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'It seems pharmacies have acquired a new regulator'

"In the past, the CQC seems to have ignored online pharmacies. It has now become very active."

Lawyer David Reissner reflects on the CQC's recent focus on online pharmacies

The Care Quality Commission (CQC) is best known for its role in regulating care homes, dental practices and, more recently, GP practices. However, as recent events have shown, the CQC’s remit is a wide one.

The Health and Social Care Act 2008 required certain healthcare practitioners – including doctors and some other prescribers, but not pharmacists – to be registered with the CQC. Anyone who is required to register is guilty of an offence if they fail to do so.

The Act requires the Secretary of State to make regulations to secure that regulated activities cause no avoidable harm to the persons for whom the services are provided. Legal duties are then imposed on the CQC to:

  • conduct reviews of the regulated activities by service providers
  • assess the performance of the service providers following each such review
  • publish a report of its assessment.

Online services that involve prescribing fall within the CQC’s jurisdiction, and all UK websites that provide such a service must be registered. This includes pharmacy businesses that provide patients with the ability to seek prescription medicines online.

In the past, the CQC seems to have ignored online pharmacies. However, prompted in part by a BBC radio investigation that revealed last year that some prescribers are being lax about prescribing antibiotics, the CQC has suddenly become very active.

The CQC has the legal power to carry out inspections of any business carrying on a regulated activity. In recent months, the CQC has visited a number of online pharmacies with large teams of investigators, and spent a long time carrying out inspections. It has expressed “significant concerns about patient safety”. In some cases, registration has been suspended. In other cases, warnings have been given. In each case, the CQC publishes a report which, if critical, can be damaging to the reputation of a business.

The chief inspector of the CQC has said: “As with conventional GP surgeries…online companies and pharmacies are required to provide safe, high-quality and compassionate care and must adhere to exactly the same standards. They must not cut corners.”

The CQC does not seem to have taken much interest in pharmacy in the past, but in addition to the General Pharmaceutical Council, the Medicines and Healthcare products Regulatory Agency and NHS England, pharmacy has acquired a new regulator.

It seems likely that those online pharmacies that provide a prescribing service – but have not yet had a visit from the CQC – will not have long to wait.

David Reissner is senior healthcare partner at law firm Charles Russell Speechlys LLP


Yuna Mason, Sales

Why do the CQC have jurisdiction over an internet pharmacy but not over a standard community pharmacy? Could someone explain?

Call Me Cycnical, Senior Management

You are confused, they don't on any pharmacy. It's prescribing only.

Yuna Mason, Sales

I was also asking because if it is the prescribing element which entitles the CQC to get involved, it would help to explain why there has been such low uptake of independent prescribing roles for pharmacists by the multiples (to avoid CQC inspections).

Yuna Mason, Sales

I'm not confused, I'm wondering if there's any legal loophole which would allow the CQC to inspect a pharmacy, or to require it to do other things such as provide information, that they and the GPhC have kept quiet. Their powers of inspection are broad Pharmacy services aren't included in the definition of a 'regulated activity' but might fall under the definition of 'the provision of NHS care'?

InSpectre Inspector, Senior Management

The CQC only have 'jurisdiction' on those companies offering and providing an on-line prescribing service.

They have no legal powers to inspect or regulate standard or on-line pharmacies that are not involved in prescribing medicines.

Yuna Mason, Sales

Do they have powers to enter and inspect any pharmacy where independent prescribing is taking place? Or any other powers relating to community pharmacy?

Call Me Cycnical, Senior Management

Your headlines are totally misleading. You ran a story a while back about a pharmacy being shutdown by CQC. At that time I thought what are you talking about! You did not make clear it was an online prescribing service in tandem with the pharmacy that had gone bent. CQC have no jurisdiction over dispensing pharmacists at all.

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