The Care Quality Commission is calling on the public to be careful when buying medicines on the internet.

The CQC’s inspections of some companies that provide online primary care have found significant concerns about patient safety. Although the commission acknowledges that well-run services can offer a convenient and effective form of treatment, inspectors have found services that were too quick to sell medicines without doing enough to check whether they were appropriate, meaning that patients could be at risk of harm.

In a joint statement, four regulatory bodies – CQC, General Medical Council, General Pharmaceutical Council, and the Medicines and Healthcare products Regulatory Agency – have reminded providers and healthcare professionals working for these services that they must provide safe and effective care, including following professional guidelines.

CQC has also published information on how it inspects and regulates providers of digital primary care, as well as advice for the public when considering using an online doctor.

Don’t cut corners

Professor Steve Field, chief inspector of general practice at the CQC, said: “We know that these websites can present convenient ways for people to access advice, treatment and medication. However, some services may be putting patients at risk. We are particularly concerned that risks to patients may not always be appropriately assessed or managed when they buy medicines online.

“As with conventional GP surgeries, these online companies and pharmacies are required to provide safe, high-quality and compassionate care and must adhere to exactly the same standards. They must not cut corners.”

Professor Field said the growth in online technology presents a real opportunity to improve people's access to medical advice and treatment and it is important that healthcare services continue to innovate.

“However, in some cases we have found websites which in effect allow people to select their own medication, including medicines restricted as prescription-only, with little or limited clinical oversight. Patients can go online, self-diagnose their condition, order their own medicine and obtain a prescription from the online doctor service, with minimal checks on who they say they are and whether the medication is safe or appropriate for them, often within a matter of seconds.

“We know there are often inadequate identity checks, no checks on patient history or suitability, no checks with patients’ GPs, and no follow-ups or monitoring,” he warned.

The CQC will now visit online providers, working closely in partnership with the relevant regulators, to check that providers are following the appropriate professional guidance. It will take action to cancel or suspend the registration of providers who are putting their patients at risk.

Duncan Rudkin, GPhC chief executive, said: “Patients and the public always have the right to expect safe and effective care, whether they are receiving this care face-to-face or online. The regulators involved all have different responsibilities, but by working closely together, we can help make sure that people are receiving safe and effective care at each stage of the process, from when they first visit an online primary care service to when they receive their medicines from a pharmacy.

“Where necessary, we are carrying out further inspections of the pharmacies linked to the online primary care services being inspected by the CQC, to assess whether they are meeting our standards and appropriately addressing the issues and risks linked with online prescribing and dispensing.”

Society antibiotic warning

Chair of RPS England, Sandra Gidley, said the Society is fully supportive of the action taken by CQC and other regulators to shut down online primary care services that offer scant regard for patient care and safety when supplying prescription medicines, in particular with regards to access to antibiotics.

“Unless and until the standards for remote prescribing by private providers reflect the standard of face-to-face consultations in the NHS that have been used to reduce unnecessary antibiotic prescribing, we cannot support services that increase the inappropriate use of antibiotics.

“Community pharmacies offer the opportunity for patients and the public to obtain health advice and we always advocate a face-to-face consultation with their local pharmacist.”

Some services may be putting patients at risk