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GPhC suspends online superintendent who allowed ‘unfettered’ opioid access

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GPhC suspends online superintendent who allowed ‘unfettered’ opioid access

A superintendent pharmacist who allowed his online business to provide “almost unfettered” access to high risk drugs including opioids and Z-drugs in the autumn of 2019 has been suspended for two months by the GPhC’s fitness to practise committee.

Liverpool pharmacist Daniel John Dempsey (registration number 2052069) of Ritecare Pharmacy admitted all allegations put to him in a remote FtP hearing that took place on March 20-21. Most of the allegations related to his commissioning of third party prescribing service prescriptiontoday.co.uk, which used a prescribing doctor who was based in Romania and not registered with the UK’s General Medical Council.

The FtP committee heard that from March 2019 until an intelligence-led inspection in November that year, Mr Dempsey – who in addition to acting as superintendent pharmacist was also a responsible pharmacist and a company director – allowed or failed to prevent the issuing of prescriptions in circumstances where the prescriber had failed to “adequately examine the clinical need for medication,” to consider the possibility of medication dependence and to refer patients back to their GP.

Concerns were raised around the online prescribing pathway, which allowed patients to amend their answers to make it more likely their request would be approved and which included yes/no questions that were “framed such that it would be apparent to a patient when an answer would prevent a prescription being issued”.

The committee also heard that Ritecare Pharmacy, which dispensed the prescriptions issued by prescriptiontoday, did not carry out robust identity checks or maintain adequate patient records.

The committee heard that the prescriptiontoday website “did not function well” when launched in April 2019 and was reinstated in September that year, seeing a “notable and significant upsurge” in October 2019 during which time it was dispensing “up to 200 prescriptions a day, 95 per cent of which were for opioids or Z-drugs”.

The website was taken down that November following the GPhC inspection, which led to restrictions being placed on Rite Care’s ability to dispense Schedule 1-5 controlled drugs.

The FtP committee found that the business model used by Mr Dempsey prioritised a “transactional approach” to medicines rather than focusing on “the wellbeing and safety of patients,” commenting: “Patients were, in effect, supplied with the medications they requested. The almost unfettered supply of such medications is in direct breach of the registrant’s duty as a gatekeeper of prescription only medications.”

While Mr Dempsey admitted he had “brought the profession into disrepute” and breached fundamental principles he was required to uphold as a pharmacist, he argued his actions did not amount to misconduct because they were not deliberate and instead “arose from naivety,” citing his previous experience with an online pharmacy that had only dispensed NHS prescriptions as having failed to prepare him for dealing with private prescriptions.

He said the business is now “focused on patient safety and wellbeing” and is currently “thriving,” focusing solely on dispensing NHS prescriptions and serving 25 care homes and “hundreds of housebound and vulnerable patients”.

While the FtP committee accepted that Mr Dempsey had “fully remediated” his behaviour through changing his practice and is “highly unlikely” to repeat it, it found that his actions constituted such a serious breach of his professional principles that a finding of misconduct was necessary.

The committee acknowledged the numerous positive testimonials it received in relation to Ritecare’s current practice, but said that in light of the ongoing need to assure the public that the regulator is tackling breaches by online pharmacies, it must ‘send a message’ and impose a “relatively short” two-month suspension order, which it described as appropriate and proportionate.

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