Pharmacist Issued Warning for Failing to Ensure Safe Online Dispensing Practices

Between September and November 2021, the registrant, acting as both Superintendent and Responsible Pharmacist, entered into a third-party dispensing arrangement with an online pharmacy. The GPhC found that:

• Prescriptions were issued solely on the basis of online questionnaires, with no two-way consultation or patient contact.
• The medications included high-risk, potentially addictive drugs requiring clinical monitoring and proper justification.
• There was no involvement of patients’ GPs, and no system for clinical background checks or follow-ups.
• The registrant did not ensure that the prescribing systems used by the online pharmacy met UK regulatory standards.

Despite being responsible for the safe management of the pharmacy service, the registrant failed to conduct due diligence before entering into the partnership, and did not establish safe and effective systems for dispensing medicines.

Findings

The GPhC Investigating Committee determined that the registrant:

• Did not prioritise patient safety, particularly where high-risk medication was supplied without adequate checks.
• Breached professional judgment and communication responsibilities, by failing to collaborate with GPs or ensure that prescribers were making decisions based on a full clinical picture.
• Did not follow regulatory guidance on providing pharmacy services at a distance, including the GPhC’s own standards and guidance from the GMC and RPS.

A direct quote from the determination underlined the seriousness of the issue:

“[The Registrant] was overseeing the dispensing of prescriptions with limited information about the patient and thus, unable to conduct a clinical check to ensure the medication was safe and appropriate for the patient.”

The committee noted that while the registrant had no history of prior concerns, the lack of safeguards and professional oversight in this case warranted formal action.

Sanction

The GPhC issued a formal warning, which:

• Will be published on the register for 12 months.
• Acts as a public reminder that pharmacy professionals must ensure safe, regulated systems are in place when working with online providers.
• Warns that future failings may lead to more serious sanctions.

The registrant was also reminded that they must:

• Ensure all third-party arrangements meet UK regulatory standards.
• Follow guidance for online and distance pharmacy services from GPhC, GMC, and RPS.
• Put in place robust safety measures for any future online prescribing or dispensing services.

Key Learning Points for Pharmacy Professionals

1. Distance selling must be conducted with full regulatory oversight – Prescriptions based solely on online questionnaires are not sufficient for high-risk or repeat medication.
2. Due diligence is essential – Pharmacy professionals must ensure that partner organisations are appropriately regulated and safe.
3. Clinical checks and patient contact are mandatory – Pharmacists must not dispense high-risk medications without verifying their appropriateness.
4. Superintendent Pharmacists carry legal and professional responsibility – They must ensure safe systems and practices are in place and maintained.
5. GPhC guidance on internet pharmacy services must be followed – Ignoring professional guidance will result in warnings or more serious regulatory action.

Conclusion

This case serves as a clear reminder of the responsibilities that come with operating online or third-party dispensing services. The 12-month warning highlights the need for rigorous clinical and governance checks, especially when supplying high-risk medications. Pharmacy professionals must ensure that patient safety, communication, and professional judgment are not compromised in any business arrangement.