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Reece Armstrong

BBC’s Panorama shows us why Digital Health regulation needs to change


The latest episode of BBC Panorama showed to the public what many of us in the digital health sector already know: that regulations surrounding online pharmacy services are lacking.

The episode featured reporter and GP Faye Kirkland investigating a number of online pharmacy sites that are available within the UK. The show revealed that certain online prescribing sites are able to avoid regulation by the Care Quality Commission (CQC). In turn, it means that these sites are able to sell large quantities of drugs to anyone looking to buy them.

That’s not to say the CQC is to blame. Loopholes in the law mean that the agency is struggling to counter online providers who make accessing potentially dangerous drugs an easy reality.

A number of online prescribing sites were highlighted in the episode for taking advantage of a legal loophole in which any site based outside of the UK can employ doctors and worse, avoid regulation by the CQC.

The CQC can currently only inspect websites that employ doctors through companies based in the UK.

Due to this oversight, opiate based drugs, antibiotics, diet pills and more can be ordered with a relevant amount of ease.

Chief inspector of general practice for the CQC, professor Steve Field, said in the programme: “You should look for the CQC logo because some of these websites, if they are not regulated by the CQC, can be very, very dangerous.”

“As a GP it makes me very angry that patients are put at risk and as a regulator it makes me even more certain that we need to try and get the legislation changed so that people can’t just bypass our regulatory activities.”

The episode highlights the way in which healthcare in general is adapting to an increasingly digital landscape. Digital prescription services have now been embedded into a large number of GP practices in the UK and patients should welcome the change to more efficient ways of working.

However, as the CQC pointed out earlier this year, the switch to digital services comes with a number of roadblocks. The organisation’s report, ‘The State of Care in Independent Online Primary Health Services’, referenced the potential of online-based health providers but also included a number of concerns relating to the inappropriate prescribing of medicines, the misuse of antibiotics and other medicines and safeguarding patients’ identities.

Indeed the report, which looks into services currently being regulated by the CQC, found that of the 55 online primary care services in the UK, almost half (43%) were not providing ‘safe care’. Worryingly, the report only features providers that can be regulated by the CQC, meaning that the public has no way to tell if unregulated services such as those mentioned in the BBC Panorama episode are safe to use.

The CQC is aware of the issue and within report mentions that the organisation is worried about online providers who fall outside of the scope of its regulatory powers.

In the report, the CQC states: ‘However, there are concerns about the effectiveness of regulation of health care delivered from abroad to patients in the UK. We are working with the Department of Health and Social Care and partner regulators throughout the UK to consider approaches to assure patients of the quality of services they may choose to use. There is a challenge that some organisations provide services online that are out of the scope of CQC’s regulation and which, therefore, do not have to be registered with us. Where the quality of these providers has the potential to cause harm, we are working closely with partner regulators to ensure the safety of patients.’

It’s good to know that the CQC is working with the Department of Health in an attempt to ensure patient safety but the rising digital landscape means that now more than ever there is more potential of harm due to online prescription providers. If things don’t change, then patient safety will continue to be at risk and vulnerable people will be able to access potentially deadly drugs.

The era of digital health is finally starting to become a reality in the UK but the law needs to catch up to the innovations currently happening within the industry.

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