Online pharmacies will have to verify the identities of patients they are prescribing for, under new guidance published by the General Pharmaceutical Council (GPhC).
The ‘Guidance for registered pharmacies providing pharmacy services at a distance, including on the internet’, which updates guidance from 2015, sets out new expectations for online pharmacies and follows the GPhC’s discussion paper on the topic which was published in June 2018.
Pharmacy bodies had previously warned that proposals laid out in the discussion paper did not go far enough.
Included in the standards is a new requirement for pharmacy staff to “check that the person receiving pharmacy services is who they claim to be, by carrying out an appropriate identity check”.
The guidance suggests, as an example, that the identity check uses NHS Digital’s ‘Identity verification and authentication standard for digital health and care services’ information standard, which was first published in June 2018 and forms part of the NHS login that aims to give patients one secure login to all digital health records and services.
NHS login is currently being piloted across five projects and is being used in the NHS App as it rolls out across the country.
The login requires patients to provide a passport or driving licence with photographic ID, as well as proof of address to verify identification.
The identity verification requirement is also listed in the guidance as a safeguard that should be put in place if one of four groups of medicines is being prescribed: antibiotics; medicines liable to abuse, overuse or misuse; medicines that require ongoing monitoring; and non-surgical cosmetic medicinal products.
However, Malcolm Harrison, chief executive of the Company Chemists’ Association, warned that identity checks “will likely place an additional burden on patients and pharmacy services”.
“We recognise that checks are needed for some medicines to ensure that the risks associated with online provision are managed as well as those in traditional face-to-face pharmacy settings,” he said. “We are however concerned that the guidance lacks the clarity to enable providers to make the necessary informed and accurate decisions about which checks would be required for different classifications of medicines.”
“It will be important for regulators to monitor the impact of the introduction of any new verification measures, to ensure that people still receive their medicines in a safe and timely way,” he continued.
The new safeguards required of pharmacy owners also include ensuring that the online prescriber contacts the patient’s regular prescriber before issuing these types of medicines, and ensuring “that the GP has confirmed to the prescriber that the prescription is appropriate for the patient and that appropriate monitoring is in place”.
The guidance will also not allow websites to offer patients the choice of a presciption-only medicine, and choice of quantity, “before there has been an appropriate consultation with a prescriber”.
Furthermore, pharmacy owners will have to audit the “suitability of communication methods with people using pharmacy services” and online pharmacies will be expected to “identify multiple orders to the same address or orders using the same payment details — this includes inappropriate combinations of medicines and requests that are too large or too frequent”.
Sandra Gidley, chair of the Royal Pharmaceutical Society’s English Pharmacy Board, said: “Any measures which ensure that sales of substances of abuse are more tightly controlled is to be welcomed. What is of utmost importance is that this is tightly controlled and monitored so that the public do not have ready access to medicines of abuse, such as opioids.
“In future there should be no excuses and people who deliberately flout the rules should be dealt with accordingly. This is an area which community pharmacists take seriously and are able to prevent inappropriate sales. The public should expect no less vigilance from internet pharmacy.”
An online YouGov survey, commissioned by the GPhC as it drew up the guidance, revealed that around half of the 2,040 adults surveyed who said they were unlikely to use online pharmacies in the future cited concerns over the safety of online pharmacies.
Speaking at the GPhC council meeting on 11 April 2018, Annette Ashley, head of policy and standards at the GPhC, said the regulator was not expecting all these changes to happen “immediately”.
But she warned that inspectors would look for implementation plans when assessing online pharmacies.
“They would have to have an implementation plan or an action plan in place which inspectors will look at”, she said.