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A lack of data-sharing between NHS providers and online prescribers raises a number of patient safety risk, warns a new report from the Health Services Safety Investigations Body (HSSIB).

Published today, the report identifies key risks arising from remote non-NHS prescribing, including the fact these organisations cannot see a patient’s NHS record, make a note of their own prescribing decisions onto that record or raise possible red flags such as repeated requests for the same medicine.

“Lack of access to patients’ NHS medical records is a barrier to independent prescribing organisations providing safe care in line with standards, regulations, and best practice,” said HSSIB.

The report also finds that online prescribers are unable to share the wealth of data generated within their organisations with the NHS, which could undermine efforts to assess the safety profile of drugs commonly prescribed privately, including weight loss medications.

HSSIB called on the Department of Health and Social Care to develop policy in this area and create mechanisms that would facilitate “appropriate NHS patient information” to be shared with online prescribers, and to “explore the options” for these clinicians to have write access to patient records. 

Matt Mansbridge, senior safety investigator at HSSIB, commented: “People are increasingly using independent online services to access medications, but the systems that support safe prescribing have not kept pace with this change.

“Our investigation found that NHS services and independent prescribing organisations are often working with incomplete information. This creates a risk that patients could be prescribed medicines that are not appropriate or that interact with other treatments.

“The ambition to introduce a Single Patient Record presents a real opportunity to address these issues, but to hold a truly complete record, it must consider how care provided by non-NHS organisations is included.”

Commenting on the report, the General Pharmaceutical Council said it agreed that online pharmacies should have read-write access to “appropriate NHS records” to improve patient safety but noted the “complex regulatory landscape” for the online sector.

GPhC chief executive Kathie Cashell said: “Where services are delivered via online pharmacies, they must be registered with the GPhC.

"We have set standards and issued guidance for those services, and we inspect online pharmacies to make sure these are being met. Many other online prescribing services are regulated by the CQC in a similar way.

“However there is a gap in regulation relating to online services in England that are not pharmacies, and which only use pharmacists or pharmacy technicians to provide services, including prescribing.

"Unlike arrangements in place in Wales and Scotland (where these services are regulated by Healthcare Inspectorate Wales and Healthcare Improvement Scotland respectively), these online services based in England do not currently fall within the GPhC’s or the CQC’s remit.

"This is a gap we have highlighted previously and have made suggestions for how it could be resolved through legislative changes.

“We agree that collaboration is critical in such a complex landscape, and we continue to work closely with the other organisations involved in regulating independent prescribing, to improve standards and guidance, share intelligence and ensure patient safety concerns are identified and acted upon.”