Focus on providing pharmacy services online
Online provision of pharmacy services is a rapidly expanding business model where pharmacy services can potentially be delivered over a larger geographic area. Services delivered in this way can improve access and convenience for those living in remote areas or people with busy lives.
However, there are also additional risks that pharmacy owners need to consider and mitigate to deliver safe and effective care to patients and public online.
Our recently published guidance for registered pharmacies providing pharmacy services at a distance, including on the internet makes clear the expectations on pharmacy owners who decide to provide these types of services.
Transparency and patient choice
Transparency is one of the key areas strengthened in our guidance. Pharmacy owners will have to supply more details about where the service and health professionals involved in prescribing and supplying the medicine are based, and how they are regulated. Transparency gives people the information they need to make informed decisions.
Managing medicines safely
A risk assessment will help pharmacy owners to identify and manage risks by looking at what could cause harm and what needs to be done to minimise them.
Medical questionnaires used to determine the suitability of medication for a person should be designed so that people requesting medication cannot circumvent the safety criteria put in place. For example, if a person provides information that means the online service isn’t suitable for them, they should not receive a prompt to alert them of this, as this information may be used, in the future, to bypass the systems put in place to ensure their safety.
One area of risk to patients is when the pharmacy has no alert or flagging system to prompt the pharmacist or prescriber to review the patient’s information. Pharmacy owners should build in systems which will identify requests for medicines that are inappropriate, such as:
- multiple orders that appear to be placed by the same person, using different accounts, or the same payment details
- orders for inappropriate combinations of medicines
- requests that are too large or too frequent
One example of how a large multiple is achieving this is by adopting a ‘lock-out’ system. If the patient requests medicine unsuitable for them or unusual activity is detected as part of their order process, the patient is locked out and unable to order further supplies. Systems are also in place to determine when patients should be ordering their next supply according to the previous prescribed quantity; so that the quantities supplied are appropriate and safe for the patient.
It is important that the pharmacy has robust systems in place for pharmacy staff to verify a person’s identity when appropriate. If pharmacy owners decide to work with an online prescribing service, they must assure themselves that the service also has the appropriate robust systems in place to verify a person’s identity.
One registered online doctors service has incorporated several processes into their operating systems to make sure they are able to do this effectively. Rather than look at verifying identity in isolation, they use their existing database as a crosschecking system to make sure that people are not creating duplicate accounts. In addition, patients must upload require photographic identification to their secure account, which is examined by trained individuals to ensure authenticity. Their service is also linked with an external organisation that verifies the person’s details through a national database or through an identity checking agency. This approach, alongside other checks such as making sure the name on the billing card matches the prescription, assures pharmacy owners that the prescribing service has a robust identity checking system in place.
Supplying medicines safely
The delivery of medicines can provide a vital service to those unable to visit a pharmacy.
All delivery options offered should be tracked and monitored. One large multiple offers a letterbox delivery option where the person using the service must declare that they understand the letterbox delivery will not require a signature and that there is no risk to animals or children. If the package doesn’t fit through the letterbox, a card is put through the door with details of how to collect the package.