Opioid prescribing 'a significant concern' NHS inspector warns after finding nearly half of online health services still unsafe

Almost half of online GP and health services are not providing safe care, the NHS care inspector has warned, as it raised “significant concerns” providers were handing out large volumes of strong opioid painkillers.

The Care Quality Commission (CQC), which inspects health services in England, flagged the concerns in a review of checks on online GP services over the past year.

Online providers can include those that offer video or questionnaire GP appointments or online prescription ordering through websites and apps.

Inspections up to the end of February found that 43 per cent of the online providers were not providing safe care in line with regulations, a figure that GP experts said was cause for alarm.

The CQC measures all registered health care providers on a range of areas, including “safety”, and has so far carried out 55 inspections and reinspections of the 35 online providers registered in England.

While this year’s findings mark a signifiant improvement on the 86 per cent of services that were deemed unsafe at the same point last year, the improvement is due in part to five of the providers having their registration cancelled.

The CQC report said: “The prescription of long-term opioid analgesics [painkillers] in isolation from the wider healthcare system presents a source of significant concern.

“While not widespread, this issue was compounded by the volume of opioid analgesics being prescribed, and a lack of information sharing with the patient’s GP, both before and after prescribing.

These medications can be extremely addictive, particularly where they are given inappropriately and without a plan to take patients off them, and have led to the nationwide opioid crisis in the US.

A major review in The Lancet journal found they were often inappropriately given to tackle back pain affecting hundreds of millions worldwide, despite having little proven benefit.

Other safety issues flagged by the CQC across the providers include handing out antibiotics too easily, unsatisfactory approaches to safeguarding children, and failures to review patients on long-term medications.

Professor Helen Stokes-Lampard, chair of the Royal College of GPs, said: “It’s very concerning to see that even now, 43 per cent of online consultation providers have been deemed unsafe in some respect.

“New services will inevitably experience some teething problems, but when our patients’ health is at risk urgent, swift action must be taken to comprehensively address these before the service is rolled out further.”

However the CQC also found these services perform well on “caring” and “responsive” measures, for example sexual health services offering a confidential scheme to trace a person’s sexual partners and offer testing.

Professor Steve Field, chief inspector of general practice at the CQC, said: “New methods of service delivery that increase access to care and give patients more control over how and when they see a GP have huge potential not only for patients but for the wider health system.

“However, while innovation should be encouraged, it must never come at the expense of quality. As with all health care services, patient safety must be at the heart of all decisions around what kind of care is offered and how it is delivered.

“This is why we have taken action where we have seen risks to patients – and why we have been encouraged to see many providers take note of our findings and make swift improvements to how they operate.