Dear Ms Gill,

Thank you for the Regulation 28 report of 19th March 2025 sent to the Secretary of State / the Department of Health and Social Care about the death of Mr Sheridan Tate Pickett. I am replying as the Minister with responsibility for medicine regulation and prescribing.

Firstly, I would like to say how saddened I was to read of the circumstances of Mr Pickett’s death and I offer my sincere condolences to their family and loved ones. The circumstances your report describes are concerning and I am grateful to you for bringing these matters to my attention.

The report raises concerns over the importance of adhering to clear guidelines for online prescribing and information sharing between private providers and NHS services.

When used appropriately, online prescribing provides a valuable route for patients to access their prescription medicines which takes pressure off GP practices. Prescribers, whether working for the NHS or privately, in-person or remotely, are accountable for their prescribing decisions. They are expected to take account of appropriate national guidance. Prescribers should work with their patient and decide on the best course of treatment, with the provision of the most clinically appropriate care for the patient always being the primary consideration. In addition to the duty of the prescriber, patients themselves must be honest when providing information to an online prescriber so that they receive advice and medicines which are appropriate for them and so that risks can be managed. The General Pharmaceutical Council (GPhC) sets out the precautions to put in place if certain medicines requiring additional safeguards are to be supplied online. These include but are not limited to assuring that the person has provided the contact details of their regular prescriber, such as their GP, and their consent to contact them about the prescription; and

that the prescriber will proactively share all relevant information about the prescription with other health professionals involved in the care of the person (for example their GP). Further information on this can be found here: Guidance for registered pharmacies providing pharmacy services at a distance, including on the internet. The above guidance was updated (February 2025) in response to concerns relating to unsafe prescribing and supply of medicines online and includes strengthened safeguards designed to prevent people from receiving medicines that are not clinically appropriate for them and may cause them harm. Specifically, the February 2025 guidance sets out what to include in a risk assessment when prescribing services are involved, this includes considering how the diverse needs of people using pharmacy services are identified, and how staff get users’ valid consent (for example, how staff assess the mental capacity of users). The February 2025 guidance states that “The risk assessment should cover the whole service, including the medicines and treatments which are provided”. The guidance also sets out strengthened safeguards that should be in place before supplying certain medicines online. It states that a prescriber should not base prescribing decisions on the information provided in a questionnaire alone. To ascertain further details about procedures followed by the provider that prescribed Mr Pickett’s medication, you could directly approach the General Medical Council (GMC) and the General Pharmaceutical Council (GPhC) who may have responsibility for their regulation. The report gives no indication that the online provider acted unlawfully but in situations where this could apply, the GPhC and other professional regulators, the Care Quality Commission and the Medicines and Healthcare products Regulatory Agency have the powers to investigate and take action against prescribers, products and suppliers who do not comply with legislation and national guidance. In your report, you raise concerns that there are no current guidelines governing communication and information sharing between private providers and NHS providers. The following guidance, Hospital discharge and community support guidance - GOV.UK states that: ‘health and care professionals (such as clinicians and social workers) should share appropriate and accurate information early to support a safe and timely discharge, for example, about medication (including whether medication has changed since hospital admission) and immediate support needs, including transport and equipment required. They should also seek information from those involved in the patient’s care prior to admission early on so this can be used to inform discharge planning. Sufficient and accurate information should be provided on discharge to enable any providers of onward care and support to meet the needs of the person transferred to them. This includes details about the person’s condition, information about the person’s medications, whether a personalised care and support plan or personal wellbeing plan has been updated or established, and arrangements to have their care and support regularly reviewed to support their recovery.’ I can confirm this does apply to communication with private as well as NHS providers.

Lastly, I would like to assure you that we are committed to tackling suicide as one the biggest killers in this country. As part of this, the 8,500 new mental health workers we will recruit will be trained to support people at risk, to reduce the lives lost to suicide. We are also committed to continuing to deliver the cross-sector Suicide Prevention Strategy for England published in 2023. This identifies a number of groups for tailored or targeted action at a national level, including people in contact with mental health services. I hope this response is helpful. Thank you for bringing these concerns to my attention.