Archived: Nationwide Pharmacies Ltd

Updated 6 December 2019

Nationwide Pharmacies Ltd is based in High Wycombe in Buckinghamshire. Nationwide Pharmacies Ltd set up an online provider in October 2012 and the service includes consultation with a GP. We did not inspect the provider’s affiliated pharmacy, which is not within the remit of registration with Care Quality Commission (CQC). We inspected the online provider which is also known as Nationwide Pharmacies Ltd at the following address:

• Unit 1, Riverside Business Centre, Victoria Street, High Wycombe, HP11 2LT.

The provider employs staff who work on site including a superintendent pharmacist, pharmacy and administrative staff. The GP worked remotely from the provider. At the time of the inspection, the provider had approximately 57,000 patients registered, in the last two years, approximately 17,000 new patients had registered with the provider, however not all of them had been prescribed medicines.

The provider can be accessed through their website:

• www.nationwidepharmacies.co.uk

Where patients can complete an online questionnaire to be reviewed by a GP which may result in a prescription being provided. The provider is available for patients in the UK. Patients can access the provider by telephone from 9am to 5.45pm, Monday to Friday. This is not an emergency service. Subscribers to the provider pay for their medicines when making their on-line application.

Once approved by the GP, medicines are supplied and dispatched directly to the patient by the affiliated pharmacy.

Nationwide Pharmacies Ltd was registered with CQC on 31 January 2012 and has a registered manager. A registered manager is a person who is registered with the CQC to manage the service. Like registered services, they are ‘registered people’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the provider is run.

The provider is registered to provide the regulated activities:

• Treatment of disease, disorder or injury
• Transport services, triage and medical advice provided remotely.

How we inspected this provider

Before visiting on 25 October 2019, the service confirmed they had taken the actions detailed in their action plan. We met with the Registered Manager and Superintendent Pharmacist who was also an independent prescriber. We reviewed information given to us by the service, including changes to prescribing policies and procedures. We also reviewed documents relevant to the management of the service. During our visit we saw a random sample of patient records to ensure the new operating model was embedded and patients were receiving safe care and treatment in accordance to regulations.

All were relevant to demonstrate the service had addressed the breach of regulation identified at the inspection of April 2019.

Updated 6 December 2019

We carried out an announced focused inspection at Nationwide Pharmacies Ltd, an online GP consultation and prescribing provider located in Buckinghamshire on 25 October 2019.

At our previous inspection in April 2019, the service was rated good overall, however we identified concerns relating to the provision of safe services. We therefore rated the safe key question as Requires Improvement and we issued a requirement notice in relation to the safety systems to manage medicines and verify patient identify. Specifically:

• The provider prescribed medicines to treat asthma and Class 4 and 5 controlled opiate medicines such as codeine and dihydrocodeine. The records we reviewed did not detail a rationale for prescribing these medicines without consent to contact and share information with the patients GP.
• Patient identity checks were not fully effective in particular for patients being prescribed medicines liable to abuse, overuse or misuse or medicines that require ongoing monitoring or management.

The April 2019 inspection was part of the digital and online providers inspection programme to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008. The inspection reports for the previous inspections can be found by selecting the ‘all services’ link for Nationwide Pharmacies Ltd on our website at www.cqc.org.uk

At this inspection, on 25 October 2019, we found the service had addressed the issues identified at the last inspection. This led to the service being rated as Good for the provision of safe services whilst the overall rating of Good remains.

At this inspection we found:

• Nationwide Pharmacies Ltd had had made significant improvements to address the concerns identified at the April 2019 inspection. We saw the provider had effectively assessed, monitored and improved the safety of the services provided. These improvements were managed via a series of action plans and resulted in a change to the operating model.
• We saw the provider had revised and strengthened the processes and supporting systems when the GP prescribed medicines for the care, treatment and management of asthma and a range of medicines for pain relief which included opiates.
• The prescribing process now included compulsory access to the patients Summary Care Record and contact with the patient’s GP prior to a prescription being issued.

• Following the April 2019 inspection, we saw the provider had added an additional verification check when completing patient identity checks. On registering with the Nationwide Pharmacies Ltd, and at each consultation patient identity was verified. These existing checks now included an additional safety check for patients who were prescribed medicines liable to abuse, overuse or misuse or medicines that require ongoing monitoring. These patients were now required to provide photo identity such as driving licence or passport.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care