Pharmacist Removed Following Unsafe Online Prescribing Practices

Date of Decision: July 12, 2024

Registrant's Role: Pharmacist

Outcome: Removal from register and interim suspension

GPhC Standards Breached: Standard 1: Provide person-centred care Standard 2: Work in partnership with others Standard 5: Use professional judgement Standard 6: Behave in a professional manner

Case Summary

The registrant, a pharmacist, was found to have engaged in widespread unsafe prescribing practices while working for online pharmacies between 2018 and 2022. The case focused on her role in approving an extensive number of prescriptions for high-risk medicines without adequate patient assessments, placing public safety at risk.

Key Allegations

The pharmacist approved approximately 35,824 prescriptions for high-risk medications over a short period, relying solely on patient-completed online questionnaires. The online system allowed patients to select their own medication, strength, and quantity, and the registrant failed to perform any meaningful clinical assessments.

Further issues included:

  • Failure to obtain sufficient medical history: The pharmacist did not access GP records or verify patient conditions before prescribing.
  • Failure to conduct proper consultations: There were no face-to-face or virtual consultations.
  • Prescribing to high-risk patients: The pharmacist approved opioid prescriptions for patients with known substance dependence or previous overdose history.
  • Insufficient time to assess prescriptions: Many prescriptions were approved within seconds, making thorough clinical evaluations impossible.
  • Dishonesty in record-keeping: The pharmacist submitted documents to the GPhC which were later found to contain inaccurate information, raising concerns about integrity.

GPhC Findings

The committee found the pharmacist’s conduct demonstrated a serious departure from professional standards. Her prescribing approach was transactional rather than patient-centred, and public safety was repeatedly put at risk. Her actions lacked integrity, prioritised financial gain over patient care, and severely undermined confidence in the profession.

The Fitness to Practise Committee determined that her fitness to practise was impaired and issued a removal order, stating that no lesser sanction would adequately protect the public or maintain confidence in the profession.

Learning Points

  • Online prescribing requires robust safeguards: Pharmacists must ensure that digital platforms facilitate safe prescribing practices, with appropriate risk assessments.
  • Regulatory standards must be upheld in all settings: Whether working in a physical pharmacy or an online service, professional standards remain the same.
  • Failure to conduct thorough patient assessments is unacceptable: Prescribing high-risk medicines requires careful review of medical history and proper oversight.
  • Dishonesty and misrepresentation can lead to removal: Integrity is fundamental to the profession, and any attempt to mislead regulators can have serious consequences.

Original Case Document

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