14 July 2017
During an inspection looking at part of the service
Letter from the Chief Inspector of General Practice
We carried out an announced focused inspection at White Pharmacy Ltd on 14 July 2017.
We carried out our initial inspection on 12 and 16 January 2017. Following this inspection conditions were placed on the provider’s registration. Further inspections were undertaken on 28 March 2017 and 22 May 2017. At these inspections we found further improvements were still required.
This report covers the findings from the 14 July 2017 focused inspection. This inspection was carried out to review the provider’s compliance with the conditions imposed on their registration following our inspection in May 2017. During the inspection we found further improvements were still required. The reports from our comprehensive inspections in January 2017, March 2017 and May 2017 can be found by selecting the ‘all reports’ link for White Pharmacy Ltd on our website at www.cqc.org.uk.
We found this service did not provide safe and well led services in accordance with the relevant regulations.
Our key findings were:
- We identified continued significant risks to the safety of patients’ health and welfare, which related to insufficient or ineffective systems in place in relation to remote prescribing of medicines having regard to the General Medical Council (GMC) ‘Good practice in prescribing and managing medicines and devices’ guidance.
- We found cases of long term opioid analgesic and neuropathic pain relief prescribing with no access to the patients’ full medical history. We saw individual risks had not been identified in the prescribing of these specific medicines and no contact had been made with the patients’ GP. Furthermore, there was no documented consideration of the risks of long term opioid analgesics use and management plans for individual patients.
- Patients were at risk of harm because effective governance systems and processes were not in place to keep them safe
- The care and treatment records of patients did not always contain sufficient documentation of clinical rationale for decisions to prescribe medicines where consent was not given to contact a registered GP.
- The prescribing policy (implemented on 12 June 2017) did not outline the corporate responsibilities in relation to the issuing of prescriptions, or the governance processes in place to ensure patient safety is assured.
We identified regulations that were not being met. The areas where the provider must make improvements are:
- Ensure care and treatment is provided in a safe way for all patients. Including the safe and effective prescribing of medicines.
- Implement effective governance systems and processes to enable the provider to assess, monitor and improve risks relating to the health, safety and well being of patients and staff.
Summary of any enforcement action
We are now taking further action in relation to this provider and will report on this when it is completed.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice