Care Quality CommissionThe Care Quality Commission (CQC) has taken further action to protect people in England who are using websites to obtain prescription medicines.

The quality regulator has published inspection reports on four more providers, which detail examples of people being put at risk of harm, with insufficient checks on their identity, poor recording of their medical history and clarification of their symptoms, inappropriate medicines being prescribed, and lack of communication with the patient’s GP.

CQC has used its urgent enforcement powers to suspend the registration of one of these providers, imposed conditions on two of them, and instructed the fourth to improve its practice.

  • Doctor Matt Ltd (www.theonlinesurgery.co.uk) was found to be issuing prescriptions after taking as little as 17 seconds to review patient questionnaires. CQC has suspended the registration of this service until the end of June.
  • Frosts Pharmacy Ltd (www.oxfordonlinepharmacy.co.uk) was found to be prescribing large quantities of inhalers for asthma without checking if the patient’s condition was out of control or if a diagnosis had been confirmed. CQC has issued the provider with warning notices.
  • White Pharmacy Ltd (www.whitepharmacy.co.uk) was prescribing a high volume of opioid-based medicines with no system in place to confirm patients’ medical or prescribing histories. CQC has placed conditions on the provider to restrict its prescribing of these medicines.
  • i-GP Ltd (www.i-gp.uk) was issued requirement notices instructing it to make improvements in a number of areas, including around ensuring it has a robust system in place to verify the identity of its patients.

In a number of cases, providers took action immediately after the inspection to address some concerns. CQC will check the impact of these changes when we return to reinspect.

Last month, CQC – alongside the General Medical Council (GMC), the General Pharmaceutical Council, and the Medicines and Healthcare products Regulatory Agency – reminded those running these websites that they must care for people in a safe and effective way, which includes following professional guidelines like any other provider.

At the same time, CQC warned the public to act with caution when considering using these websites.

This came as CQC published the first two inspection reports on web-based primary care – HR Healthcare Ltd and MD Direct – which highlighted similar concerns. CQC suspended the registration of HR Healthcare Ltd and MD Direct voluntarily cancelled its registration following CQC’s inspection, meaning that neither provider is providing care in England currently.

Professor Steve Field, Chief Inspector of General Practice at the Care Quality Commission, said: “It is understandable that people want convenient access to advice and medicines, but it is important that providers do not compromise on patient safety. We expect the same standards of quality and safety to be met as we would see in more traditional GP settings – this is exactly what people deserve.”

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

Following an internal review of all 46 online services that are registered in England, CQC brought forward a programme of inspections prioritising those services it considers as potentially presenting a significant risk to patients. CQC will continue to inspect these providers and report publicly on its findings.