Inspection outcome: Standards not all met
Last inspection: 14/11/2019View enforcement action (PDF 137.5KB)
This is a distance selling pharmacy which offers services to people through its website www.clinicalcarepharmacy.co.uk. People do not visit the pharmacy and medicines are delivered or sent by post. The pharmacy mainly dispenses NHS prescriptions and supplies a number of care homes. Some medicines are supplied in multi-compartment compliance packs to help people take their medicines at the right time. The pharmacy has recently started supplying medicines via another website owned by a separate company (www.mdher.com), which provides access to an online prescribing service. The website offers prescription medicines for a range of conditions, but it mainly supplies medicines for the treatment of pain and sleeping tablets to people in the UK. This online prescribing service is not registered with the Care Quality Commission as it is based in Romania. The pharmacy’s NHS business and its dispensing for the online prescribing service are managed as separate operations, but both are provided from the same registered premises. After the inspection, the pharmacy voluntarily decided to stop dispensing prescriptions issued by the online prescribing service.
Inspection summary findings
Principle 1. Governance
The pharmacy’s working practices in relation to NHS services are generally safe and effective. But it does not have appropriate governance arrangements or risk management procedures in place in relation to the supplies it makes on behalf of the private online prescribing services. The pharmacy cannot demonstrate that appropriate indemnity arrangements are in place to protect people who use the online prescribing service. And it does not keep records to demonstrate whether there is adequate professional control when it supplies high-risk medicines. This means the pharmacy cannot show that the online prescribing service is safe, and vulnerable patients might be able to obtain medicines that could cause them harm.
Principle 2. Staff
The pharmacy has enough team members to manage the current workload and the services that it provides. The team members plan absences in advance, so they always have enough cover to provide the services. They work well together in a supportive environment and can raise concerns and make suggestions. The targets set in relation to the care home service do not affect the care people receive. But the remuneration that the pharmacy receives in relation to online prescribing service could influence the pharmacist’s professional judgement and may increase the risk of inappropriate supplies.
Principle 3. Premises
The pharmacy is clean, hygienic, properly maintained and provides a suitable environment for the services carried out. The pharmacy’s own website provides clear and accurate information about the NHS services. But the third-party website that it works with allows people to select the prescription only medicines they want before they have a consultation with a prescriber. This means people may receive medicines that are not the most suitable for them.
Principle 4. Services, including medicines management
The pharmacy suitably manages its NHS services. It sources and manages medicines appropriately. The pharmacy is not able to demonstrate that adequate safeguards are in place to ensure online supplies of opioid painkiller and sleeping tablets are clinically appropriate. Medicines prescribed by the online service are supplied without informing the patient's regular doctor or making sure they agree to the supply. This means people's conditions might not be properly monitored, and their use of medication may not be appropriately controlled.
Principle 5. Equipment and facilities
The pharmacy has the equipment it needs to provide services safely. The team uses in a way that keeps people’s information safe.
The Brian Clough Business Centre
200-222 Cotton Lane
What do the inspection outcomes mean?
After an inspection each pharmacy receives one overall outcome. This will be either Standards met or Standards not all met
|The pharmacy has met all the standards for registered pharmacies|
|The pharmacy has not met one or more of the standards for registered pharmacies|
What does 'pharmacy has not met all standards' mean?
When a pharmacy has not met all standards, they are required to complete an improvement action plan, which you can find via a link at the top left of this page. We monitor progress to check the improvements are made and inspect again after six months to make sure the pharmacy is maintaining these improvements. A new report will then be published.