Since April 2019, 1,040 fitness-to-practise concerns have been raised with the regulator concerning pharmacy professionals who were or are working in online pharmacies, Ms Bryce-Smith revealed during her address at the Clinical Pharmacy Congress in London on Friday (May 13).
Of these, 187 cases remain open, which are linked to 83 online pharmacies and involve 84 registrants.
The number of open cases against online pharmacies is “quite high” Ms Bryce-Smith commented.
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Currently, two pharmacy professionals are under interim orders, while two online pharmacies are subject to interim orders.
The GPhC has inspected 394 online pharmacies since April 2019, Ms Bryce-Smith said.
While 85% of all pharmacies inspected by the regulator meet its standards, this percentage goes down to 71% for online pharmacies, with some failing as many as nine of the GPhC’s standards, she added.
“Clinically inexperienced” independent prescribers
Speaking of the "higher risk" themes that emerged following the regulator’s inspections of online pharmacies, Ms Bryce-Smith revealed there were “quite a number of clinically inexperienced independent pharmacist prescribers operating in that online pharmacy sector”.
“When you combine that with poor risk management [and] very weak clinical governance, you’ve got a little bit of a recipe for disaster,” she added.
While pharmacy “is experiencing a fast pace of change” and “there’s nothing wrong with that”, the GPhC must ensure that that is “well managed”, she told delegates.
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Last week (May 12), the GPhC announced that it will scrap a rule meaning that prospective independent prescribers must have two years of experience before they can begin training to become one.
The regulator’s new group focusing on shoring up the post-registration practice of pharmacists and pharmacy technicians will also consider what further support and oversight should be put in place for pharmacist independent prescribers, a GPhC spokesperson told C+D yesterday (May 17).
Other common themes identified
Other common themes identified by the regulator in the online supply of high-risk medicines involved weak leadership and governance, including understanding the clinical governance required, poor risk management around safeguarding for those who may be vulnerable, and inadequate indemnity checks, Ms Bryce-Smith explained.
“People are now accessing health services as we open up online. I think probably we all know that perhaps the education and awareness of the public using those services has not necessarily followed with that,” she told delegates.
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The GPhC also “quite often” saw an imbalance towards financial incentives for prescribers by some online pharmacies, according to Ms Bryce-Smith.
“There’s a lot of money to be made out of online pharmacy – nothing wrong with that, as long as it’s done well – but you need to look out for how you’re incentivising particularly the prescribers,” she said.
“If you’re paying them only when they actually deliver a prescription for a medicine, not if they refuse it, then you’re building into your system [some] sort of perverse incentives.”
In February, former GPhC chair Nigel Clarke told delegates at the Association of Independent Multiple Pharmacies conference that the regulator must “improve the processes” of fitness-to-practise cases and speed up its investigations “as a matter of priority”.
Meanwhile, in November last year, Ms Bryce-Smith acknowledged that the GPhC recognises that, with “all of these changes to online service delivery, there hasn't really been the same amount of investment by anybody in educating the public”.
