Pharmacist Removed Following Unsafe Prescribing via Online Pharmacy

A Fitness to Practise hearing was conducted for a pharmacist who worked as an independent prescriber at an online pharmacy, UK Meds Direct Ltd. The case revolved around unsafe prescribing practices, particularly of high-risk medications, between May and October 2019. The hearing spanned multiple sessions from May to October 2024.

Key Issues

The pharmacist approved 7,684 prescriptions for high-risk medications, including opioids, Z-drugs, and other controlled substances, based solely on online questionnaires. The case highlighted significant patient safety concerns, including:

• Failure to obtain adequate patient medical histories before prescribing.
• Failure to access GP records or request face-to-face consultations when necessary.
• Reliance on a questionnaire-based prescribing model that allowed patients to manipulate responses.
• Prescribing at a rate that was too fast to allow proper clinical evaluation.
• Failure to identify potential medication misuse and dependency risks.

One notable incident involved the pharmacist prescribing 100 dihydrocodeine tablets to a patient who had already placed 18 previous orders for the same medication.

GPhC’s Decision

The committee found that the pharmacist’s fitness to practise was impaired due to misconduct. It concluded that the pharmacist’s prescribing approach was transactional rather than patient-centred, prioritising efficiency over safety. The committee imposed removal from the GPhC register, with an interim suspension taking immediate effect.

Learning Points

1. Prescribing safety is paramount – Clinicians must ensure thorough patient assessments and not rely on unverified online responses.
2. Due diligence is essential – Prescribers must review medical histories and liaise with GPs when required.
3. Regulatory compliance is crucial – Following GPhC guidelines and national prescribing standards is a fundamental duty of all prescribers.
4. Avoid transactional prescribing – The role of a prescriber extends beyond approving medication requests; patient welfare must be central.