Once you have established an online presence for your pharmacy business, you may then decide to offer services or products through your website.

Let’s first look at some of the simple things you can do, starting with adding on services.

Ordering prescriptions online

Getting online means you can start to reproduce many of the services you provide customers in store by providing information in a digital format. For pharmacies in England, one of the easiest first steps is to add a sign-up form for the electronic prescription service (EPS) to your website, where patients can order their prescription online. In addition to streamlining prescription provision, EPS has the added advantage for pharmacy businesses that you now submit the prescription for remuneration electronically, so you don’t have to worry about paper copies getting lost in the post and losing income.

There are now lots of apps that enable patients in England to order repeat prescriptions and have them sent to their homes or to a local pharmacy so there is no point in developing something bespoke for this purpose. These include Emis Health (which provides Patient Access), and Healthera, which provides a repeat prescriptions app specifically for independent pharmacies.

Briefly, these apps require the patient to type in the drugs and doses that they require or choose from a list of repeat prescriptions. The order is sent to the app’s pharmacy partner, which sends an e-request to the patient’s GP surgery to request the prescription. Once the pharmacy receives the prescription, the medicine is posted to the patient.

“We offer delivery services that people can nominate electronically from home using the Patient Access app and we kind of integrated it into our service where we offer people the convenience of delivery, for those people who don’t want to come out and get their prescriptions. We were also very conscious of the fact that people don’t want to have multiple apps for multiple different things. So that’s why we chose to go through a third party app company, because the patients already download this from their GPs. If they already have it, they’re more likely to use it with us.”
Amir Bhogal, Pyramid Pharmacy

Following concerns about medicines waste, several clinical commissioning groups decided to prevent pharmacies from ordering prescriptions on behalf of patients (i.e. third-party ordering). However, some apps now link to GP software so the patient’s repeat prescription request is sent directly to the GP practice.

“Once you have chosen an app to partner with, you have lots of options such as being able to email all your patients and offering different services when they log on to order their prescriptions. It also takes away the burden of keeping the software or tools up to date and future-proofed, because the app providers do all of it for you.”
Andy Boysan, The Independent Pharmacy

Providing expert healthcare advice online

Another easy step in offering services online is to start by offering advice on healthy living or on common ailments. You could create additional web pages with information on how to use devices such as inhalers properly or how to take certain medicines.

“Just video yourself using your mobile phone. You can then create a list of videos on your website so that when people come into your store, if they can’t remember what you told them over the counter, they can find that advice online. Rather than give them a leaflet that gets thrown away at home, you could send a link with videos of how to use an inhaler properly.”
Andy Boysan, The Independent Pharmacy

You can make this information even easier to find by printing the link on prescription labels or even using a QR code, so that customers can scan this on their phone and be directed to the information they need.

Top tip: Use QR codes to direct people to information or services on your website. QR codes are square patterns of machine-readable data. They work similarly to barcodes but can encode much more data which means they are becoming increasingly popular for a wide range of uses. The Covid-19 pandemic led to a considerable increase in their use1 for everything from the NHS contact ‘track and trace’ programme to downloading digital menus for ordering ‘contactless’ food and drinks in bars and restaurants. You can buy QR codes online. Find more information about QR codes.

Enabling customers to book services online

The next step up from offering a basic website with health information might be to offer appointments for certain services online. This could range from an e-consultation with a pharmacist, either completed via an online form, or by making a videocall appointment. Bear in mind that you will need to be able to identity check the person before you can supply any medicinal products (see below for more details).

You might also offer services such as vaccinations, smoking cessation, or advice on conditions such as hair loss through your website. For popular services such as vaccinations you can add an appointment booking plug-in or widget to your website, which allows customers to choose a date and book online without you having to manage a diary. For other conditions where more bespoke care is needed you can use the website to provide useful background information about patients’ options, with a form or email address to contact you to arrange further consultation.

“The booking system we use for vaccinations is Patient Access, which patients are encouraged to download from GPs anyway to book appointments with them, so they just work with us. The company is run by Emis Health, which is a health care software provider, and they also provide the training. And it’s integrated with our patient medical records systems in the pharmacy, so the pharmacists don’t have to go anywhere else to do the training. It’s all in the pharmacy on the same computer they use every day.”
Amir Bhogal, Pyramid Pharmacy

Many potential customers are unaware that their local pharmacy provides so many services. It is important that once you have these services listed on your website you take steps to market them using our advice on search and social.

Selling healthcare products and medicines online

The next step up after offering appointments for services and healthcare advice is to sell products online.

There are two aspects to this: 1) the technical and logistical requirements, and 2) the regulatory requirements of offering healthcare products online. As we will see, many of the regulatory requirements relate to the technical and logistical requirements. Let’s look at these first.

1. Technical and logistical requirements

As we mentioned in Getting online: The first steps to building a web presence for your pharmacy, an online shop requires a more sophisticated website called an e-commerce platform.

If you decide to go down this route then it might be worth investing in working with a website designer to build this for you. However, it is also possible to add on plug-ins that turn your website into a shop.

“You can start off with a fairly cheap website built on a platform like Squarespace and then add tools like Shopify that can help you create an online store very easily.”
Tim Dunton, Director of Nimbus Hosting

In addition to the shop-front, for an online pharmacy you also need a mechanism for identity checking customers, and you will need a registered premises and business postal account if you are sending out orders. You also need to consider how you will support customers if orders don’t arrive or are not as expected. Finally, you will need to consider how to manage stockholding for an online shop. This all may start off quite small, but can ramp up quite quickly.

“There is nothing to say that as a small pharmacy you can’t approach a web developer, ask them to build your web site and you maintain it for you, and give them some of the profits. There are people out there that have got pharmacy web sites, but they don’t own them, an SEO/marketing company owns the website and they do all the fulfilment. So you can offset some of the risk and that way you might not always you have to go ‘all in’.”
Andy Boysan, The Independent Pharmacy

There are advantages to investing in an online shop: it can help you manage stock more effectively, because you have a more accurate picture of what you’ve sold, which means you can save money by buying more stock at the right times. It can also improve safety, by making it easier to keep an audit trail of how often individual people are repeat buying medicines. By starting this journey now and in small steps you are also moving with the times and technology, and preparing yourself if there was another pandemic.

“To build an online shop that could compete with the big players, you’d be looking at investing a six-figure sum. But if you get it right, it will introduce new markets to you. So whereas before you were fighting for everybody who walks on the high street, now all you’ve got to do is take a slither of a very big pie rather than a chunk of a very small one.”
Andy Boysan, The Independent Pharmacy

“We are trying to set up an online store, but it will be associated to the branch that’s local to the patients. It won’t be a centralized online store where we send our deliveries by DHL or Parcelforce, we will use our own drivers who are already delivering medication to deliver these products as well. The reason is that centralizing it would require us to have a central depot, which we don’t want to do. We want to keep everything within those individual stores because they all have their own character and they offer different products within each store because they are in different areas and caring
for different people.”
Amir Bhogal, Pyramid Pharmacy

2. Regulatory requirements

As a pharmacy, there are four types of products you might consider selling:

1. Toiletries and sanitary products
2. General sale list (GSL) medicines
3. Prescription-only medicines
4. Pharmacy-only medicines

Toiletries and GSL medicines are straightforward to sell. You will need to follow laws relating to online sales and data protection, as well as laws for supplying and advertising medicines that apply to your bricks and mortar shop. However, most people will be able to find GSL medicines and toiletries cheaply in any supermarket, and so you need to consider whether this provides adequate return on your investment.

“It’s almost impossible to compete for customers attention when they want those low-end products like deodorants and things like that. For example, Superdrug or Savers are selling those normal toiletry products for a pound and we have to sell them for two pounds. What we’re finding is that we’re having to go for niche brands, usually local businesses that we’re trying to support. So if someone in the area is making a skincare range or something, we try to support those kind of local businesses. Young customers in particular are so used to using Amazon to order everything without going out, but by having niche brands it forces them to come out to our pharmacy and pulls them away from those online only-pharmacies. Being an independent, we really have to make ourselves stand out a bit more.”
Amir Bhogal, Pyramid Pharmacy

Once you start to look at selling Pharmacy-only medicines (P-medicines), or Prescription-only Medicines (POMs) then you need to adhere to the GPhC guidance² for distance selling.

Pharmacy-only medicines such as emergency contraception or short-course antibiotics for UTIs, are community pharmacy’s specialty, but these require you to ensure that your website operates like a pharmacy.

With POMs, if your online prescribing services employ a listed healthcare professional (i.e. a nurse or doctor, not a pharmacist) then the provision of online services will need to be regulated by the Care Quality Commission. However, if you operate with pharmacy independent prescribers or nurse independent prescribers then the pharmacist prescribers themselves are regulated by the GPhC.

The GPhC’s guidance explains what pharmacy owners should consider before deciding which parts of their pharmacy service can be provided safely and effectively online. The guidance is set out under the five principles that make up GPhC standards for registered pharmacies. The table below summarises these five principles, the standards within them and shows some of the requirements for meeting them. This is illustrative and not exhaustive, the guidance document offers more detail.²

Download the 5 principles pdf

Even if your online store is not registered with the CQC, it can also be worth looking at the CQC guidelines for online primary care.⁵

When you’re starting out to develop an online shop, it is worth beginning with low-risk, well known conditions – here are some examples of the types of products you could start off with, compared to those that are higher risk and not commonly provided online.

Scale of risk for selling online healthcare products and medicines

Online pharmacy is mostly operating at the bottom end of this scale right now, but as technology advances, it is more likely to be used for these higher risk chronic conditions.

“The higher up the bands you go the more complicated it gets, and the more complicated it gets, the more time consuming it is and the more money it needs. Some pharmacies build an online pharmacy and then ask ‘what’s going to make us different to other shops?’ and they decide to reduce their prices. What they don’t realise is, the cheaper their prices, the less margin they have, and the less margin they have, the less they have to spend on advertising and maintaining their website. It’s a long-term investment. You’ve got to have a decent website and a decent platform.”
Andy Boysan, The Independent Pharmacy

Accreditation of your website and insurance

Under the GPhC guidance, there is certain information you must display on your website.
This includes:

• the pharmacy’s GPhC registration number
• your name as the owner of the registered pharmacy
• the name of the superintendent pharmacist, if there is one
• the name and physical address of the registered pharmacy or any other pharmacies that supply the medicines
• the email address and phone number of the pharmacy
• details of the registered pharmacy where medicines are prepared, assembled, dispensed and labelled for individual patients against prescriptions (if any of these happen at a pharmacy different from that supplying the medicines)
• information about how to check the registration status of the pharmacy – and the superintendent pharmacist, if there is one
• details of how users of pharmacy services can give feedback and raise concerns

Online pharmacies must also be registered with the Medicines and Healthcare products Regulatory Agency (MHRA) and display the EU common ‘Distance Selling’ logo on every page of their website offering medicines for sale. The GPhC also operates a voluntary internet pharmacy logo scheme to reassure patients that they are purchasing medicines online from registered pharmacies. The GphC internet logo links directly to the GPhC register entry for your pharmacy. You will need to apply for the GPhC internet logo and can do so only once you’ve successfully registered with the MHRA as a Distance Selling Pharmacy. You must only use the GPhC logo on your own website and never allow third parties to use it.

If you are a member of the National Pharmacy Association (NPA) you can call them to ensure you are fully covered by any additional insurance for providing services at a distance.

References

1. Techradarpro, 2020. QR codes finally find their groove during the pandemic. (Accessed July 2021)
2. General Pharmaceutical Council, 2019. Guidance for registered pharmacies providing pharmacy services at a distance, including on the internet (Accessed July 2021)
3. Information Commissioner’s Office, Health and Social Care guidance (Accessed July 2021)
4. NHS Digital, 2020. Identity Verification and Authentication Standard for Digital Health and Care Services (Accessed July 2021)
5. Care Quality Commission, Additional prompts for online healthcare providers of primary care (Accessed July 2021)

Resources

Alliance for Safe Online Pharmacies (ASOP Global)

Care Quality Commission. Online primary care: Information for providers

Cyberaware. Improve your online security today

Digital Clinical Excellence (DICE)

Electronic prescription service

General Pharmaceutical Council, How to keep safe when getting medicines or treatment online

Pharmaceutical Services Negotiating Committee, Distance-selling pharmacies

Register for the Distance Selling Logo

UK Government, Online and Distance Selling