Online pharmacies and healthcare services in the UK fail to meet safety standards

A number of online pharmacies and healthcare services in the UK have recently been suspended or warned, after undertaking lax healthcare practices and endangering patients. Doctors and pharmacies are allowed to provide medical care and advice online, but their standards must be up to par. The healthcare services that Care Quality Commission (CQC) has examined were found to be prescribing medications without reviewing medical histories, following best practice guidelines, or confirming patient identities.

What is the CQC?

The CQC is a health and social care agency that monitors and regulates the behaviour of health and social care providers. In approaching their task, the CQC looks at five main issues with the providers they regulate: safety; effectiveness; care; responsiveness; and leadership.

What are the main issues with these online healthcare services?

The primary issue is that online healthcare services still have a duty to provide safe, effective care for their patients, even though patient-doctor or patient-pharmacist interactions are through a website. Numerous providers have been found by the CQC to be falling short of these standards of safe care.

Online Pharmacy

Online Pharmacy

Four providers in early April 2017 were inspected and assessed by the CQC, and significant failures were discovered in the providers’ patient interactions and regulatory compliance. For instance, one of them had no systems in place to mitigate safety risks, as well as inadequate recruitment and background checks for staff. Others had “no system in place to confirm patients’ medical history and previous prescribing decisions before prescribing medicines”, which was determined by the CQC to put patients at risk of serious harm.

Other problems that were noted by inspectors only the month prior (March 2017) included:

  • Some services had no methods in place to determine whether patients lacked capacity to consent. They also had no measures to determine whether patients understand the treatment or medical advice they had been given.
  • No systems for updating the patient’s regular GP. This was particularly unacceptable in situations where medication was prescribed that that required follow-up
  • Prescribing practice that did not take account of the patient’s clinical condition, and differential diagnoses were often not considered.
  • Some providers had no evidence or assurances that medical professions were qualified for their role.

Professor Steve Field from the CQC noted that “we expect the same standards of quality and safety to be met as we would see in more traditional GP settings”, even though the service is provided online and without direct patient contact.

A solicitor from Patient Claim Line, a medical negligence law firm that deals with cases where harm has been caused due to prescription mistakes notes that online companies must “still comply with best practice guidelines and regulations in every case. They must also ensure that they validate patient identity, examine medical and prescription history of patients, and link up with the patient’s own GP to pass on information about decisions that have been made.”

Are there any online services that are safe?

Despite these few bad apples, there are a number of online prescription services and medical providers online that follow guidelines to the letter and provide safe and effective care. GOV.UK provides a portal through which consumers can check if a website can legally sell medicines online, operated by the Medicines and Healthcare products Regulatory Agency.

The CQC itself also provides guidelines for how consumers can choose an online healthcare service with minimal risk. The factors they advocate examining are:

  • Checking whether the service is registered with CQC
  • Confirming the service’s contact details and where they are based
  • Looking at whether the pricing is clear and reasonable
  • Checking what exactly the service includes
  • Performing your own background checks on the medical staff, including checking if Doctors based in the UK are listed on the General Medical Council register
  • Whether the doctor checks your identity and medical history during your consultation and asks for permission to share the consultation with your GP
  • Whether the doctor or pharmacist provides clear information about what the medication is, how and when to take it, and any possible side effects
  • If the provider is a testing service, check who reviews the results, how results are shared, and what follow-up support is provided

The Bottom Line

Ultimately, online healthcare services can be both safe or unsafe, but the recent spate of issues discovered by the CQC should prompt consumers to more closely examine any providers they are dealing with. Consumers should be vigilant about checking registration of healthcare providers and closely examining how the service operates before feeling safe and confident with that provider’s care. The CQC will continue to take action against providers that are falling short, to ensure that services that put people at risk of harm are appropriately suspended or shut down.

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