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A pharmacist who prescribed and approved prescriptions for thousands of high-risk medicines without looking at patients’ medical records or seeing them in-person, leading to the death of one patient from an overdose, has been suspended for six months.

A General Pharmaceutical Council fitness-to-practise committee found William Terry Obeng prescribed from four online pharmacies, approving 20 prescriptions for high-risk controlled medicines, 5,303 high-risk non-controlled medicines and 47,024 medicines that are not high-risk or habit-forming but may require ongoing monitoring and management.

The committee heard he did so without requesting a face-to-face consultation with patients while working for UK Meds Direct Ltd between November 2019 and February 2022.

On June 14, 2021, Obeng prescribed propranolol to a patient with a history of poor mental health and self-harm when he “knew or should have known that the patient had made a previous and or/repeated orders for the same medicines from UK Meds Direct Ltd”.

A report on the hearing said Obeng failed to get “adequate” information about the patient’s health before prescribing and relied “principally” on information from an online questionnaire.

“(Obeng) failed to adequately consider the possibility of medication dependence and misuse,” the report said.

Patient died from an overdose of propranolol

The committee heard the patient, who ordered propranolol to be sent to her home, concealed the fact she was an inpatient at a psychiatric ward. The patient died from an overdose of propranolol on June 19, 2021.

“The registrant accepted the information provided by patient at face value and she was prescribed a three-month supply,” the report said.

The committee heard that while giving evidence at the inquest in January 2023, Obeng “accepted his work for UK Meds was remote work and that he would work from 7am to 9 am and then 6pm to 10pm Monday to Friday as well as Sunday evening”.

“The registrant confirmed that at the time he prescribed (the patient) propranolol on 15 June 2021, he was not aware she had overdosed on propranolol (10 days before),” the report said.

Prescribed over 8,000 high-risk medicines from two pharmacies

The committee was told Obeng prescribed from four online pharmacies in total, including over 8,000 high-risk medicines from two pharmacies, “neither of which had the facility for a face-to-face consultation or had access to a patient’s medical history”.

Between January 2022 and May 2022, Obeng also prescribed and approved 2,920 prescriptions for high-risk non-controlled medicines and 10,217 medicines that are not high-risk and habit-forming while working for Prescription Doctor, connected to Halliwell Midnight Pharmacy.

While working for PillDoctor, connected to Aktive Pharmacy, he prescribed and approved 2,960 prescriptions between August 2021 and June 2022 while between April and June 2022 during his time working for Pharmacorp, connected with Medicines Direct, he failed to obtain adequate information about patients’ health before prescribing and relied “principally” on information from an online questionnaire.

A report on the hearing said Obeng failed to “adequately consider the possibility of medication dependence and misuse, refer patients back to their GP for appropriate assessment and put adequate safety-netting in place”. The report also said he prescribed “in circumstances where the prescribing model or service was incapable of supporting safe prescribing decisions”.

The committee found patients “could easily” manipulate the questionnaire they used to provide information because “it highlighted to them answers which could prevent the supply of the medication they desired and permit the patient to change their answer”.

“Patients were allowed to pre-select the medicine, strength and quantity they desired,” the report said.

The committee said he had shown “a lot of insight in relation to training, the risks of online pharmacies and his current practice”, had “undertaken ongoing reflection since 2022” and “remediated his practice over a period of four years”.

The committee also heard Obeng had worked “in all areas of the NHS to see how the system worked”, including NHS 111, got specialist mental health training and underwent “extensive supervision”.

However, the committee concluded the case was “serious”, his misconduct took place over four online pharmacies and he failed to access GP records. It also took into account the length of time he practised in online prescribing and the risk of harm to others.