New guidance for online and distance selling pharmacies

The GPhC has issued new guidance that says pharmacies operating online or providing services at a distance must carry out identity checks on patients before prescribing a medicine.

Entitled ‘Guidance for registered pharmacies providing pharmacy services at a distance, including on the internet’, it updates guidance from 2015 and is effective immediately.

However, the NPA understands inspectors will take a pragmatic approach and pharmacies that do not meet all standards must be able to demonstrate there is a plan in place to do so.

The guidance follows the GPhC’s discussion paper on the topic that was published in June 2018.

The NPA was one of several pharmacy bodies that called for appropriate identity checks and other controls. The safeguards for patients and the public now focus on the following two key areas:

1) Making sure medicines are clinically appropriate for patients.

Online pharmacies will have to make sure:

• there are robust processes in place to carry out identity checks on people obtaining medicines
• the pharmacy team can identify requests for medicines that are inappropriate, including by being able to identify multiple orders to the same address or orders using the same payment details
• the pharmacy websites do not allow a patient to choose a prescription-only medicine and its quantity before there has been an appropriate consultation with a prescriber.

2) Further safeguards for certain categories of prescription only medicines.

Further safeguards will have to be in place before supplying the following categories of medicines to make sure that they are clinically appropriate:

• Antimicrobials (antibiotics).
• Medicines liable to abuse, overuse or misuse, or where there is a risk of addiction and ongoing monitoring is important. For example, opiates, sedatives, laxatives, pregabalin and gabapentin.
• Medicines that require ongoing monitoring or management. For example, those used to treat diabetes, asthma, epilepsy and mental health conditions.

Responding to the new guidance the NPA said:

• People seeking medicines online ought to be protected from harm to the same high standards they experience in their local community pharmacies. Medicines are not ordinary items of commerce and have the power to harm as well as to heal.
• We support the new safeguards introduced by the pharmacy regulator, including requirements for online pharmacies to carry out age identity checks and to track mailed packages to make sure they reach the right person.
• The guidance says that people should be able to choose where they get their medicines from on the basis of accurate information, so online pharmacies mustn’t mislead service users about the identity or location of the pharmacy. We know that many patients have been confused by marketing materials that seem wrongly to suggest a connection to local GPs and pharmacies.
• It is now incumbent on the regulator to enforce the guidance robustly – in the interests of patient safety and levelling up standards such that all pharmacies can operate on a level playing field.

The full guidance is available to read here.