Whilst the NHS remains "free at the point of contact", cuts in funding and the inability to obtain appointments and treatments that fit in with modern living is leading to a rise in private prescribing and pharmacy services.
We have acted for a number of online private prescribing and pharmacy service providers and it is clear that this is a growth area in the healthcare sector. Typically we are instructed by companies that are new to the UK healthcare market and have seen a gap in personalised healthcare where patients are willing to pay for access to prescribing and treatment that they would be unable to access via traditional NHS routes. Our clients have included online dermatology providers, men's health (typically erectile dysfunction and hair loss treatment), private GP services (with associated pharmacy) and hormone replacement providers. Some of these providers manufacture their own medicines to specific formulations.
Often the starting point of these conversations is a phone call from a potential new client where they say that they have researched online / distance selling pharmacy and heard that "it is very difficult to get permission to open an online pharmacy". What we have found is that there is a lot of confusion between the NHS requirements for a distance selling pharmacy. Anyone entering this area (and indeed all pharmacies whether NHS or private or a mix of both) needs to understand that the General Pharmaceutical Council ("GPhC") regulates all pharmacies, whereas those who also wish to provide NHS services must go through an additional process to secure that permission and also meet the NHS Terms of Service.
We come across a range of shared issues for these new entrants which typically involve considering;
- Is online prescribing suitable in this case? [our first question, but often overlooked]
- Who should prescribe?
- Who will regulate the prescribing? This differs depending on the qualifications of the prescriber.
- GP prescribing versus independent prescribers
- Can prescribing be advertised?
- What will the relationship between the prescriber and pharmacy be?
- Will the associated pharmacy have a website?
- Can the pharmacy provide unlicensed / compounded medicines / "specials"?
- What registration is required for online pharmacy websites?
- What involvement will the MHRA have?
- What Standard Operating Procedures ("SOPs") do I need?
- Who will write the SOPs?
- Will my current insurance cover this new venture?
Whilst these are common themes, every client is different and we take the time to understand what your needs really are.
Assuming projects progress the client will inevitably end up making an application to the GPhC to register the pharmacy premises. This is another area where we are increasingly being asked to advise, as the GPhC is deliberately vague about what they expect to see in an application or during a physical inspection. Some companies will have invested hundreds of thousands of pounds by the time they get to filling in the GPhC application form and a failed inspection can put plans back by many months.
One thing that any new entrant should be very cautious about saying is something that we hear all too often and is, "I don't need any advice on that because [xyz website] is doing it that way so I know it is legal". When I hear that my normal response is "Of course that is fine, but isn't that like saying that stealing a car must be legal because you know someone who steals cars?".
Partner | Rushport Advisory LLP
Some feedback from our clients:
"Rushport set up an entire private pharmacy for us. They project managed and delivered every aspect needed and were an absolute pleasure to work with. I have been involved in many projects, both public and private, over many years and I can honestly say I have never found anyone who delivers as effectively."
"Rushport helped us with the opening of our new pharmacy within our surgery. This was a whole new area of business for us and a steep learning curve. They provided us with knowledge and advice in planning and strategy, including detailed project planning to actually get us open on time, IT solutions, management and operational aspects, marketing and recommendations to maximise profits. He provided a valuable source of business and finance expertise that we continue to tap into since we have opened as we come across new issues. We couldn't have got everything done within our timeframe, and so efficiently, without this help."
"Rushport have been invaluable in helping us set up our pharmacy from scratch. With a deep knowledge of MHRA wholesale and GPhC standards they have guided us through the regulatory framework to obtain a registered pharmacy and Wholesale Dealers Authorisation. We feel confident that we are compliant in all aspects of running the pharmacy and can get on with the core business of making it flourish and grow. The team are thorough, patient and professional and take the time to understand your particular business model. They can advise on everything from online pharmacy requirements, shopfitting and quality management systems to recruitment and marketing. I would advise anyone thinking of establishing a pharmacy to let Rushport help them get it right from the start."