PrivateDoc Limited

Updated 24 November 2020

PrivateDoc Limited offers a digital medical service providing patients with prescriptions for medicines that they can obtain from the affiliated pharmacy (which we do not regulate). We inspected the digital service at the following address: Unit 7, Wharfside House, Prentice Road, Stowmarket, Suffolk, IP14 1RD.

The service can be accessed through the website . Patients can register with the website, select a condition they would like treatment for and complete a consultation form. Once the consultation form has been reviewed and approved, a private prescription for the appropriate medicine is issued. This is sent to the affiliated pharmacy for the medicines to be supplied. Service users pay for their medicines when their on-line application is approved.

Patients can access the service 24 hours a day however phone and e-mail communications are only monitored between 9am to 5pm, Monday to Friday. Outside of these hours patients are directed to appropriate NHS services for emergency medical care.

A registered manager is in place. A registered manager is a person 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

We took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering how we carried out this inspection. We therefore undertook most of the inspection processes remotely and spent less time on site. Before visiting, we reviewed a range of information we hold about the service including information from the provider supporting improvements made in response to concerns identified at our previous inspection.

During our visit we:

• Spoke with a range of staff

• Reviewed organisational documents, processes and procedures

• Reviewed patient records.

We did not speak with any patients as part of the inspection, but reviewed feedback collected by the service and patient feedback received directly by CQC.

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

• Is it safe?
• Is it effective?
• Is it caring?
• Is it responsive to people’s needs?
• Is it well-led?

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

Updated 24 November 2020

We rated this service as Good overall.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an announced comprehensive inspection of PrivateDoc Limited on 10 May 2017 and found that the provider was not providing safe, effective and well led care in accordance with the requirements of the Health and Social Care Act 2008. We issued Requirement Notices and a Warning Notice to the provider to drive improvement.

We undertook a desk-based review on 3 August 2017 to check that the provider had followed their action plan and to confirm that the requirements of the Health and Social Care Act 2008 had been met following our Warning Notice.

Following the review on 3 August 2017, we found that the provider had responded appropriately to our findings and had met the requirements set out in our enforcement action.

We carried out an announced comprehensive inspection on 25 January 2018 and found the improvements made had been embedded and the provider had met all of the standards.

We carried out an announced comprehensive inspection at PrivateDoc Limited on 1 July 2019 as part of our inspection programme to rate independent healthcare providers. Shortly after the inspection, CQC received an enquiry via our National Customer Service Centre raising multiple concerns and carried out a second announced visit on 15 July 2019. Following that inspection, we imposed urgent conditions on the provider’s registration, in relation to breaches of Regulation 12 (Safe Care and Treatment) and Regulation 17 (Good Governance) of the Health and Social Care Act. The service was rated as inadequate overall and in all key questions.

We carried out an announced comprehensive inspection at PrivateDoc Limited on 26 February 2020 as part of our regulatory response to breaches of regulation we identified at our July 2019 inspection. We rated the provider as Inadequate overall and the service was placed in special measures as insufficient improvements had been made such that there remained a rating of inadequate for safe, effective and well-led services. We took action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. The service was kept under review and provided regular information detailing the improvements they had made. Based on the assurances from the provider on the improvements made and in light of the COVID-19 pandemic, we withdrew our proposal to cancel the providers registration and issued a serious concerns letter detailing the monitoring arrangements for the service until such time as we could safely inspect.

We carried out this inspection on 20 October 2020 and found the improvements made had been implemented, sustained and were effective.

Details of the previous inspection and reports can be found by following the links for the provider on our website www.cqc.org.uk.

At this inspection, we rated the provider as Good for providing safe services because:

• The service had good systems to manage risk so that safety incidents were less likely to happen. When they did happen, the service learned from them and improved their processes.

Improvements made since our last inspection included;

• Continued improvement of identification checks including anti money laundering checks and development of facial recognition technology.
• The service ensured patient records and patient contacts were always completed and recorded, with the quality of patient records monitored through quality improvement activity.
• Systems and processes were strengthened to provide assurance that the named account holder was the person receiving and using the medicines ordered and ensuring the facility of using an alternative delivery address kept patients safe.
• Improved processes and procedures to manage or respond to emergency medical situations in the event a patient presented with an emergency situation.

At this inspection, we rated the provider as Good for providing effective services because:

• The service routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.

Improvements made since our last inspection included;

• The service had further improved and embedded an effective quality improvement program.
• There was a clear audit trail of the clinician’s rationale for approving or declining each prescription request. This was monitored through the services quality improvement activity.
• The service had improved their consultation review process which was extended to all patients at fourteen days after the initial consultation. This formed part of the service’s quality improvement activity and was effective in identifying issues and concerns and driving improvements for patients.
• There were now clear and effective processes in place for contacting and reviewing patients who were on medicine for weight loss and who had not achieved the manufacturer’s suggested weight loss.

At this inspection, we rated the provider as Good for providing caring services because:

• Team members treated patients with kindness and respect and involved them in decisions about their care.
• The service was rated as “Excellent” in 95 percent of 2,886 online reviews with an average rating of 4.9 out of five stars.

At this inspection, we rated the provider as Good for providing responsive services because:

• Patients could access care and treatment from the service within an appropriate timescale for their needs.

Improvements made since our last inspection included;

• The service had improved processes for identifying, managing and responding to complaints which drove improvement.

At this inspection, we rated the provider as Good for providing well-led services because:

• There was a strong focus on continuous learning and improvement at all levels of the organisation.

Improvements made since our last inspection included;

• The service had acted upon all of the concerns identified from our previous inspections.
• Governance structures, systems and processes were improved, embedded and were effective.
• There was a comprehensive programme of quality improvement activity in place to monitor and improve the performance of the service.
• There were effective systems in place to ensure care and treatment records were complete, accurate of sufficient quality and contained information on the decision-making process of the clinicians.

I am taking this service out of special measures. This recognises the significant improvements that have been made to the quality of care provided by this service.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care