GPs could be at medico-legal risk if they ignore requests from online pharmacies for patient information when they are prescribing weight-loss medications.
The warning has been issued by the Medical Defence Union (MDU) after the General Pharmaceutical Council mandated stricter rules around prescribing weight-loss injections.
Pharmacies selling drugs such as Wegovy (semaglutide) and Mounjaro (tirzepatide) will now have to independently verify information the patient, provides which could include checking with their GP.
The MDU said they had already seen a rise in queries from GPs about whether they should disclose information to online pharmacists.
Some pharmacies were already contacting GPs to inform them of what has been prescribed and asking if they know of any contraindications. Letters are often signed by the organisation rather than a named prescriber, the MDU noted.
GPs should not ignore such requests but should also ask the patient if they have their consent to share their information, the MDU said.
But GPs may also be faced with a circumstance where the patient had misrepresented their BMI or medical history, the MDU added.
If the patient withholds consent, the GP should then explain to the pharmacy that they are ‘aware of information that makes the prescription inappropriate, but the patient has not given you consent to share this’.
It will be the responsibility of the pharmacy to follow this up and the patient should also be told that the GP will be sending this response, the MDU advised.
In these circumstances, the GPs should also consider explaining that a general review of the patient’s notes ‘might not capture every relevant consideration that the prescriber may need to know when making their decision to continue to prescribe’.
The MDU added that these requests may come at a time when practices are under specific strain from high workload and they could seek advice from LMCs or the BMA about any charges that might apply.
Last month, Pulse reported that GP leaders across the country are advising practices to push back on private providers requesting input for weight-loss jab prescriptions.
Advice from LMCs in Cornwall, Essex and Derbyshire revealed that GP practices are dealing with a rising number of requests from private providers seeking patient information to inform their prescribing of weight-loss medication.
Dr Ellie Mein, MDU medico-legal adviser said: ‘GPs have an ethical duty to share accurate and up to date information with those providing patient care.
‘However, when they are contacted by pharmacies for information about patients receiving weight loss medications, they can face a dilemma about whether they can rely on the pharmacy’s reassurance that a patient has consented to their information being shared.
‘Another issue is what to do if a patient has misrepresented their BMI or medical history to the pharmacy.
‘Our advice is that if it becomes clear there may be a risk to the patient in receiving the medication, GPs will need to discuss this with the patient and check if they agree to this being shared with the pharmacy.
‘If the patient objects, GPs will need to explain this to the pharmacy and it will then be for the pharmacy to consider whether the prescription is appropriate.’
Dr Mein added: ‘Investigating these requests places an additional burden on GP practices at a time when they are already under strain.
‘However, if there isn’t a robust system in place to gather relevant information before a prescription is provided, patients could be at risk and prescribers vulnerable to criticism and medico-legal investigations.’
But surely the medicolegal risk lies with the prescriber?
Patients can send a copy of their online records to the provider. No need to bother the GP. Typically MDOs tend to give advice that protects them rather than the GP.
There should be a change in the rules so that the GP can provide these drugs privately to their NHS patients.
Much safer for the patient alround.
If a request arrives without written consent, wing it back to the prescriber,
Insurance companies etc requesting patient info always attach consent…..it’s not our responsibility.
And as this is not NHS work, don’t forget to add a bill to your reply.
Why would the GP need to provide any information?
The online doctors can access the patients’ information directly in the online Unique Health Record for the patient, with no need for GPs to do anything.
All it needs os for the on-line doctor to get authorisation from the patient and prove they are a suitable person to access the NHS database. ( or is there a problem with these prescribers being able to prove they are qualified doctors?)
The headline appears to be incorrect.
It says “GPs could face legal risk” but the last sentence – the key fact – says “patients could be at risk and prescribers vulnerable to criticism and medico-legal investigations”
IE (as Graham says) it will be the prescriber, not the GP, who is at medico-legal risk.
We have a standard response we email back to all of these.
It is basically:
“We do not review records for third parties. If you wish to commission a report from us then you are welcome to do so. Alternatively, you may advise the patient to request their records for you to review.”
We send them with every single request and are hopeful that this will cover any concerns.
Pippa V’s response seems about right.
Worth noting that getting information from the GP is NOT mandatory according to the new advice. It is one of a range of options.
Another option is to actually do a proper consultation.
As Dr Isaacs above, if GPs were able to offer private services to their own patients this would be a potential opportunity rather than a potential burden; better for patients, better for GPs.
We do what Pippa says. We are not emplyed to do work for private providers and never will be. Our fee is above £100 and every single reply back states “don’t worry, well sort it out”. No medicolegal risk what so ever.
“If the patient withholds consent, the GP should then explain to the pharmacy that they are ‘aware of information that makes the prescription inappropriate, but the patient has not given you consent to share this’” … this is wrong. A lying patient who has withheld consent will view this intervention as sharing medical information and likely to complain accordingly. And they’d be right.
the online pharmacist can do a proper zoom consultation and assess the patient themselves; take a proper history, etc. If the patient lies there is no medicolegal risk. End of. Keep us out of this workflow
The headline isn’t a true representation of what the MDU said. It was overly cautious -but their statement was just replying to members concerns “can I write to provider when I have concerns ../or would this be breach of confidentiality?”. This is very different to “GPs have a duty to intervene” or will get sued if they don’t.