Floor 5 Aspect House

Updated 8 December 2021

Teladoc Health UK offers a virtual care service, including a primary care service. They provide an online GP consultation, treatment and prescribing service for a limited range of medical conditions. They do not routinely prescribe pain relief, controlled drugs or high-risk medicines. They are registered with CQC for the following regulated activities; Treatment of disease, disorder or injury, Transport services, triage and medical advice provided remotely.

They have a team of approximately 100 clinicians, including 50 GPs working remotely in the primary care service. There are 150 full time staff, including the customer services team and management team. The management and support team are based at the Teladoc head office in Brighton, East Sussex.

Virtual care is typically embedded within the insurance plans of private insurance company clients of Teladoc Health UK which, in turn, becomes an available service for their policyholders. There are no elements of the service that the patient directly pays for themselves.

The service provides care, treatment and support to people using:

• Telephone and video systems
• Via an app or online portal
• Email.

Patients from anywhere in England can consult with the GPs. When the GP decided to issue a prescription, it was sent to the patient’s local pharmacy or to a pharmacy which offered a delivery service.

The service is open 24 hours a day, seven days a week. This service is not an emergency service. Patients who have a medical emergency are advised to ask for immediate medical help via 999 or, if appropriate, to contact their own GP or NHS 111.

This service is registered with CQC under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. There are some exemptions from regulation by CQC, which relate to particular types of regulated activities and services and these are set out in Schedule 1 and Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Teladoc Health UK also provide a psychology and nutritional advice service, which are not within the CQC scope of registration. Therefore, we did not inspect or report on these services.

Updated 8 December 2021

We carried out an announced inspection of Teladoc Health UK on 20 October 2021 to follow up on the breach of regulation found at our previous inspection.

Following our last inspection in September 2020, we issued a requirement notice for regulation 17 (good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Teladoc Health UK on our website at www.cqc.org.uk.

Teladoc Health UK provides an online GP consultation, treatment and prescribing service for a limited number of medical conditions to patients in England.

The Chief Medical Officer is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Why we carried out this inspection

This inspection was a focused inspection to confirm whether the provider now met the legal requirements of regulations and to ensure enough improvements had been made.

At our last inspection we found:

• The service had systems to record, investigate and monitor significant events and safety alerts. However, we found that not all incidents had been recorded and not all staff were clear about the significant event policy or process.

We also identified areas where the provider should make improvements. These were:

• Continue making improvements to the clinical system and ensure patient information about previous consultations is available in an immediately accessible way.
• Continue to improve the complaints process and information for patients.

How we carried out the inspection

Throughout the pandemic CQC has continued to regulate and respond to risk. However, taking into account the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently.

This inspection was carried out remotely. This was with consent from the provider and in line with all data protection and information governance requirements.

This included:

• Requesting and reviewing evidence from the provider.
• Remotely reviewing information held by the service on electronic records systems, to identify any issues and to clarify actions taken by the provider.
• Speaking with a range of staff using video conferencing. Including; the registered manager, members of the management team, and support staff.

Our key findings were:

• We found that the provider had taken all our concerns seriously and had undertaken a range of actions to make improvements.
• We saw an effective system for reporting and recording significant events. There was a dedicated quality assurance team that handled significant events, data breaches and complaints.
• Staff we spoke with were able to describe what a significant event was. Staff understood their duty to raise concerns and report incidents and near misses.
• We found the provider had a new clinical system that improved access to information about patients care and treatment.
• The provider had taken action to improve information available to patients on how to make a complaint.

Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care