The General Pharmaceutical Council (GPhC) has proposed new guidance to safeguard against the risks of online prescribing, including of weight loss medication.

This follows 'significant risks to patient safety when online questionnaires have inappropriately been the only mode of consultation used', which the GPhC said it had observed through its inspections and investigations.

Chief executive Duncan Rudkin said the GPhC thought the proposed changes would improve patient safety, and following the consultation, would be actioned 'as soon as possible'.

The guidance proposes to add weight loss medicines to a list of those 'known to be associated with greater risks', that require 'extra safeguards... to make sure they are clinically appropriate', and that they would not be suitable to be prescribed 'using a questionnaire model alone'.

'This is in response to concerns raised with us relating to inappropriate supplies of weight loss medicines that are resulting in risks and harm to patients,' the GPhC said.

As well as weight loss medications, the GPhC is also proposing to add medicines which have a high risk of fatality or serious harm to a patient if taken in overdose, medicines where there needs to be a physical examination of the person to support a safe prescribing decision, and medicines labelled with a black triangle (▼ or ▼*) to the list.

The GPhC proposals also set out further guidance for prescribers to follow in circumstances where the person does not have a regular prescriber such as a GP, or if the person has not given consent to the prescriber to share information with the person’s GP.

Additionally, the proposed changes would make it the responsibility of both the superintendent pharmacist and pharmacy owners to meet the guidance, rather than just the pharmacy owner as currently stands.

The changes would also require online pharmacy websites to be arranged to ensure that a patient has 'an appropriate consultation with a prescriber' before any supply of a prescription-only medicine is made.

The GPhC is seeking views on its proposed updates to the guidance until 9 October 2024, and has said it wants 'to hear views from everyone with an interest in online pharmacy, including members of the public, carers, pharmacists, pharmacy technicians and other health professionals, and pharmacy owners'.

Speaking to delegates at the Avicenna Heathrow conference earlier this month (8 September), Mr Rudkin said the GPhC had been reviewing its online pharmacy guidance, taking account of both the regulator's own insights as well as media coverage, including a prominent BBC investigation.

He said the regulator had found that online pharmacies met its standards for premises in 72% of cases, compared to 84% of pharmacies overall.

Cases against online pharmacies often involved high risk medicines being supplied against private prescriptions, in particular where an 'excessive reliance' had been placed on online questionnaires.

And he suggested that where online pharmacies were failing to meet GPhC standards, they were often delivering clinical services 'in a very transactional way', with 'poor risk management and governance', and where 'professional perspective has been squeezed out by a commercial imperative'.