Alto House

Updated 25 March 2020

The provider, Polypill Limited, was incorporated in 2001 to offer an online health programme which aims to contribute to the prevention of cardiovascular disease, the service is provided to patients aged 50 and above, who are based in the United Kingdom. Its management offices are at 29-30 Newbury Street, London, EC1A 7HZ.

The service was established following the findings of research projects. undertaken by the founders of the service. and published in 2003 this is supported by a further study undertaken in 2012, in which 84 people participated, together with more recent research findings. It carries out asynchronous (text based) consultations and where there is a need for any clarification of a patient’s suitability for the programme the clinician contacts them to clarify any issues. Patients participating in the programme are prescribed medicines and also provided with lifestyle advice via the services website. At the time we inspected, there were approximately 135 active participants in the programme.

The clinical leadership team are based in the nearby Wolfson Institute for Preventive Medicine and at Alto House. The prescribing doctor works remotely. One prescribing doctor works for the service and is supported by two members of the clinical leadership team who are also doctors and cover the prescribing duties as necessary.

Two members of staff employed by another company run by the Registered Manager provide administrative support; there are formal arrangements in place to support this relationship.

How we inspected this service

Before the inspection we gathered and reviewed information from the provider. During this inspection we spoke to the Registered Manager and the service manager.

To get to the heart of patients’ experiences of care and treatment, we ask the following five questions:

• Is it safe?
• Is it effective?

These questions therefore formed the framework for the areas we looked at during the inspection.

Updated 25 March 2020

We carried out an announced focused inspection at Alto House (Polypill) on 26 February 2020 to follow up on breaches of regulations in regard to two key questions: are services safe; and are services effective.

Alto House (Polypill) is an online health programme for the prevention of cardiovascular disease, intended for patients aged 50 and above. The programme combines the prescribing of medicines with the provision of lifestyle advice. Patients initially complete a free online assessment, and if suitable for the programme patients can then request a prescription for the medicines. Prescriptions are sent to Polypill’s designated pharmacy who dispense the medicines and dispatch them to the patient’s address. When patients require a further supply of medicines, they complete another online questionnaire before a repeat prescription is issued.

At this inspection we found:

• The service had changed the information on its website to make clear to patients not all medicines being prescribed were licensed for use as preventative of the conditions for which the service was prescribing them.
• It required a signature on delivery to ensure medicines were delivered to the correct recipient.
• The prescribing doctor had received training in the protection of vulnerable adults and children to a level appropriate to their role.
• The service had implemented identity checks to ensure the service could not be accessed by anyone under the age of 18.
• The service had introduced patient identity checks in line with NHS Digital standard for Identity verification and authentication when using digital health and care services
• The service had introduced a programme of regular audit.
• It had developed a strategy to encourage more patients to agree to information sharing with their NHS GP.
• Patients could access care and treatment from the service within an appropriate timescale for their needs.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care