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Inspection Summary


Overall summary & rating

Updated 16 October 2017

We carried out an announced comprehensive inspection at Health Bridge Ltd on 31 May 2017.

Health Bridge Ltd was established in 2011 and registered with the Care Quality Commission in 2011. Health Bridge Ltd operates an online clinic for patients via the following websites: www.dred.com; www.zavamed.com; www.onlinedoctor.superdrug.com ; providing consultations and private prescriptions.

We found this service provided safe, effective, caring, responsive and well led services in accordance with the relevant regulations.

Our key findings were:

  • The service 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 doctors were prescribing appropriately.

  • There were systems to ensure staff had the information they needed to deliver safe care and treatment to patients.

  • The service learned and made improvements when things went wrong. 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.

  • The service 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 service shared information about treatment with the patient’s own GP with their consent.

  • Patient survey information we reviewed showed the latest Trust Pilot score for the ‘Superdrug online doctor’ service was ‘9.3 out of 10’ based on a total of 6,443 reviews of the service. The Trust Pilot score for ‘Dr Ed’ was also ‘9.3 out of 10’ based on a total of 1,070 reviews. Patients’ comments included satisfaction with the provider’s delivery times and the convenience of using the service.

  • There was a clear business strategy and plans in place.

  • 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.

  • The service encouraged and acted on feedback from both patients and staff.

  • Systems were in place to protect personal information about patients. The company was registered with the Information Commissioner’s Office.


Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Inspection areas

Safe

Updated 16 October 2017

We found that this service was providing safe care in accordance with the relevant regulations.

  • All staff had received safeguarding training appropriate for their role. All staff had access to local authority information if safeguarding referrals were necessary.

  • Patient identity was checked on registration and at every consultation or when prescriptions were issued.

  • There were enough GPs to meet the demand of the service and appropriate recruitment checks for all staff were in place.

  • In the event of a medical emergency occurring during a consultation, systems were in place to ensure emergency services were directed to the patient. The service had a business contingency plan.

  • Prescribing was constantly monitored and all consultations were monitored for any risks.

  • There were systems in place to meet health and safety legislation and to respond to patient risk.

  • There were systems in place for identifying, investigating and learning from incidents relating to the safety of patients and staff members. The provider was aware of and complied with the requirements of the Duty of Candour and encouraged a culture of openness and honesty.

Effective

Updated 16 October 2017

We found that this service was providing effective care in accordance with the relevant regulations.

  • We saw evidence that GPs assessed patients’ needs and delivered care in line with relevant and current evidence based guidance and standards, for example, National Institute for Health and Care Excellence (NICE) evidence based practice.

  • The service had a programme of ongoing quality improvement activity.

  • There were induction, training, monitoring and appraisal arrangements in place to ensure staff had the skills, knowledge and competence to deliver effective care and treatment.

  • The service had arrangements in place to coordinate care and share information appropriately for example, when patients were referred to other services.

  • The service’s websites contained information to help support patients lead healthier lives, and information on healthy living was provided in consultations as appropriate.

Caring

Updated 16 October 2017

We found that this service was providing caring services in accordance with the relevant regulations.

  • We saw GPs undertook consultations in private rooms within the service headquarters and we were told that GPs working remotely undertook consultations in a private room in their own home. The provider carried out checks to ensure GPs were complying with the expected service standards and communicating appropriately with patients.

  • We did not speak to patients directly on the days of the inspection. However, we reviewed the latest ‘Trust Pilot’ survey information. The latest Trust Pilot score for the ‘Superdrug online doctor’ service was ‘9.3 out of 10’ based on a total of 6,443 reviews of the service. The Trust Pilot score for ‘Dr Ed’ was also ‘9.3 out of 10’ based on a total of 1,070 reviews. Patients’ comments included satisfaction with the provider’s delivery times and the convenience of using the service.

Responsive

Updated 16 October 2017

We found that this service was providing responsive care in accordance with the relevant regulations.

  • There was information available to patients to demonstrate how the service operated.

  • Patients could access the service through a web browser, on a IOS, Android or windows device.

  • There was a complaints policy which provided staff with information about handling formal and informal complaints from patients.

  • Consent to care and treatment was sought in line with the provider policy. All of the GPs had received training about the Mental Capacity Act.

Well-led

Updated 16 October 2017

We found that this service was providing well-led care in accordance with the relevant regulations.

  • There were business plans and an overarching governance framework to support clinical governance and risk management.

  • There was a management structure in place and the staff we spoke with understood their responsibilities. Staff were aware of the organisational ethos and philosophy and they told us they felt well supported and could raise any concerns with the provider or the manager.

  • The service encouraged patient feedback. There was evidence that staff could also feedback about the quality of the operating system and any change requests were discussed.

  • Systems were in place to ensure that all patient information was stored securely and kept confidential. There were systems in place to protect all patient information and ensure records were stored securely. The service was registered with the Information Commissioner’s Office.