On 20 October 2020 the Department of Health and Social Care announced a number of changes to Regulations which govern the opening of new NHS pharmacies in England and the obligations that those pharmacies must comply with when they are open (their "Terms of Service").

There are a number of changes that will impact all NHS pharmacies in England, but here I want to focus on the rules that cover Distance Selling or "internet" pharmacies.

The description "internet pharmacy" is not an accurate one, yet people use it all the time to describe pharmacies that have been permitted to open as "distance selling" pharmacies. For example, all internet pharmacies have a website... right? In fact, that is wrong. Many do, but there has never been a requirement to have a website associated with a distance selling pharmacy. However, that will all change from 1 April 2021.

From 1 April 2021 a new regulation comes into force which states;

Distance selling premises requirements in respect of websites and health promotion zones

28C.An NHS pharmacist (P) in respect of distance selling premises must ensure that P has a website for use by the public for the purpose of accessing pharmaceutical services from those premises, on which there is an interactive page, clearly promoted to any user of the website when they first access it, which provides public access to a reasonable range of up to date materials that promote healthy lifestyles by addressing a reasonable range of health issues.

So that means you will need;

  1. A website
  2. With an "interactive page" - so not just a normal page of information.An interactive web page is supposed to make the user actively engage with the site. For example a website that displays weather forecasts for a specific region would allow the user to type in their location and shows the detailed weather report for that region or allow the user to focus on specific regions, or play around with a globe showing weather.
  3. The interactive page must be "clearly promoted" to any user of the website when they first access it - so maybe a banner on every page of the website which links to your interactive page?
  4. Your interactive page will need to provide access to a "reasonable range of up to date materials"
  5. The content on the interactive page must promote healthy lifestyles.
  6. The content must cover a "reasonable" range of health issues.

Once you have done all of this it will then be up to the NHS England Local Area Teams to monitor compliance with these requirements. Hopefully in most cases that will simply mean someone from NHS England looking at your website and deciding if it is interactive enough, up to date and has a reasonable range of material on a reasonable range of health issues. And of course every different NHS Area Team will form its own view about what is reasonable or unreasonable.

It doesn't take a genius to see that there will be some disagreements about how these new rules are interpreted, policed and enforced.

The new rules don't stop there though.

From 1 January 2021 (so you have about 10 weeks notice if you read this on the day I published it), another new rule comes in to force and states;

Consultations held from distance selling premises and some small pharmacy premises

28B.An NHS pharmacist in respect of distance selling premises must ensure that there are arrangements in place at those premises which enable a person performing pharmaceutical services to communicate confidentially with a person accessing pharmaceutical services—

(a) by telephone or another live audio link; and

(b) via a live video link.

This should not be too difficult for most pharmacies as they will have a telephone line and internet access already, but note that the requirement is to communicate "confidentially" and to do so from the pharmacy premises. This suggests a need to have an area where a member of the pharmacy staff cannot be overheard when communicating with patients. In addition, there is a requirement to not only communicate by phone (or an "audio link") but also via a "live video link". So if you are not using things like Zoom, Teams and Skype (is anyone using Skype now?), then you will be soon.

There is a clear direction of travel in government policy here. Yes - you can open a new pharmacy if it is operating as a distance selling pharmacy, but the NHS wants it to interact properly with patients and be more than just a place where medicines are picked, packed and dispatched.