A fear of the new?

Consultation has been launched on online prescribing. Take the opportunity to contribute to better understanding, says Nicole Ridgwell.

The General Pharmaceutical Council (GPhC) has just launched a consultation on changes to their 2015 guidance for pharmacy services provided on the internet or at a distance. The consultation runs until 21 August 2018, and I strongly urge all such providers to contribute.

Significantly, the consultation’s tone is one of concern rather than collaboration. In the introduction, it states that GPhC ‘are increasingly concerned about the way some services appear to undermine the important safeguards that are in place to protect patients from accessing medicines that are not clinically appropriate for them’.

There is much of note within the consultation and providers must consider the detail to appreciate the potential consequences. For example, the consultation advises that ‘a good pharmacy service will verify the patient’s identity so that the medicines are right for the patient’ – within itself, wholly unarguable, but how to verify? I have seen a provider criticised for not contacting a service user’s NHS GP, where the service user had explicitly refused consent.

Also in the consultation, ‘We believe that there are certain categories of medicines that may not be suitable to be prescribed and supplied online unless further action is taken to make sure that they are clinically appropriate for the patient’. The list includes:

•  antibiotics

•  opiates and sedatives

•  medicines for mental health conditions

This would have a potentially huge (and hugely financially damaging) impact on the sector, if providers are not prepared. The consultation’s timing and sector scrutiny is unsurprising. A cursory Google search brings up numerous cases in which service users died or were seriously injured after taking inappropriately prescribed medication. Many involve individuals who, for whatever reason, did not divulge their full medical history to an online prescriber. This is of course a risk with prescribing in any environment, but regulators argue that there are greater inherent safeguards in the traditional face-to-face interaction with a GP.

Providers will highlight the safeguards that have already been built into online service provision and that current criticism is more a reflection of fear of ‘the new’ (and the financial impact on ‘the traditional’) than any legitimate concern. It will always be the case that new approaches encounter suspicion and scrutiny; it is to be expected. This is not the time for the sector to stick their fingers in their ears and merely hope that regulators will learn to trust them soon.

Providers should instead treat this consultation as an opportunity; to demonstrate their willingness to engage, to explain their safeguards, to demonstrate their procedural safety and their rationales. It is the absence of understanding which is more likely to engender fear and retaliation. I therefore urge providers – take this opportunity to allow the GPhC to understand you.

Nicole Ridgwell is solicitor at Ridouts Solicitors


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