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Pharmacy regulator ‘is putting burden of policing online pharmacists on GPs’

Exclusive The pharmacy regulator is putting GPs in the position of policing the prescribing of online pharmacies when it comes to high-risk medicines, the BMA has warned.

The General Pharmaceutical Council has issued new rules for online pharmacies in response to concerns people were being put at risk by being able to pick their preferred drug ‘off the shelf’.

Under the tighter regulations, online pharmacies will be expected to follow stricter guidance with particular focus on antibiotics, drugs as risk for misuse including opioids, and medicines that require ongoing monitoring or management.

The guidelines also state that for high-risk medicines, providers should ensure the ‘prescriber has contacted the GP in advance of issuing a prescription, and that the GP has confirmed to the prescriber that the prescription is appropriate for the patient and that appropriate monitoring is in place’.

But Dr Andrew Green, BMA GP committee clinical and prescribing lead. said it would be better to stop availability of addictive drugs online altogether.

‘A situation where patients can pick their preferred drug “off the shelf”, often with little or no medically correct information available, represents a potentially grave threat to their health.

‘The suggestion from the GPhC that GPs authorise the provision of high-risk medication before issue is inappropriate, it is not the function of NHS GPs to police the prescribing of others, and it would be better to blacklist the supply of addictive drugs through this route.’

He added that while a face-to-face consultation was not always necessary before prescribing a high-risk medication, without previous knowledge of a patient or access to their medical record ‘it would be very difficult to demonstrate to a regulator that proper care had been taken’.

He said the BMA had been working closely with regulators including the GMC to push for tighter regulation around online prescribing.

‘The ability of patients to effectively self-prescribe by buying medicines online places them at real risk of harm.’

A Pulse investigation last year highlighted fears among GPs that patients were too easily able to access medicines inappropriately online.

In 2018, the Care Quality Commission carried out a series of inspections and found that 15 of the 35 providers it looked at ‘were found not to be providing “safe” care’ – even after re-inspection.

A spokesperson for the GPhC said: ‘We have strengthened our guidance for pharmacy owners to help make sure that people can only obtain medicines from online pharmacies that are safe and clinically appropriate for them.

‘This guidance was put together following a public consultation, and was informed by what we heard from patients and health professionals, including concerns raised with us by medical practitioners regarding the appropriateness of some medicines being supplied to vulnerable patients.’

The spokesperson added: ‘We are continuing to work closely with other regulators involved in regulating to improve the quality of care for patients online.’