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Within the last few weeks, at least six pharmacists have been subjected to interim order applications - either suspended or had significant restrictions placed upon their registration pending a full 'Fitness to Practise' hearing into serious allegations being made about their prescribing practices, the Pharmacists' Defence Association (PDA) has found. It said that there has been a "dramatic increase in action being taken by the pharmacy regulator (GPhC) against pharmacist prescribers associated with certain types of online prescribing services". It has warned pharmacist prescribers who work for online pharmacies about the specific risks associated with remote prescribing using a questionnaire-based model, typically with no direct prescriber/patient interaction. Common features that underpin the allegations include the following: Overreliance on a patient questionnaire to inform clinical decision making; No patient/prescriber interaction; Prescribing high risk medicines without adequate safeguards; Inadequate systems and processes leading to inappropriate prescribing; Very high volumes of prescriptions being authorised in short periods of time; and Prescribers/patient relationship established via an unregulated online portal.

The Pharmacist's Defence Association (PDA) has raised concerns over the adoption of Digital Clinical Excellence (DiCE) guidelines for online prescribing of GLP-1 receptor agonists for weight management in adults. This follows a clash with expert recommendations commissioned by the General Pharmaceutical Council (GPhC) as the PDA "believes the final guidance conflicts with the expert opinion underpins the GPhC's prosecution strategy towards pharmacist prescribers under investigation." In a recent statement, the PDA highlighted the discrepancy between DiCE's guidance and the expert report employed by the GPhC to prosecute pharmacist prescribers using a questionnaire-based consultation model. This conflict has prompted the PDA to withhold its endorsement of the DiCE guidance as it differs from an expert report commissioned by the GPhC. The PDA's reservations stem from the inherent risks associated with questionnaire-based prescribing.

Health Education England (HEE) has developed funded training offers for community pharmacists, including locums aiming to become independent prescribers. Almost 3000 independent prescribing training places will be available to pharmacists from March 2023. This training enables pharmacists to support patients from diagnosis to prescribing, and to provide advice and follow-up - while also helping them to feel confident and prepared for the new challenges of their role. Courses will be available between April 2023 and March 2024, with several universities offering multiple dates for cohort intakes. Start dates will depend on the university provider. Training will enable the provision of new models of care: supporting patients from diagnosis to prescribing, providing advice and follow-up, and preparing pharmacists to provide clinical care, as pharmacy services become more widespread within emerging clinical pathways.

Pharmacists with 'relevant experience in a pharmacy setting' can enroll for accredited independent prescribing course, as the General Pharmaceutical Council (GPhC) has decided to scrap the requirement of spending at least two years on the register and having previous experience in a specified clinical or therapeutic area before enrolling for the course. The GPhC Council meeting held on Thursday instead proposed that applicants must have "relevant experience in a pharmacy setting and be able to recognise, understand and articulate the skills and attributes required by a prescriber." This experience and awareness will act as the basis of their prescribing practice whilst training. The regulator noted that the majority of stakeholder organisations, including the Chief Pharmaceutical Officers, the Royal Pharmaceutical Society and the statutory education bodies, were in favour of removing the requirement in a consultation on the topic. They highlighted that a specific two-year period was not in itself a robust indication of whether an individual was ready to become a prescriber. They also highlighted that the rapidly developing roles in the profession meant more pharmacists were likely to gain the necessary experience more quickly than in the past. A smaller number of organisations and a larger minority of individuals were opposed, citing that a specific two-year period gave pharmacists the time they needed to develop experience and confidence before being ready to enrol on a course.

The General Pharmaceutical Council (GPhC) has raised concerns over the rising risks related to online pharmacy services. It revealed over 30 per cent of its open Fitness to Practise (FtP) cases were related to online pharmacy, which is disproportionate to the sector of the market that online services occupy. The regulator has advised pharmacists and pharmacy owners providing online services that they should "not work with online providers who try to circumvent the regulatory oversight put in place within the UK to ensure patient safety". In the past five months, the Council has imposed seven interim orders on the registration of pharmacists who have worked for or with online prescribing services - after identifying serious concerns with their practice. It said: "These pharmacists were working as pharmacist independent prescribers for online services or were dispensing medicines prescribed online. Some of these pharmacists were the Responsible Pharmacist (RP) or the Superintendent Pharmacist (SP)."

"Our main concerns are that the use of what they call an asynchronous supply, where the prescriber neither sees nor talks to the patient at the time they issue the prescription, does lay itself open to perhaps people getting hold of medication that they shouldn't," the Head of Policy, PDA said. The Pharmacists' Defence Association (PDA) engages in a critical conversation on BBC Radio 4's Woman's Hour, shedding light on the online prescribing of weight loss drugs and advocating for safer practices. The PDA's spokesperson, Head of Policy Alima Batchelor, emphasised the importance of adhering to professional guidelines to ensure patient safety and mitigate regulatory concerns. During the feature, the PDA highlighted the complexities and risks associated with online supply chains, stressing the necessity for direct clinical consultations and pharmacist involvement in medication management. ""There are guidelines and advice about verification within the DiCE guidance, but it doesn't go quite far enough for us. We are concerned when patients decline to allow the online prescriber to advise their GP of what they're taking," Batchelor highlighted.

The General Pharmaceutical Council (GPhC) has called for comments and views on the recently launched consultation on selecting the appropriate mode of consultation when assessing a person's needs by pharmacy professionals including pharmacist prescribers. The guidance note sets out what the pharmacy professional or prescriber, in agreement with the patient, needs to consider when selecting the mode of consultation - such as face-to-face; video-link, video-chat, or other online platforms; telephone and online questionnaires - best suited to gaining the information needed to deliver safe and effective pharmacy care. The principles outlined in the guidance apply to consultations undertaken in all pharmacy settings, including those undertaken by online pharmacy services providers. "Our plan is to include the contents of this guidance note in the document: 'In practice: Guidance for pharmacist prescribers' when we undertake our next review," said the regulator.

Online pharmacies have to operate from bricks & mortar premises that are registered with the General Pharmaceutical Council, but recent cases show that, in reality, the practices of online pharmacies are often very different to other pharmacies, and the regulation of online pharmacies is also different - and evolving as issues arise. For a start, the General Pharmaceutical Council (GPhC) is only one of the regulators taking an interest in online pharmacy services. Other regulators include the Medicines and Healthcare products Regulatory Agency (MHRA) which enforces the advertising and promotion of medicines, and the Care Quality Commission (CQC) which regulates prescribing services. The different regulation of online pharmacies is attributable to the higher risk to patients and the public from medicines bought online. These risks often arise from a combination of patients who do not tell the truth in order to obtain medicines and the nature of a transaction in which a pharmacist does not see patients face-to-face. "The GPhC has strong enforcement powers that it uses when it considers its premises standards have not complied with." However, there are also things that go wrong because pharmacists have simply failed to act professionally or take sufficient care, as well as cases where things have gone wrong through misfortune.

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The Medicines and Healthcare products Regulatory Agency (MHRA) and the Committees of Advertising Practice (CAP) have issued a joint enforcement notice about the 'illegal' advertising of Kenalog injections on digital platforms. The notice warns all organisations offering Kenalog as a 'hay fever treatment' to stop advertising it in any of their social media or website advertising. "Kenalog is a prescription-only medicine (POM), which must not be directly or indirectly advertised to the public. Kenalog is not licensed for the treatment of hay fever in the UK, although it is offered by some beauty and aesthetics clinics, under the personal responsibility of an individual prescriber, and advertised widely on social media," said MHRA. "Now, advertisers must ensure that all references to Kenalog in the text, images or emojis on social media are removed, as well as commonly-used descriptive phrases for the jab such as 'hay fever injection' or hay fever jab' or any account names, testimonials or memes by 29 August 2022." After this date, the CAP's compliance team will remove non-compliant ads using targeted software and those who continue to promote it may be referred to the MHRA for further enforcement action.

Data crunched by an online pharmacy delivery company paints a concerning picture for the pharmacy sector in England. Gophr's 'Prescription For Pressure' initiative reveals a challenging time for the sector and is supported by separate analysis by the BBC showing that the number of pharmacies in England is at its lowest since 2010. In addition, new powers being introduced for pharmacists to prescribe common prescription drugs and perform routine tests create an even greater workload for already overstretched pharmacists. Gophr's data reveals that: * Each pharmacy in England serves an average of 6,078 people. * In 2022, pharmacists dispensed 1.043 billion prescriptions, 26.3 million more than 2021. * A single pharmacy in England dispensed 248 prescriptions a day on average in 2022. Based on the most up-to-date statistics from the Office for National Statistics, NHS England and Statista, Gophr's calculations show that pharmacists have around 116 seconds to dispense a prescription, which is less time than the 180 seconds it takes to make a Quarter Pounder at McDonald's.

Over the last few years, we've seen the aftermath of Covid-19, with the demand for consumer health products being unprecedented and unpredictable, placing pressure on supply chains and labour market. In turn, the industry has experienced acute shortages across the healthcare sector, placing huge pressure on pharmacists, doctors, nurses, and other healthcare professionals. Europe has an estimated shortage of around 50,000 public-sector doctors[1], which is set to increase in the coming years. While this shortage stems from several complex problems, there is a hidden force that could play a key part in helping to alleviate this burden. That force is the potential of self-care. Encouragingly, last month the UK government recognised the unique role that self-care can play through the introduction of its Delivery plan for recovering access to primary care. Through this, it has pledged to empower patients to manage their own health through several commitments, including improving accessibility to online tools and reclassifying medicines to make formerly prescribed options available over the counter.

The General Pharmaceutical Council (GPhC) today decided to convene a new group, involving all the key stakeholders, focused on assurance of practice post-registration. The decision in today's (9 December) council meeting follows the recommendation of a working group chaired by council member and pharmacist Aamer Safdar on the role of the regulator in post-registration education and training. The new group will be tasked with articulating a set of guiding principles where patient safety is the overarching priority, after carrying out a horizon scanning exercise to pull together an understanding of the system wide approach currently in place. The working group noted that the wider approach, in relation to regulation of post-registration practice and not simply education and training, may require the GPhC reviewing and developing its own control measures, and involving patients and the public in the next stages of work. Reviewing the work on online pharmacy services, the council meeting supported the regulator's plans to continue to require pharmacy websites to be arranged so that a person cannot choose a prescription only medicine and its quantity before there has been an appropriate consultation with a prescriber.

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The large majority of adults in the England knew that flu jabs are available in many pharmacies, just over half were aware of the GP Community Pharmacist Consultation Service or the New Medicine Service, according to a new survey by the National Pharmacy Association (NPA). The new survey revealed the need to raise the public awareness of key NHS services such as the New Medicine Service. According to the survey, 56 per cent of those asked believed that pharmacies in England offer NHS consultations for people newly prescribed a medicine for a long-term condition. While 48 per cent believed that many pharmacies in England offer blood pressure monitoring (NHS or private). 51 per cent believed it to be true that GPs can formally refer patients for same-day clinical advice from their local pharmacist about minor ailments.