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Care Quality Commission announces warning against online prescription services FOO

CQC announces warning against online prescription services
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Online prescription services put patients at risk by failing to put the correct processes in place, according to the Care Quality Commission’s (CQC) inspectors.

An investigation into two popular websites, MD Direct (using the site and HR Healthcare Limited (through the website revealed that they had no processes for contacting a patient’s GP to query any orders placed. This puts patients at risk of harm as medicine could be prescribed to them even if it would usually require monitoring or a follow up appointment. These websites often failed to take down patient’s medical history before prescribing medicines.  It is also unclear whether the clinicians prescribing medicine had the correct skills or qualifications to diagnose illnesses accurately or to prescribe the correct medicine.

Other problems uncovered included the lack of means to ascertain whether patients had the capacity to consent to treatment or even to establish that they are who they are claiming to be.

Following the investigation, the CQC suspended the registration of HR Healthcare Limited, while MD Direct chose to cancel their registration. The site continues to operate but instead uses a different GP provider to carry out its prescription service. It isn’t just these two websites who should be held accountable however. All 43 of the online services registered with the CQC were reviewed, and others showed signs of potentially posing a risk to patients. The CQC will now be carrying out further inspections with these services taking top priority.

The most risky versions of these websites are those that allow patients to select their own medicines and choose their symptoms and suspected diagnosis from a drop down menu.  The prescription is then forwarded to a medic, and passed to a pharmacist who completes the prescription. If the prescription is authorised by a doctor registered within the General Medical Council or by a qualified EU doctor then the pharmacist can lawfully supply the medication.

Although the CQC concedes that well-run online services can offer a useful and convenient alternative means of accessing treatment, Professor Steve Field, Chief Inspector of General Practice stated that, “Some services may be putting patients at risk. We are particularly concerned that risks to patients may not always be appropriately assessed or managed when they buy medicines online.”  Professor Field also stressed that, “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.”

As a result of the findings, four regulatory bodies - The Care Quality Commission, the General Medical Council, the General Pharmaceutical Council, and the Medicines and Healthcare Products Regulatory Agency released the following statement:

“Technological advances have brought opportunities to deliver healthcare in new ways, including online primary medical services. Potentially, this innovation allows patients easier access to care and treatment when they need it.

“We share a joint commitment to ensure that the same safeguards are in place for patients whether they attend a physical consultation with their GP or seek medical advice and treatment online.

“We will continue to work closely together to share intelligence where we have concerns and take action where necessary to protect patients. We will ensure providers and clinicians are clear on their responsibilities to protect people who use their services and deliver safe, high quality care.”

The CQC have also released information on how it inspects providers of online GP services as well as advice for the public to consider before using an online GP service. Online services are also being advised to base their service around the General Medical Council guidelines to help protect patients from harm.

Duncan Rudkin, the Chief Executive of the General Pharmaceutical Council, said "Patients and the public always have the right to expect safe and effective care, whether they are receiving this care face-to-face or online. The regulators involved all have different responsibilities, but by working closely together, we can help make sure that people are receiving safe and effective care at each stage of the process, from when they first visit an online primary care service to when they receive their medicines from a pharmacy.

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To download as a PDF, click here: Care Quality Commission announces warning against online prescription services

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