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Archived: i-GP

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Inspection Summary


Overall summary & rating

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

Inspection areas

Safe

Updated 6 April 2017

We found that this service was not 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. However, there was a lack of consideration as to how safeguarding should be implemented within the service.

  • 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. On registering with the service, patient identity was verified. In the rare event of a medical emergency occurring during a consultation, systems were in place to direct the patient to seek medical emergency help. The service had a business contingency plan.
  • 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.

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

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

Effective

Updated 6 April 2017

We found that this service was not providing effective care in accordance with the relevant regulations.

  • Some checks were in place to confirm the patient’s identification.
  • The service did not regularly share information with other services such as a patient’s NHS GP.

  • GPs had received training about the Mental Capacity Act.

  • We were told that each GP 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) best practice guidelines. We reviewed a sample of anonymised consultation records that demonstrated appropriate patient treatment.

  • The service had arrangements in place to coordinate care and share information appropriately. However, Information sharing with a patients NHS GP would only happen if a patient consented.

  • If the provider could not deal with the patient’s request, this was adequately explained to the patient but a record of the decision was not kept.

  • The service’s web site contained information to help support patients lead healthier lives.

  • 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.

Caring

Updated 6 April 2017

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

  • Systems were in place to ensure that all patient information was stored and kept confidential.

  • We were told that GPs undertook consultations in a private.

  • We did not speak to patients directly on the days of the inspection. The service had carried out a patient survey and received 100% satisfaction score out of 10 responses.

Responsive

Updated 6 April 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 help from the service.

  • The service’s website was accessible 24 hours a day and aimed to be able to issue a prescription within one hour between the hours of 8am to 10pm daily.

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

Well-led

Updated 6 April 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.