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Inspection Summary


Overall summary & rating

Good

Updated 4 August 2021

This service is rated as

Good

overall. The service had previously been inspected on 27 June 2019. Overall the report was rated as good, but at the latest inspection in 2019 the service was found to be in breach of regulation 12 of HSCA (RA) 2014. The safe key question was rated as requires improvement and a requirement notice was issued. The specific issues found which beached regulation 12 were in regards to arrangements for managing medical emergencies, systems for prescribing and dispensing medicines, services being provided outside of the scope of the service, and insufficient systems to check parental authority or guardianship when children attended..

We carried out an announced focussed inspection of Doctorcall London on 7 July 2021, where we reviewed the identified breaches from the previous report in the safe key question only. We are mindful of the impact of COVID-19 pandemic on our regulatory function. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so. We found that all of the breaches of regulation from the previous inspection had been addressed. Following this inspection, the key questions are rated as:

The key questions are rated as:

Are services safe? – Good

Our key findings were:

  • The service provided care in a way that kept patients safe and protected them from avoidable harm.

Dr Rosie Benneyworth BM BS BMedSci MRCGP


Chief Inspector of Primary Medical Services and Integrated Care

Inspection areas

Safe

Good

Updated 4 August 2021

We rated safe as Good because:

We carried out this announced focussed inspection on 7 July 2021. We had previously carried out an announced comprehensive inspection in June 2019. At the time of the first inspection the service was not providing safe services. We found the following:

  • Arrangements to manage medical emergencies in the clinic lacked clarity and could potentially delay the delivery of treatment.
  • The service was not effectively monitoring risks associated with prescribing and dispensing medicines and was not monitoring its prescribing activity.
  • There was a lack of clarity about the range of services being provided by different clinic-based doctors (for example, in relation to long term conditions) and whether all risks were being appropriately monitored.
  • The provider had not implemented an effective system to check that adults accompanying children had parental authority.

At the time of the inspection visit on 7 July 2021, these issues had been addressed.

Safety systems and processes

The service had clear systems to keep people safe and safeguarded from abuse.

  • The provider conducted safety risk assessments. It had appropriate safety policies, which were regularly reviewed and communicated to staff. They outlined clearly who to go to for further guidance. Staff received safety information from the service as part of their induction and refresher training. The service had systems to safeguard children and vulnerable adults from abuse.
  • The service had systems in place to assure that an adult accompanying a child had parental authority.

Risks to patients

There were systems to assess, monitor and manage risks to patient safety.

  • Emergency equipment which included oxygen, a defibrillator, pulse oximeters, oxygen masks and tubing, and some medicines were available and accessible to treat patients in an emergency.
  • The service had reviewed the emergency medicines it considered appropriate to hold at the clinic and to be carried by the visiting doctors.

Information to deliver safe care and treatment

Staff had the information they needed to deliver safe care and treatment to patients.

  • The service had systems for sharing information with staff and other agencies to enable them to deliver safe care and treatment. This included NHS GPs.

Safe and appropriate use of medicines

The service had reliable systems for appropriate and safe handling of medicines.

  • The systems and arrangements for managing medicines, including vaccines, controlled drugs, emergency medicines and equipment minimised risks. The service kept prescription stationery securely and monitored its use.
  • The service does not prescribe Schedule 2 and 3 controlled drugs (medicines that have the highest level of control due to their risk of misuse and dependence).
  • Staff prescribed, administered or supplied medicines to patients and gave advice on medicines in line with legal requirements and current national guidance. Processes were in place for checking medicines and prescribing patterns, and staff kept accurate records of medicines. Reviews ensured that the service was not prescribing medicines for longer than was safe, and that prescribing was in line with the organisation’s operating model.

Effective

Good

Updated 4 August 2021

Caring

Good

Updated 4 August 2021

Responsive

Good

Updated 4 August 2021

Well-led

Good

Updated 4 August 2021