Eucalyptus (9011842) - Improvement action plan

The pharmacy has not fully considered and managed all the risks involved in supplying higher-risk medicine by solely relying on an on-line questionnaire model. It cannot show that it gets all the information it needs to prescribe weight loss treatments safely.

● We will validate the submitted BMI of all patients by requiring the submission of photographs for assessment of body habitus by PIPs during their initial consultations. Patients who are assessed as potentially ineligible for treatment based on submitted photographs will be refused treatment unless they can independently verify their weight, such as by obtaining confirmation from their usual GP or visiting a local pharmacy.
● We will amend our online questionnaire to explain and reinforce the safety benefits to patients of consenting to their regular GP being notified of their treatment with us.
● We will amend our questionnaire to include an explanation to further reinforce the importance and safety benefits of patients providing up-to-date and accurate medical history and current medication information.
● Where patients do not consent to notify their usual GP of treatment, we will remind and encourage the provision of this consent during PIP consultations, or at the stage of confirming their new or amended treatment plan (for example, by adding a consent question into all review & follow-up consultation questionnaires). If consent is still not provided at the time of initial consultation, PIPs will be required to explain the importance of this and will probe all such patients’ medical histories and current medicines, via instant messages, to fully satisfy themselves that all information necessary to prescribe safely and effectively has been gathered before prescribing. This may include requiring patients to upload medication repeat lists from a verified source or requesting further information from the patient’s usual GP.
[We are also building a sophisticated communication tool that will enable more advanced, effective handover of clinical information between clinicians, including liaising with a patient’s regular GP (where available) and enable accurate and significant detail in the communication. Expected to be ready for implementation in approximately 3 months.]

The pharmacy cannot show that it gets enough, accurate information to make sure the medicines it supplies to people are clinically appropriate.

● We will provide all new patients with free Bluetooth-enabled scales which connect to our mobile app and automatically record and track the patient’s verified weight in our platform for review by their prescriber and/or health coach. Health coaches and PIPs will review recorded weights for patients during their interactions with patients and will prompt any necessary changes to treatment, or cessation of treatment, where measurements appear to be unusual or they fall outside our treatment protocols.
● We will implement a trends engine system to proactively identify all patients that fall outside our clinical guardrails. This will monitor patients who are not tracking indicators such as regular weight, waist circumference, quality-of-life indicators, or who are not engaging with our Medical Support and Health Coaching teams to the degree that we require to ensure repeated supplies of medication. We will assess all such patients and take action where patient eligibility may no longer be valid or where patients do not engage with us,, including removing patients from treatment or requiring a review by their PIP before continuing supplies of treatment.