Updated 14 January 2020
Background
The Boots Company plc is registered with the Care Quality Commission (CQC) as an Independent Medical Agency (IMA). The IMA operates an online prescription-only medicine clinic and advice service, and the development of patient group directions (PGDs). PGDs provide a legal framework that allows some registered health professionals to supply and/or administer specified medicines to a pre-defined group of patients, without them having to see a GP or non-medical prescriber. PGDs were not reviewed at our inspection as these fall outside of the scope of their registration with the CQC.
We inspected the online service at the following address: 1 Thane Road, Beeston, Nottingham, NG2 3AA.
The online clinic service was established in 2010, and provides an online facility that allows patients to request prescriptions through the Boots company website. Patients are able to register with the website, select from a list of specific conditions they would like treatment for, and complete a consultation form. Online clinics are available for hair loss, stop smoking, malaria prevention, acne, erectile dysfunction, premature ejaculation and period delay. The medicines being prescribed are deemed low-risk, and the service does not provide any high-risk medicines or those that have the potential to be abused. Once the consultation form has been reviewed by a pharmacist independent prescriber and deemed approved, a private prescription for the appropriate medicine is issued. This is sent to the affiliated pharmacy (which we do not regulate) for dispensing and supply to the patient.
The service can be accessed through the company website and patients can request orders for medicines seven days a week. The service is only available for patients in the United Kingdom and subscribers pay for their medicines when making their on-line application. Patients can speak to a pharmacist independent prescriber by telephone Monday to Friday between 8am to 8pm, and also on Saturdays 8.30am to 5.30pm, and Sundays 10.30am to 5pm. It is not an emergency service.
The IMA branch within Boots employs staff who work either from the site or remotely and includes seven independent pharmacist prescribers. This team is managed by a Pharmacist Independent Prescribing Manager who in turn reports to the Senior Manager Professional Support, and this individual is accountable to the Chief Pharmacist within the organisation. The Senior Manager Professional Support also manages the professional support team across the wider organisation. The service also contracts a local GP to provide approximately three sessions/month as a clinical advisor.
At the time of the inspection, the service had approximately 45,000 registered patients, some of whom had accessed the service on a single occasion and some who were repeat customers.
The Pharmacist Independent Prescribing Manager is the registered manager. A registered manager is a person who is registered with the CQC to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
How we inspected this service
Our inspection team was led by a CQC Lead Inspector accompanied by a GP specialist advisor and a member of the CQC medicines team.
During our visit we:
- Spoke with a range of staff
- Reviewed organisational documents.
- Reviewed patient records.
To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:
- Is it safe?
- Is it effective?
- Is it caring?
- Is it responsive to people’s needs?
- Is it well-led?
These questions therefore formed the framework for the areas we looked at during the inspection.
Why we inspected this service
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.