Online prescribing: challenges and opportunities to improve patient safety

We have launched an investigation that explores risks to patient safety when patients use online prescribing services which are outside of their usual NHS care provision, including:

• independent online pharmacies
• other independent online services that prescribe medications.

The prescribing of medicines online has seen growth over the past decade, with further momentum since the COVID-19 pandemic. This growth has seen the number of providers increase from 45 to over 200 within the last nine years. Online prescribing can be delivered by an array of professionals including doctors, nurse independent prescribers, pharmacist independent prescribers and paramedic independent prescribers.

We identified the focus for this investigation after engagement with various stakeholders, to seek their insights in relation to the risks to patient safety associated with the use of online prescribing services. These stakeholders included representatives from regulators in this area, national bodies involved in medication and patient safety as well as patient and provider representative groups.

We triangulated this evidence with additional sources including reports to prevent future deaths issued by HM Coroners, and academic and policy literature.

From the evidence we gathered we have identified two main areas of focus for the investigation:

• Concerns around the complex regulatory landscape of this sector and the gaps within this which may give rise to patient safety risks.
• Challenges with sharing patient information between the NHS and independent online prescribing services.

Many different patient groups use online prescribing services and the investigation will seek to explore how the above areas may impact the prescribing of specific types of medications and specific patient groups, including those with vulnerabilities and/or protected characteristics.

The protected characteristics covered by the Equality Act 2010 are:

• age
• disability
• gender reassignment
• marriage and civil partnership
• pregnancy and maternity
• race
• religion or belief
• sex
• sexual orientation.

We expect to publish our report in June 2026.

We are keen to hear from anybody with an interest in this subject matter. This includes patients, families, carers and health and care professionals who may wish to share their experience. If you would like to speak to us about this investigation before we publish the final report, please email enquiries@hssib.org.uk.