The Care Quality Commission
  • Remote clinical advice

Archived: The GP Service (UK) Limited

Lloyds Chambers, 1 Portsoken Street, London, E1 8BT (020) 3105 0352

Provided and run by:
The GP Service (UK) Ltd

Important: This service is now registered at a different address - see new profile

All Inspections

22 February 2018

During an inspection looking at part of the service

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

27 July 2017

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The GP Service (UK) Ltd.

The GP Service (UK) Ltd provides an online GP consultation service. They employ GPs on the General Medical Council (GMC) GP register to work remotely in undertaking patient consultations. Patients are able to book a consultation with a GP Monday to Sunday 8am until 8pm. Consultations were via a video call or assessment questionnaire. Medicines prescribed were collected by the patient, or delivered, by an affiliated pharmacy (which we do not regulate). No medicines were delivered by post to patients.

We found this service did not provide safe and well-led services but did provide effective, caring, and responsive services in accordance with the relevant regulations.

Our key findings were:

  • The provider had clear systems to keep people safe and safeguarded from abuse.
  • There was a comprehensive system in place to check the patient’s identity.
  • There were systems in place to mitigate safety risks including analysing and learning from significant events and safeguarding.
  • There were appropriate recruitment checks in place for all staff.
  • Prescribing was monitored to prevent any misuse of the service by patients and to ensure GPs were prescribing appropriately. However there was no system in place for auditing incidents, near misses and clinical errors picked up at the affiliated pharmacies, at the point of dispensing, by the pharmacist and, therefore, no opportunity to review  them.
  • There were systems to ensure staff had the information they needed to deliver safe care and treatment to patients.
  • The provider was aware of and complied with the requirements of the Duty of Candour.
  • Patients were treated in line with best practice guidance and appropriate medical records were maintained. However the provider did not ensure patients diagnosed with a long term condition had received recommended monitoring of their condition; in line with national guidance.
  • The provider’s website did not give information about the GPs who worked for them so patients were unable to book a consultation with a GP of their choice or see details of their professional registrations.
  • The provider had a programme of ongoing quality improvement activity.
  • An induction programme was in place for all staff and GPs registered with the service received specific induction training prior to treating patients. Staff, including GPs, also had access to all policies.
  • The provider shared information about treatment with the patient’s own GP in line with General Medical Council guidance. However there was no policy in place and no evidence that risk assessments had been undertaken should a patient refuse permission for information to be shared.
  • Staff we spoke with were aware of the organisational ethos and philosophy and told us they felt well supported and that they could raise any concerns.
  • There were clinical governance systems and processes in place to ensure the quality of service provision. However these did not always operate effectively, for example in relation to management oversight of adherence to policies.
  • The provider encouraged and acted on feedback from both patients and staff.
  • Systems were in place to protect personal information about patients. Both the company and individual GPs were registered with the Information Commissioner’s Office.

We identified regulations that were not being met and the provider must:

  • Ensure systems and processes are reviewed in order that that good governance and management oversight of operational delivery is consistently achieved.
  • Ensure risk assessments and processes are in place that follow good practice guidelines and ensure safe care and treatment.

The areas where the provider should make improvements are:

  • Ensure patients have access to information about GPs they are able to consult with.
  • Ensure risk assessments are undertaken should a patient refuse permission for information to be shared with their own GP.

You can see full details of the regulations not being met at the end of this report.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice