Archived: The Independent Pharmacy

Updated 8 August 2019

The Independent Pharmacy is the trading name of two companies, ABSM Healthcare Ltd and Red Label Medical Ltd. ABSM Healthcare Ltd operates the organisation’s affiliated pharmacy (which does not require registration with the Care Quality Commission) and Red Label Medical Ltd operates the online consultation service. We inspected the online consultation service only, which is located at Unit 3, Heston House, Emery Road, Bristol, BS4 5PF.

The Independent Pharmacy was established in 2013 and provides an online service that allows patients to request prescriptions through a website, which are then directed to the pharmacy business that is part of the same legal entity. Patients are able to register with the website and select a condition they would like treatment for. A consultation form is completed by the patient, which is then reviewed by a clinician. Once the consultation form has been reviewed and approved, a private prescription for the appropriate medicine is issued. This is checked by a pharmacist at the affiliated pharmacy (which we do not regulate) before being dispensed, packed and sent to the patient by secure post.

The service can be accessed through their website, www.the independentpharmacy.co.uk where patients can place orders for medicines seven days a week. The service is available for patients living in the UK only. Patients can access the service by phone or e-mail from 9am to 5pm, Monday to Friday. This is not an emergency service. Subscribers to the service pay for their medicines when making their online application.

The provider employs staff who work on site including dispensing staff and pharmacy technicians. They also employ clinicians who work remotely including one GP, one doctor (who was not a GP and would be stop working for the provider at the beginning of July 2019) and three prescribing pharmacists.

Red Label Limited was registered with Care Quality Commission (CQC) on 14 January 2014 and there is a registered manager in place. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

How we inspected this service

Before visiting, we reviewed a range of information we hold about the service and asked other organisations to share what they knew.

During our visits we:

• Spoke with a range of staff including two Directors, one GP and non-medical prescriber.
• Reviewed a sample of consultation records.
• Reviewed staff recruitment and training records.

To get to the heart of patients’ experiences of care and treatment, we ask the following five questions:

• Is it safe?

• Is it effective?

• Is it caring?

• Is it responsive to people’s needs?

• Is it well-led?

These questions therefore formed the framework for the areas we looked at during the inspection.

Updated 8 August 2019

Letter from the Chief Inspector of General Practice

We rated this service as Good overall. (Previous inspection January 2018 – the service was not rated but was found to be providing care in accordance with the relevant regulations).

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an announced comprehensive inspection at The Independent Pharmacy on 20 June 2019 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether The Independent Pharmacy was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to provide a rating for the service.

The Independent Pharmacy is an online service providing patients with prescriptions for medicines that they can obtain from the provider’s registered pharmacy (which we do not regulate). The service issues prescriptions for an average of 3500 items per month.

At this inspection we found:

• The service had systems to manage risk so that safety incidents were less likely to happen. When they did happen, the service learned from them and improved their processes.
• The service routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated people with compassion, kindness, dignity and respect.
• Patients could access care and treatment from the service within an appropriate timescale for their needs.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider should make improvements are:

• Improve risks assessments so patients are referred to their own registered NHS GP following regular dermatological treatment.
• Review the Clinical leadership so staff in this role are clear on their areas of responsibility and have up to date information.
• Review information given to patients when prescribing medicines off label so they understand who is liable should anything go wrong. Medicines are given licences after trials which show they are safe and effective for treating a particular condition. Use for a different medical condition is called off label use and is a higher risk because less information is available about the benefits and potential risks
• Identify ways to improve attendance at clinical meetings.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care