Shyam Morjaria, registration number 2081035, has been removed from the register by the General Pharmaceutical Council (GPhC) after he failed on multiple occasions to act in accordance with prescribing and dispensing safety guidelines.
At hearings between June 29 and July 31, the GPhC’s fitness-to-practise committee heard that in his time at Meds UK as both a responsible pharmacist (RP) and superintendent pharmacist (SP), Morjaria committed “exceptionally serious” misconduct on multiple occasions.
According to the hearing document, Morjaria oversaw the prescription of “high risk” medications on 97,599 occasions where “the time taken by the prescriber to consider the prescription would not have been sufficient”.
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In each of these instances, the medications “were reviewed by a prescriber who had made their previous prescribing decision within less than one minute”.
In hearing the case, the committee acknowledged that Morjaria had not been the subject of any previous regulatory concerns.
However, they stressed that his conduct was “serious and deplorable” and affected “real and often vulnerable individuals”.
“Routine failings”
Morjaria joined UK Meds in September 2018 as a RP and became SP in October 2018, a position he maintained until September 6, 2021.
The committee heard that while the role of SP did not involve prescription, it was a “senior supervisory” position and Morjaria was therefore responsible for ensuring prescribers “did so safely and in accordance with GPhC guidance”.
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The committee announced that under Mojaria’s supervision prescribers committed “routine failings”.
It heard that under Morjaria’s supervision, prescribers “relied principally” on a patient completed online questionnaire which “could be easily manipulated” and which was not suitable for dictating the prescription of certain medications.
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Further, prescribers failed to access or attempt to access patient medical records, share information about prescribed medications with relevant healthcare professionals, and to adequately consider the possibility of “medication dependence and/or misuse” by patients.
Morjaria also neglected to ensure prescribers kept “adequate records” of their decisions and were complying with the companies Standard Operating Procedures.
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The committee heard that while Morjaria was SP, there were 2,663 occasions where a customer was prescribed the same “high risk” medication “more than ten times” with insufficient monitoring and intervention.
Morjaria also failed to ensure UK Meds carried out audits and risk assessments which accounted for the risks associated with their business model.
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Critically, the committee heard that Morjaria failed to ensure additional medical information requested by prescribers was received prior to the prescription being issued, and that he had failed to ensure “patients’ GPs were given sufficient opportunity to confirm the appropriateness” of prescribed medicines.
Morjaria’s senior position was also a key consideration of the committee, who found that despite multiple concerns being identified by GPhC inspections and numerous opportunities given to make improvements, “the deficiencies and poor practices at UK Meds persisted” under Morjaria’s “oversight and responsibility.”
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The committee paid particular attention to “vulnerable patients” who were prescribed medication under Morjaria’s supervision. One patient with a “history of poor mental health/and or opioid dependence” was prescribed one hundred 30mg tablets of dihydrocodeine while Morjaria was the RP. The patient had previously received four orders for the medication from UK Meds, which Morjaria also failed to take into account.
The committee called Morjaria’s approach to prescribing and dispensing “transactional”, with him and his staff processing requests with reference to the “patient completed online questionnaire rather than in accordance with UK prescribing guidance”.
Attempted improvements
The committee acknowledged that while at Meds UK, Morjaria did attempt to make some improvements, such as to Meds UK’s identity checking procedure.
They also recognised “a level of partial insight” made by Morjaria into his own behavior indicated by him wishing he had “behaved differently” and expressing regret regarding patient outcomes under his supervision.
“Real risk of the highest level of harm”
However, the committee emphasised the “duration and persistence” of Morjaria’s behaviour which “continued over several years”.
They also drew attention to the “numerous opportunities” for improvement which were “resisted” and the “real risk of the highest level of harm which had a significant impact on patients”.
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Owing to Morjaria’s senior position at UK Meds and his experienced career as a pharmacist, the committee believed he was “aware of what good practice should look like” and “failed to demonstrate effective leadership”.
When deciding on a sanction and considering Morjaria’s seniority and the magnitude of failings, the committee found that suspension “does not go far enough” and would fail to “maintain public confidence in the profession and uphold proper professional standards”.
They therefore concluded that removal from the register was the only suitable outcome.
Read the full determination here.
