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The demand for online pharmacy services is growing just as the regulations surrounding the granting of licences tighten. Pharmacies can expect greater scrutiny of their operations, says Sonia Bhachu

The market entry test for high street pharmacies with NHS contracts is long established, with new entrants having to demonstrate a clear unmet local need. It is seen as a hard test to pass with most areas of England judged to already have sufficient pharmacies. 

However, online pharmacies were historically exempt. The rationale was that a pharmacy serving patients across the whole of the country cannot easily meet the local need test so it could be ignored. 

That changed in June last year when the Department of Health closed all new distance selling pharmacy (DSP) applications. Applications submitted before June 2025 continue to be processed under the previous rules. 

So how, in 2026, can pharmacies secure permission to sell online? It starts with a pharmacy licence.

All pharmacies, whether private or within the NHS, online or bricks and mortar, will need physical premises from which to dispense, and those premises must be registered with General Pharmaceutical Council (GPhC). It will look to make sure those premises are secure, how prescribing is checked and the role of the Superintendent Pharmacist.

To dispense NHS prescriptions, a pharmacy must be added to the local ‘pharmaceutical list’, with applications in England made to the local Integrated Care Board. Here, the question of whether the pharmacy should be allowed to join the NHS system is asked with a focus on local need for new pharmacies.

It is, of course, entirely possible for a pharmacy to operate as a private online pharmacy with GPhC registration only. To operate online within the NHS, however, it will mean acquiring or relocating an existing DSP, or taking advantage of the ability to offer limited NHS services remotely and the growing use of Electronic Prescription Services and remote prescribing.

Governance and documentation critical

Like physical community pharmacies, online pharmacies need to demonstrate clear governance, documentation and the role Superintendent Pharmacist (SI).

Every pharmacy needs to have an SI, a GPhC-registered pharmacist who is ultimately responsible for making sure the practice is safe, legal and follows all the rules. Without an SI there is no pharmacy. 

The SI is also responsible for the mandatory clear Standard Operating Procedures (SOPs). They must provide written step-by-step instructions for how each task is performed, the checking of patient identity, packaging and delivery and handling complaints.

For online pharmacies those SOPs need to go further, showing that everything can be done safely even though dispensing staff will have never met the patient. This means the website, effectively the pharmacy’s shop window, is clear and honest, shows who operates the pharmacy, where it is based and its GPhC registrations

When acquiring a NHS pharmacy with an existing DSP licence or relocating an existing DSP, it is critical that the pharmacy can clearly demonstrate to the local Integrated Care Board that they meet all the DSP rules, namely that no face-to-face NHS services are provided at the premises, the service is genuinely available to anyone in England, and the premises are not on the same site as a GP surgery. 

In short, the new owner cannot just ‘inherit’ the contract, they have to prove they can run it properly. 

It is here that many applications fall down.

We have seen incomplete or weak SOPs and SOPs missing entirely from applications. Problems with premises are often another common reason for refused applications and repeated failure to meet DSP conditions.

For example, the SOPs can fail to address how all essential services are likely to be secured without interruption during opening hours.

They are often mistakes that could have easily been avoided but now take time and expense to rectify, typically by making an appeal with NHS Resolution. 

Increased scrutiny

While licences can be hard to secure, they can all too easily be lost. Failure to act on GPhC improvement notices can lead to removal of the licence. We have seen too increased fitness to practice action taken against SIs. This will result in the SI having to attend the Fitness to Practice Committee and undergo a hearing to determine the sanction that may be imposed, such as a warning, and in worst case scenarios, erasure.

Breaches of NHS DSP terms, such as including face-to-face services, can have significant consequences. Once a DSP is lost, it is not possible to make a new application and that can have significant implications for the business.

It is possible to challenge GPhC and Integrated Care Board decisions through their dedicated appeals process, and asking the courts for a judicial review of a decision. But it is a time consuming and costly process. 

Sonia Bhachu is a partner at the law firm Orwins