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More inWhite Papers  

a delivery man imageApril 19 2018

The National Pharmacy Association has welcomed the government report which has identified “strong evidence of prescription direction” to some distance selling pharmacies. The report could ultimately require amending the regulations around online pharmacy services, to include tightening up regulations around conflicts of interest.

Last month, the Department of Health and Social Care published its assessment of changes to pharmacy regulation and control of entry introduced in 2013.

The report noted that 46 distance selling premises (also known as distance selling pharmacies or DSPs) had opened between November 2016 and December 2017, in addition to 16 other types of pharmacy opening for business. A total of 343 DSPs were registered at the end of November 2017.

Under the 2013 Regulations:

  • DSPs must offer essential services to people based anywhere in England but these services cannot be delivered face to face; and
  • DSPs, in their publicity material, must not expressly state or imply that the essential services provided at or from the premises are only available to persons in particular areas of England.

During its post implementation review of the regulations five years on, the DHSC was made aware that “DSPs were operating on a predominantly local level, instead of delivering a national service as stipulated.”

In addition, concerns were raised “about vested interests resulting in the direction of prescriptions to a particular DSP for personal commercial gain.” Examples included “sudden drops in the dispensing volume at bricks and mortar pharmacies following the opening of a DSP located nearby, with a corresponding spike in prescriptions at the new DSP, the vast majority coming from a single general practice.”

Responding to the DHSC publication, the NPA said it “has long argued for tighter regulations and enforcement to curb prescription direction and we regard this review as a significant moment. 

“The first step to addressing a problem is to recognise that a problem exists – we are pleased that the government is finally waking up to the reality that the system is being abused.”

However, it warned that “the review itself will not solve the nationwide problems overnight, so NPA members are reminded that in the meantime they have access to our Level Playing Field toolkit, which can help mitigate specific incidents.”

The NPA says the DHSC’s review is likely to lead to a formal consultation on amendments to the 2013 Regulations.

Specific recommendations in the DHSC report include:

  • to require DSPs to declare any vested or significant interests – including if any of the business owners or partners, are themselves, or have family members who are prescribers of NHS prescriptions dispensed by the DSP;
  • to require DSP contractors to maintain functional websites which detail how their services can be accessed nationally and their arrangements for the disposal of patient returned waste medicines;
  • NHS England to develop a complaints process to allow suspected breeches to be reported and investigated;
  • DHSC to consider how the development and roll out of the electronic prescription service and patient nomination processes could help mitigate prescription direction.

Links:
NPA statement
DHSC ‘The National Health Service (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013’             
Today’s Pharmacist coverage of DHSC publication         

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