Patients at risk as NHS and online prescriptions not joined up

Patients using online prescribing services may be at risk of harm because NHS and independent healthcare providers cannot consistently share vital health information, according to a new investigation by the Health Services Safety Investigations Body (HSSIB).

HSSIB, the independent body responsible for investigating patient safety risks across the NHS in England, said in its latest report, published on 25 June 2026, that there are significant gaps in the way patient information is exchanged between NHS organisations and independent prescribing services.

It warns that clinicians are often making prescribing decisions without access to patients’ complete medical histories or an up-to-date list of medicines.

As online prescribing has expanded rapidly, particularly for medicines such as weight-loss drugs and ADHD medicines, HSSIB found that existing digital infrastructure has failed to keep pace.

Independent prescribers frequently cannot access NHS patient records, while medicines prescribed outside the NHS are often not recorded in NHS systems, leaving GPs and other healthcare professionals unaware of the treatments patients are receiving.

The investigation found that this fragmented approach increases the risk of harmful drug interactions, inappropriate prescribing and missed contraindications.

Matt Mansbridge, senior safety investigator at HSSIB, said: “People are increasingly using independent online services to access medications, but the systems that support safe prescribing have not kept pace with this change.

“Our investigation found that NHS services and independent prescribing organisations are often working with incomplete information. This creates a risk that patients could be prescribed medicines that are not appropriate or that interact with other treatments.”

In many cases, independent providers are forced to rely on information supplied by patients or request screenshots from the NHS App to verify patients’ medical histories.

HSSIB said these workarounds not only introduce additional safety risks because of incomplete or unverifiable information but also place further pressure on GP practices, which are regularly contacted by online providers for patient records, delaying access to care.

The findings come as the government continues work on a proposed Single Patient Record as part of wider NHS digital reform.

HSSIB said the initiative presents an opportunity to ensure healthcare information is shared consistently across NHS and non-NHS providers, provided it incorporates care delivered by independent organisations.

Mansbridge added: “The ambition to introduce a Single Patient Record presents a real opportunity to address these issues, but to hold a truly complete record, it must consider how care provided by non-NHS organisations is included.”

To improve patient safety, it has made three recommendations to the Department of Health and Social Care.

These include developing a mechanism to allow independent prescribing organisations to access relevant NHS patient information with patient consent, and reviewing options to enable authorised providers to write information directly into NHS health records.

HSSIB also recommends establishing a framework to share safety-critical information between independent prescribing organisations where patients access multiple providers.

Digital Health News contacted the Department of Health and Social Care for comment.