.
Read more: Pharmacist warned for using ‘unlicensed’ drug from China
The GPhC outlined several proven allegations relating to Samnani’s “prescribing practices and oversight responsibilities” during his time at UK Meds, including:
- Prescribing or approving approximately 70,618 prescriptions, including around 4,876 for medicines categorised as high-risk or requiring ongoing monitoring
- “Routinely” failing to issue or approve prescriptions “in accordance with the relevant guidance on prescribing”
- Issuing or approving prescriptions “in circumstances where the UK Meds prescribing model or service was incapable of supporting safe prescribing decisions” - namely, without a face-to-face or virtual consultation and with patients providing information “primarily through a questionnaire”
- Prescribing medicines that are “unsuitable to be prescribed only on the basis of an online questionnaire”, including opioids, z-drugs, amitriptyline and weight loss drugs Orlistat and Saxenda
- Prescribing or approving a prescription for 100 codeine tablets to a patient “with a history of poor mental health and opioid dependence” without “adequate safety-netting in place”
Read more: Target-focused ‘transactional’ online pharmacist suspended after inadequate online consultations
“Difficult circumstances”
The GPhC acknowledged that Samnani had “indicated at an early stage” that “he accepted some wrongdoing” - albeit that some allegations “were not fully admitted” and the admissions he did make “were formally confirmed only at the outset of the hearing”.
It also noted that Samnani “had significant personal commitments towards family members in difficult circumstances”.
Patient safety “compromised”
But it stressed that the misconduct “extended for over two years with high-risk medicine prescribing which presented a substantial risk to patient safety, including vulnerable patients”.
It added that while previous FtP proceedings involving Samnani in 2022 were “different in nature”, they were “largely concurrent with the period of misconduct that is the subject of these proceedings”.
“This should have heightened [his] adherence to proper behaviour and practise,” it said.
Read more: Superintendent warned for stealing £3,000 from pharmacy till
The regulator also noted that Samnani’s “personal circumstances were prioritised above patient safety” and the “potential for harm and impact on others was widespread and significant”.
It said patient safety was “compromised” when he “failed to raise concerns about the deficiencies at UK Meds” - and that this “was more acute when he took on the role of clinical lead”.
“Serious”
The committee said the “steps of remediation” taken by Samnani satisfy it that “removal is neither proportionate nor necessary”.
But it concluded that his misconduct “was so serious that only the maximum period of suspension of 12 months would be appropriate”.
Read more: Pharmacist warned for refusing patient morning after pill
“The committee acknowledges that this restriction will impact [Samnani] and his patients but the public would expect no less an outcome,” it added.
Read the determination in full here.
