Archived: i-GP

Updated 6 April 2017

Background

i-GP is an online service that patients can use to access a prescription for medication to treat illnesses from a set list of 25 conditions. Conditions treated as advertised on the website include coughs, flu, sore throat, sexually transmitted infections, and asthma. The cost of an online assessment is £10 and the patient will also pay for the cost of the medicine when the prescription is dispensed. Over the past 12 months the service has issued approximately 500 prescriptions.

The i-GP service uses a system called ‘swarm intelligence’. This is an online treatment platform which asks patients questions relating to the condition they want treatment for in order to gather information to allow the GP to make a diagnosis.

i-GP employs two GMC registered GPs who work remotely in assessing patient consultation forms when they apply online for prescriptions. The service also employs a systems and service manager on an ad hoc basis.

A registered manager is in place. (A registered manager is a person who is 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).

We conducted our inspection on 17 January 2017 when we visited i-GP’s registered location Regus House, Crossways Business Park, Dartford, Kent. We spoke with the registered manager who was also the lead GP. We spoke with the service manager on 20 January 2017, and another GP on 26 January 2017 as both these staff members were unavailable at the time of the inspection.

Our inspection team was led by a CQC Lead Inspector. The team included a GP specialist adviser, a second CQC inspector, and a member of the CQC medicines team.

Before visiting, we reviewed a range of information we hold about the service and asked other organisations to share what they knew.

During our visits we:

• Spoke with a range of staff
• Reviewed organisational documents.
• Reviewed a random sample of patient records.

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?

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

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

Updated 6 April 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at i-GP on 17 January 2017. i-GP is an online service that patients can use to access a prescription for medication to treat illnesses from a set list of 25 conditions.

We found this service provided caring, responsive and well led services in accordance with the relevant regulations but was not providing safe or effective care in line with the relevant regulations.

Our key findings were:

• Patients could access a brief description of the GPs available.
• Systems were in place to protect personal information about patients. i-GP was registered with the Information Commissioner’s Office.
• Prescribing was monitored to prevent any misuse of the service by patients and to ensure GPs were prescribing appropriately.
• There were systems in place to mitigate safety risks including analysing and learning from significant events.
• The provider was aware of and complied with the requirements of the Duty of Candour.
• There were appropriate recruitment checks in place for all staff.
• Patients were treated in line with best practice guidance and appropriate medical records were maintained.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints.
• There were clear business strategy plans in place.
• 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.
• Policies were available to staff but some were generic and not service specific.
• There was a lack of consideration to safeguarding within the service. The safeguarding policy was not service specific.

The areas where the provider must make improvements are:

• Ensure safeguarding systems and processes are established and operated effectively.
• The provider must ensure that nationally recognised guidance about delivering safe care and treatment is implemented.
• The service must have a robust system in place to verify the identity of patient.

The areas where the provider should make improvements are:

• Policies should be more specific to the service and contain relevant information.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice