Patients at risk as NHS and online prescriptions not joined up, report finds

Missing information

Our report warns that clinicians may be missing vital information about a patient’s health, including other medications they are taking, because there is no consistent way for independent prescribing organisations to see NHS records or for their prescribing decisions to be recorded within them. Consequently, this also means NHS GPs and other healthcare professionals may not be aware of a patient’s online prescriptions when making decisions about their care.

The findings come at a time of significant national focus on how patient information is shared across healthcare, including plans for a Single Patient Record as part of wider health reform. Our investigation highlights the challenges that may arise if information is not consistently shared across all parts of the system.

Rise of online prescribing

Online prescribing has grown rapidly in recent years, with patients increasingly accessing medicines such as weight loss treatments and ADHD medications through independent services. However, the report highlights that limited access to patient records creates risks where prescribers are unable to check for potential interactions, contraindications or previous medical history.

In the absence of shared systems, independent prescribing organisations are contacting GP practices for information or relying on patient-reported information – even requesting screenshots of the NHS app as evidence of medical history. HSSIB warns these approaches add pressure to already stretched NHS services, can delay care, and introduce further safety risks where information cannot be verified or is incomplete.

The investigation also found that information about medications prescribed online is often not reflected in NHS records, because independent prescribing organisations do not have the ability to update them directly. This creates gaps that can affect patient safety, as clinicians may be unaware of treatments started outside the NHS.

HSSIB has made safety recommendations to national bodies to improve how information is shared, including enabling independent prescribing organisations to access NHS patient information and to mitigate known safety risks for people accessing multiple online prescribing providers.