Online IP Pharmacist Found No Longer Impaired After Demonstrating Remediation and Safe Prescribing

Date of Decision: September 1, 2026

Registrant's Role: Pharmacist

Allegations:

• The registrant prescribed medicines on 62,689 occasions between approximately 5 November 2019 and 7 July 2022 using an online questionnaire-based prescribing model. Of those prescriptions, 4,859 involved high-risk medicines.
• The registrant failed to prescribe in accordance with, or pay due regard to, relevant GMC, Royal Pharmaceutical Society and GPhC prescribing guidance. The identified deficiencies included: failing to obtain adequate information about patients’ health before prescribing; relying principally on information supplied through an online questionnaire; failing to access or attempt to access GP or specialist medical records to obtain a fuller picture of physical and mental health, current medicines and addiction history; failing to request face-to-face consultations where necessary to assess clinical need; failing adequately to consider medication dependence and misuse; failing to refer patients to their GP for appropriate assessment, review or monitoring; and failing to establish adequate safety-netting.
• Between approximately November 2019 and October 2020, the registrant prescribed through a service that was found incapable of supporting safe prescribing decisions because no face-to-face consultation took place, patients primarily supplied information through questionnaires, and the questionnaire could be manipulated because patients were alerted to answers that might prevent supply and could change those answers.
• Between approximately October 2020 and July 2022, the registrant continued prescribing in a model in which there was no face-to-face consultation and information was principally obtained via an online questionnaire.
• A significant proportion of prescriptions were processed in a timeframe that was considered insufficient to allow proper clinical evaluation, including consideration of the questionnaire, the need to contact the GP or patient, whether a face-to-face consultation was necessary, the patient’s clinical background, and the steps required by UK prescribing guidance.
• On 10 May 2020, the registrant prescribed 28 tablets of propranolol 10 mg to a patient without obtaining sufficient clinical information, principally relying on unverified questionnaire responses and without adequate access to records, consultation, consideration of dependence or misuse, GP referral or safety-netting.
• On 25 June 2020, the registrant prescribed 84 tablets of amitriptyline 50 mg to another patient in materially similar circumstances, without sufficient verification of the patient’s clinical position or appropriate monitoring and safety precautions.
• The registrant repeatedly prescribed amitriptyline and propranolol to a number of patients despite repeated orders, without sufficiently investigating their health, medication history, potential misuse or dependence, or arranging appropriate review and monitoring.
• The registrant prescribed medicines regarded as unsuitable for supply solely through this questionnaire-based model, including 18 prescriptions for Z-drugs, 61 for opioids, 5 for modafinil, 610 for amitriptyline, 2,086 for propranolol, 19 for carbamazepine, 1,007 for orlistat/Xenical, 933 for promethazine, 1,162 for metformin and 7,595 for Ventolin.
• The registrant’s approach to prescribing was characterised as “transactional”, with patient requests being processed through questionnaire responses rather than through prescribing practice consistent with UK professional guidance.
• As Clinical Lead, the registrant also failed to ensure that other prescribers obtained adequate clinical information, avoided inappropriate reliance on unverified questionnaires and accessed or attempted to access appropriate GP or specialist records in relation to approximately 14,259 prescriptions for high-risk medicines.

Outcome: Fitness to practise was found to be no longer impaired

Case Summary

Original Case Document