Overview
With GPhC standards now being developed for online prescribing, the PDA has been able to extend the IP indemnity cover that it provides to include online and private prescribing. This is currently seen mainly in the private sector, for example for weight loss and ADHD clinics, but according to the NHS 10 year plan, online prescribing will increasingly become a service available in the NHS.
Consequently, the PDA has extended its existing standard IP indemnity protection which is designed for NHS work and/or from a NHS setting. This development means that whilst members can now prescribe on the NHS and/or from a NHS setting either face to face or online with their existing standard IP extension, the new additional cover which is called IP+, means that they can now also prescribe face to face or online in private clinics and via a non NHS service. Examples might include private clinics for weight loss and ADHD.
This change responds to the evolving roles of pharmacists, changes in regulatory standards, and the increased reputational risks associated with private and online independent prescribing.
Why is this IP+ policy extension needed?
- The new NHS focus on prevention, digital health and neighbourhood care models, as well as meeting the needs of pharmacists providing private clinic IP services.
- Market growth of private prescribing: Online weight loss clinics and other private clinical services are expanding rapidly, with pharmacists increasingly involved in providing private consultations and prescribing. Private prescribing in specific clinics introduces a whole new set of risks and exposure to liability for pharmacists.
- Risk management: Growth has led to a huge surge in patient harms and subsequent fitness to practise investigations for pharmacists linked to inappropriate online prescribing. This has highlighted the need for more robust safeguards.
- Regulatory changes: The General Pharmaceutical Council (GPhC) has introduced stricter standards for providing online prescribing services. These include, for example, independent verification for weight management medications and enhanced risk assessments for patients without regular prescribers, and who may access clinics online.
- A new underwriting approach. Not all IP pharmacists will be interested in private clinic prescribing work, so they need not incur the expense of the extra cover. For those who are, this new IP+ policy extension recognises the new, more robust regulatory frameworks and guidance and enables pharmacists to work within them in new evolving practice environments. It ensures they have bespoke indemnity designed for prescribing in private clinics, which may be face-to-face or online.
What does the IP+ extension cover?
- Professional indemnity: Up to £10 million to cover claims for compensation, with £500,000 in legal defence costs.
- Legal support: In-house legal team with pharmacists, paralegals, and barristers for holistic defence services. Providing cover for inquests, Fitness to Practice proceedings, RPS Member conduct panel hearings, criminal sanctions and disputes with employers.
- Annual declarations: When applying for IP+ policy extension, you will need to declare that you have undertaken the required training and that you have gained the necessary underpinning competence.
Who qualifies for the IP+ extension?
Irrespective of what is your current membership category (Hospital, community, locum, GP practice or primary care pharmacist), to qualify for the IP+ policy extension, which covers prescribing in private clinics, you must already have the standard Independent Prescribing (IP) policy in place.
The IP+ policy extension allows you to expand your cover to include private clinic online and face-to-face prescribing, such as weight loss and other clinics, provided you meet the additional training and governance requirements.
Key requirements for cover
- Training & competence:
- Completion of training as stipulated by the GPhC or PSNI. From time to time practice updates will be provided by the PDA.
- Evidence of clinical competence (logbooks, DOPS, case-based discussions, university modules) needs to be retained as it will be required to organise defence arguments in the event of a claim.
- Annual declarations of competence and scope of practice.
- Regulatory compliance:
Complying with the additional regulatory requirements for private and online prescribing set by the respective regulators.
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- For private clinic prescribing (either online or face-to-face) work within the clinical governance framework of an organisation registered with a UK health regulator.
- Ensure two-way communication with patients; prescribing based solely on questionnaires is not acceptable.
- Independently verify patient details (e.g., weight, BMI) via video link, clinical records, GP consultation or via direct face to face consultation.
- Advise the patient’s regular prescriber of supply and ensure ongoing monitoring where clinically required.
- Due diligence:
- If working online, check that your employer’s systems align with the additional regulatory requirements.
- Confirm that your employer has a credible training programme, clinical governance structure, and escalation process for clinical concerns.
- Risk assurance: supporting your practice
- To comply with underwriter requirements, the PDA may, during the duration of the cover request details of your training and development records. This measure can help to pre-emptively demonstrate your adherence to regulatory standards. It helps to ensure that your competencies and are in line with the constantly developing safe prescribing professional standards.
How to Apply
- Ensure you have the standard IP extension.
- Complete PDA-recommended training and maintain evidence of competence.
- Work for a UK-registered provider with robust clinical governance.
- Submit your annual declarations and comply with all regulatory requirements.
- Apply for the additional IP+ policy extension to enable private clinic prescribing (online and face to face).
Note, you do not need to wait until your next member renewal date. You can upgrade with an IP+ policy extension at any stage if you already have an active IP policy extension in place. If you have just become an IP and you want to work in the private clinic sector, then you will need to take out an IP extension as well as an IP+ policy extension.
Case study
A pharmacist working for an online weight loss clinic wants to prescribe GLP-1 agonists privately.
- They hold the standard PDA IP policy and they have completed the required training.
- Their prospective employer is registered with a UK health regulator and the pharmacist has checked that they have a clinical governance framework in place.
- The pharmacist understands that the service framework requires patient verification details via video consultation and communication with the patient’s GP.
- The pharmacist applies for the IP+ policy extension and submits their declaration of competence and scope of practice.
- They are now covered for private prescribing (online and face to face) under the new IP+ policy extension.
For more information or to apply, contact the PDA directly. Protect your practice and expand your clinical role with confidence
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