HSSIB warns of safety gaps in online prescribing
Patients using independent online prescribing services may face safety risks because NHS and private clinicians do not always have access to the same information, the Health Services Safety Investigations Body has warned.
The HSSIB investigation looked at the challenges independent prescribing organisations face when trying to access NHS clinical information, and the risks created when medicines prescribed outside the NHS are not recorded in NHS systems.
The report found that independent prescribing organisations without an NHS contract do not usually have access to a patient’s NHS medical records. This can make it harder to verify medical history, current medication, allergies or other information needed for safe prescribing.
At the same time, NHS GPs and other clinicians may not know when a patient has been prescribed medicine through an independent online provider. This can affect future prescribing decisions if the NHS record does not show the full medication history.
Why this matters
Online prescribing has expanded in recent years, with patients increasingly using digital services to access medicines outside the NHS.
HSSIB said that limited information can affect safe prescribing decisions for both NHS and independent providers. If clinicians do not have a complete picture, there is a risk that a patient could be prescribed a medicine that is unsuitable, interacts with another treatment, or duplicates medicine already being supplied elsewhere.
The investigation also found that some online providers had asked patients to share screenshots or video footage of their NHS App records to help verify information. HSSIB said the NHS App was not designed to be used in this way and should not be relied on as the sole source of verification for clinical decisions.
Missing information between services
HSSIB found that independent prescribing organisations cannot currently write directly into NHS medical records. This means medicines prescribed privately may not be visible to NHS clinicians.
The report also found that online providers may hold safety information that could help NHS care, but there is no clear mechanism for that information to be shared back into the NHS.
HSSIB said this issue is particularly relevant as the government develops plans for a Single Patient Record. The investigation warned that a complete record would need to consider care provided by non-NHS organisations as well as NHS services.
Safety recommendations
HSSIB made three safety recommendations to the Department of Health and Social Care.
These include developing a way for independent prescribing organisations to access appropriate NHS patient information, with patient consent, when making prescribing decisions.
The report also recommends reviewing options for allowing appropriate write access to NHS health records, so medicines prescribed outside the NHS can be recorded.
A further recommendation calls for a national framework to share safety-critical information between independent prescribing organisations where patients use more than one provider.
HSSIB said these changes would help create safeguards for patients who may be at risk of harm and support safer prescribing across NHS and independent services.