Archived: The GP Service (UK) Limited

Updated 21 March 2018

The GP Service (UK) Ltd launched its online service in February 2017, and is based in central London. At the time of the inspection, 1500 patients were registered with The GP Service (UK) Ltd. Patients are able to consult with a qualified General Medical Council registered GP via online assessment questionnaires or through secure video calling. The operating model of the service enables any medicines prescribed following consultations, to be available for collection through independent pharmacies that The GP Service (UK) Ltd has signed up as affiliated pharmacies. Patients then choose to collect their medicine from one of these affiliated pharmacies or to have them delivered to them by that pharmacy. The service also allows GPs, to provide prescriptions where appropriate, as well as referral letters and fit notes. If there is no affiliated pharmacy close to the patient, prescriptions can be posted to the patient. If patients choose to consult via an online assessment questionnaire, any medicines prescribed must be collected from an affiliated pharmacy, selected by the patient.

We inspected the online service The GP Service (UK) Ltd at the following address from where the provider is registered to provide services:

Lloyds Chambers 5th Floor, 1 Portsoken Street, London E1 8BT.

The service is led by a chairman and a chief executive officer (CEO) and supported by a leadership team of five, which included medical, technological and sales expertise. There were four GPs who carried out the online consultations remotely; usually from their home, one of whom was based outside the UK.

A registered manager is in place. 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.

How we inspected this service

The inspection was carried out by a CQC Inspector.

Before visiting, we reviewed a range of information we hold about the service and asked other organisations to share what they knew.

During our visit we:

• Spoke with three members of staff which included directors of the organisation, the registered manager and a GP who carried out online consultations.
• Reviewed policies and guidance documents.

We carried out an announced focussed inspection to follow up on breaches of Regulations identified at our previous comprehensive inspection on 27 July 2017. We inspected the service on the following two key questions:

• Is the service safe?
• Is the service well-led?

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

Why we inspected this service

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

Updated 21 March 2018

We previously inspected The GP Service (UK) Ltd on 27 July 2017. The full comprehensive report for this inspection can be found by selecting the ‘all services’ link for The GP Service(UK) Ltd on our website at www.cqc.org.uk.

At the July 2017 inspection we found the service was not meeting certain areas of the relevant regulations in that it was not providing Safe and Well-led services. We did however, find that the provider delivered Caring, Effective and Responsive services in accordance with the relevant regulations.

We carried out an announced focused inspection at The GP Service (UK) Ltd on 22 February 2018. This inspection covered the Safe and Well Led key questions to confirm the provider had carried out their plan to meet legal requirements in relation to the breaches of regulations identified in our July 2017 inspection. This report covers our review of the Requirement Notices and findings in relation to those requirements.

Our findings in relation to the key questions were as follows:

Are services safe? – We found the service was providing a safe service in accordance with the relevant regulations. Specifically:

• There was clear information on the consultation form to explain that the medicines were being used outside of their licence, and patients had to acknowledge that they understood this information. An email reinforcing this and a guide on when and how to use these medicines safely was supplied to patients following the consultation.
• A policy was now in place that provided guidance to prescribers when issuing prescriptions for medicines for management of long-term conditions. These medicines were only supplied in emergency situations and if the patient had given consent for the information to be shared with their own GP.
• A risk assessment and clear process to follow was in place should a patient refuse to give consent for information about their treatment to be shared with their own GP.

Are services well-led? - We found the service was providing a well-led service in accordance with the relevant regulations. Specifically:

• The provider had strengthened their identity checking processes by initiating additional checks. Due to these additional steps, photographic ID was no longer mandatory when prescriptions were collected by the patient from an affiliated pharmacy.
• We saw that policies had been strengthened regarding identifying incidents, near misses and clinical errors which ensured management oversight.
• All relevant staff were now signed up to receive email alerts from the Medicines and Healthcare products Regulatory Agency (MHRA) and had been trained on actions to be taken and had ensured that there was consistent management oversight.
• When a patient booked a consultation, they were sent the details of the GP they would be consulting with at that point.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice