HR Healthcare Ltd

Updated 14 June 2019

HR Healthcare Limited is an organisation (registered with the Care Quality Commission in October 2018) that operates an online clinic for patients providing consultations and prescriptions and medicines. A registered manager is in place (a registered manager is a person who is registered with the CQC to manage the service. Like registered services, they are ‘registered people. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the provider is run).

We inspected HR Healthcare at Unit 18 Britannia Way, Waters Meeting, BL2 2HH.

HR Healthcare employs GPs on the GMC register, to work remotely in undertaking patient consultations when they apply for medicines online. The service is open between 9am and 5pm on weekdays and only available to UK residents. This is not an emergency service. Patients of the service pay for their medicines when their online application has been assessed and approved.

Once approved by the prescriber, medicines are dispensed, packed and posted; they are delivered by a third-party courier service. HR Healthcare is operated via a website (www.treated.com).

The provider is registered to provide the regulated activities: Treatment of disease, disorder or injury.

How we inspected this service

Before the inspection we gathered and reviewed information from the provider. During this inspection we spoke to the clinical team, and members of the management and administration team.

To get to the heart of patients’ experiences of care and treatment, we 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 14 June 2019

Letter from the Chief Inspector of General Practice

We rated this service as Good overall. (Previous inspection 9 October 2019 was not rated).

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 at HR Healthcare on 20 May 2019 as part of our inspection programme. At our previous inspection on 9 October 2018 we found the service breached Regulation 12: Safe Care and Treatment because routine monitoring was not happening for patients with long term conditions, and Regulation 17: Good Governance because the service did not have a system to identify when patients changed their answers on a medical questionnaire. We issued a requirement notice in relation to the breaches.

HR Healthcare employs GPs on the GMC register, to work remotely in undertaking patient consultations when they apply for medicines online. Patients are able to complete a medical questionnaire which is then reviewed by a GP and the medicine is posted directly to the patient.

At this inspection we found:

• The service had 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.
• The service now had a system in place to ensure GPs were aware of any answers that had been changed when a patient was completing the online medical questionnaire.
• Arrangements were in place to safeguard people, including arrangements to check patient identity.
• 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.
• Staff involved and treated people with compassion, kindness, dignity and respect.
• Patients could access care and treatment from the service within an appropriate timescale for their needs.
• Patients were told about the risks associated with any medicines used outside of their licence.
• Suitable numbers of staff were employed and appropriately recruited.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider should make improvements are:

• Review assessment forms for each medicine and compare this against the company’s recommendations in the summary care characteristics.

• The service should contact the patient if a letter is returned from a GP practice because the patient is not registered at that GP practice.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care