GPhC, CQC and MHRA: who regulates what for an online clinic
An online clinic that prescribes and posts a GLP-1 medicine answers to three regulators: one for the pharmacy, one for the clinical service and one for the medicine. What each does, where it applies and what to look for.
An online provider of Wegovy or Mounjaro is usually two services behind one website: a prescribing service, where a clinician assesses you and writes the prescription, and a pharmacy, which dispenses the medicine and posts it. Behind both sits the medicine itself, licensed by a third body. Each has its own regulator, and the three are often confused. This article sets out what each does, in the regulators' own words.
The GPhC: the pharmacy
The General Pharmaceutical Council describes itself as "the regulator for pharmacists, pharmacy technicians and pharmacies in Great Britain". It is "a statutory organisation set up by the UK and Scottish parliaments" and "independent from government and those we regulate", funded by the fees of those it registers. It sets standards, inspects pharmacies and keeps the public registers: "We maintain a register of pharmacists, pharmacy technicians and pharmacies in Great Britain. To be registered with us, they must meet our requirements and standards."
Great Britain means England, Scotland and Wales. In Northern Ireland the Pharmaceutical Society of Northern Ireland "regulates pharmacists and pharmacy owners". An online pharmacy is a registered pharmacy like any other. The medicines are dispensed from registered premises, and the GPhC publishes specific guidance for pharmacies "providing pharmacy services at a distance, including on the internet". The registration number on every provider page of this site is the GPhC entry.
The CQC: the clinical service in England
The Care Quality Commission regulates health and adult social care services in England. Its registration guidance says: "Any person (individual, partnership or organisation) who provides regulated activity in England must be registered with us otherwise they commit an offence." The regulated activities are set out in the Health and Social Care Act 2008 and its regulations.
For online services the CQC's public guidance says: "Online doctor services: provide online medical consultations and may issue prescriptions or arrange medical tests. If they are based in England, and treat people in England, we register and regulate most of them. However, some companies operate in a way that means that they fall outside of CQC's scope of regulation." It adds: "We can only register services that are based in England." And it separates the two halves of a provider: "Services that dispense medicines must also be registered with GPhC."
The CQC's advice to anyone using an online service is to find out "which regulators they are registered with", and to check that the doctors are on the General Medical Council register.
Outside England the clinical service answers to a different body. The GPhC's page on checking online health services lists them: Healthcare Inspectorate Wales, Healthcare Improvement Scotland and, in Northern Ireland, the Regulation and Quality Improvement Authority.
The MHRA: the medicine
The Medicines and Healthcare products Regulatory Agency "regulates medicines, medical devices and blood components for transfusion in the UK". It is "an executive agency, sponsored by the Department of Health and Social Care", and it covers the whole of the UK. The MHRA licenses a medicine before it can be marketed, approves the leaflet and the summary of product characteristics, runs the Yellow Card scheme for safety reports and takes action against illegal online sellers.
The MHRA does not register pharmacies or clinics. Its Yellow Card scheme is where a fake or suspect product is reported, and its products website is where the licensed leaflet is published.
The prescriber's own regulator
A fourth check sits beside the three. The person who signs the prescription is registered with a professional regulator: the General Medical Council for doctors, the GPhC for pharmacist prescribers and the Nursing and Midwifery Council for nurses. The GPhC says a healthcare professional giving you advice and treatment "should give you details of their professional registration, including their full name and registration number", and that you should ask for them if they are not offered.
Putting it together
| Question | Who answers it |
|---|---|
| Is this a registered pharmacy? | GPhC register in Great Britain, PSNI in Northern Ireland |
| Is the clinical service registered? | CQC in England, HIW in Wales, HIS in Scotland, RQIA in Northern Ireland |
| Is the medicine licensed, and what does the leaflet say? | MHRA, through the emc and products.mhra.gov.uk |
| Is the prescriber registered? | GMC, GPhC or NMC |
| Where do I report a problem with the medicine? | MHRA Yellow Card scheme |
The Dose Club checks the first of these for every listed provider and shows the registration number. It does not check the registration of the prescribing service, and the provider pages make no claim about it.
Sources
- General Pharmaceutical Council, About us: pharmacyregulation.org/about-us
- General Pharmaceutical Council, Check registration for online health services: pharmacyregulation.org
- Care Quality Commission, Choosing an online healthcare service: cqc.org.uk
- Care Quality Commission, What is registration?: cqc.org.uk
- Medicines and Healthcare products Regulatory Agency: gov.uk
This article is information, not medical advice. Talk to your prescriber about your treatment.
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