CQC slams more online pharmacies for lax prescribing

The UK's Care Quality Commission is continuing in its regulatory crack down on registered internet pharmacies and digital primary care providers that have been too lax in issuing prescription medicines to the public.

The quality regulator has revealed more examples of people being put at risk of harm when seeking prescriptions through online services and has reprimanded four providers.

Using its urgent enforcement powers, the CQC has suspended the registration of one online provider, imposed conditions on two, and instructed the fourth to improve its practice.

Professor Steve Field, chief inspector of general practice at the CQC, said online healthcare providers have a "duty" to protect patients that seek their support.

The measures follow the latest publication of inspection reports as part of an ongoing review of registered digital providers in the UK. The latest reports detail examples of insufficient identity checks, poor recording of medical histories, inappropriate prescriptions and lack of communication with a patient's GP.

One internet pharmacy – Doctor Matt Ltd, whose registration has been suspended – was found to be issuing prescriptions within 17 seconds of reviewing patient questionnaires and, in one incident, prescribed an asthma inhaler with no GP confirmation the patient suffered from asthma.

The CQC also issued warning notices to Frosts Pharmacy Ltd after it was found the provider was prescribing large quantities of asthma inhalers without appropriate review or in line with best practice, while White Pharmacy Ltd has been restricted in its prescription of opioid-based medicines after high volumes were prescribed when there was no system to confirm patients' medical histories.

A fourth provider i-GP Ltd was instructed by the CQC to make a number of improvements including ensuring it had a robust system to verify the identity of its patients.

"It is understandable that people want convenient access to advice and medicines but it is important that providers do not compromise on patient safety," Field said. "We expect the same standards of quality and safety to be met as we would see in more traditional GP settings. Online companies, and the people working for them, have a duty to protect the people seeking their support. They must follow relevant guidance and best practice to make sure they know who they are communicating with, how medicines fit in with their medical history, and that their GP is made aware of any prescribing decisions."

This most recent crackdown follows an earlier publication of two other inspection reports on providers HR Healthcare Ltd and MD Direct, which highlighted similar risk concerns and led to both providers having their registration suspended.

Technological advances have seen the introduction of many digital healthcare providers, which can improve access to care and treatment, and in the UK there are 46 online services that are registered. But concerns have been raised that such digital providers may put patients at undue risk and has led the CQC to review and inspect each of the registered online services and ensure they are appropriately regulated.

More broadly, there is also concern around the growing presence of fraudulent internet pharmacies – many of which are located in countries such as China – that sell counterfeit drugs or prescription only medicines illegally and without a prescription. Experts believe there are more than 30,000 of these sites online.

Last month, the CQC – alongside the General Medical Council, the General Pharmaceutical Council, and the Medicines and Healthcare products Regulatory Agency – warned online health providers to ensure their practices were safe and up to standards while urging the public to act with caution when considering the use of such websites.

"This might be a new way of working but the risks and responsibilities need to be understood and action taken in response," Field said. "As the regulator of health and social care, we will continue to play our part in guaranteeing this."

Health minister, Lord O'Shaughnessy said: "We have empowered the CQC to run a tough and comprehensive inspection regime and comment their work to uncover failings in digital care provision. Online providers can be a convenient option but patient safety must always be the priority and we urge the public to follow CQC's advice when buying medicines online."

The CQC will re-inspect the digital providers to review how they have addressed the regulator's concerns.