• Outgoing chief inspector says people can still get prescriptions for powerful drugs online
  • Steve Field says officials have discussed the problem but not yet found a solution
  • Remarks follow death of a woman last year
  • Professor Field says introducing a GP inspection regime was “a rocky ride” which he believes has improved services and commissioning

Regulators and policymakers are at a loss for how to stop people accessing dangerous medicines using online services overseas, the outgoing chief inspector of GPs has said.

Steve Field’s comments come after details emerged of a woman who died after obtaining a prescription for drugs online.

Professor Field said the Care Quality Commission had looked into how to change the law to make it harder for people to get prescriptions and medicines from providers abroad.

In an interview with HSJ, he said it was “a real problem” and “something clearly needs to be done”.

He said the CQC had been working with the Department of Health and Social Care and other regulators, and said: “The problem is, how do you police the rest of the world when people now have access from the internet?”

Other regulators told HSJ they had been working with the CQC on the issue, but also admitted they had limited scope to deal with doctors and pharmacists based outside the UK.

It emerged last month that a woman in London died last year after obtaining a prescription from an online doctor based in Prague for tramadol, a powerful opioid medication used for pain relief. The doctor had not seen her medical history or consulted with her GP at home – the patient had to fill out a form after a brief online consultation, according to the coroner Fiona Wilcox.

She called on NHS England and the General Pharmaceutical Council to take steps “to prevent future deaths” as she believes they “have the power to take such action”.

A spokeswoman for the General Pharmaceutical Council, which runs a register of all online and high street pharmacies in the UK, told HSJ: “Unfortunately, patients and the public often purchase medicines on websites that are associated with businesses that have no physical presence in Great Britain. These are outside our regulatory remit.”

The Medicines and Healthcare products Regulatory Agency said it was working to “review legislative framework for digital healthcare provision” and “would support any legislative changes that make the online sale of medicines safer for patients”.

Professor Field is leaving the CQC after five-and-a-half years in which he led the establishment of an inspection and ratings regime which has covered all GP practices, sparking massive resistance from some GPs, including personal abuse, and from some organisations.

“There was a natural push back, which was not unexpected, from some in the profession who did not want to be regulated,” he said. “When we started, we knew it was going to be a rocky ride, but what we have tried to do is be consistent and do things fairly across the country.”

He said he believed it had improved both the quality of general practice, and of commissioning of primary care.

Professor Field said: “What we found was that some of the [clinical commissioning groups] did a very good job… and others didn’t.

“But over the first three years we started inspecting, the quality of the cooperation and intervention from CCGs improved. So we not only improved the quality of provision but the quality of commissioning of GPs as well.” The regime has now been replaced with one involving much less regular full inspections for well-rated practices.

Professor Field becomes chair of the Royal Wolverhampton Trust, which runs several GP practices in its area as well as acute and community services, next month.