27 September 2019
Anytime Medical Limited (the provider) operates under the trading name of Anytime Doctor, providing an on-line consultation, prescribing and testing service for various healthcare issues from the website: .
This inspection was carried out at the provider’s proposed new CQC registered location: 64 Cropley Street, London N1 7GX. At the time of inspection, the provider was in the process of registering this address as a location and deregistering its old location: 30 Percy Street, London,W1T 2DB. This process was concluded shortly after our inspection. The owner and sole director of the company is the Registered Manager and is responsible for all aspects of the management and operational activity of the service. 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. In addition, the provider has commissioned an independent doctor as external clinical assessor to conduct audits and monitor consultations and prescribing.
The provider is registered with the CQC to provide the Regulated Activity of treatment of disease, disorder or injury. The service offers consultations and prescriptions for various healthcare issues including some long-term conditions, such as asthma, diabetes and hypertension and offers testing kits for sexually transmitted diseases.
To access the service, patients complete and then securely submit an online consultation questionnaire appropriate to their healthcare issue. The provider employs doctors to review these questionnaires and if it is safe to do so, approves the patient for treatment. If approved for treatment, the patient is asked to pay for the prescription and to update and confirm their consultation information. The doctor will review this information again, prior to authorising the prescription (which is then sent electronically to the provider’s affiliated pharmacy for dispensing and delivery).
If the process is completed before 4.00 pm Monday to Friday the pharmacy will aim to dispense and despatch the prescribed medicine for delivery before 1.00 pm the next working day. For an additional payment, patients living with the bounds of the M25 can arrange for same day delivery. The service is available only to adults over the age of 18 years, with delivery addresses in the UK.
How we inspected this service
Before the inspection we gathered and reviewed information from the provider. During this inspection we spoke with the Registered Manager and one of the two doctors working at the service.
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.
27 September 2019
Letter from the Chief Inspector of General Practice
We rated this service as Good overall. (Previous inspection March 2018– 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 Anytime Medical Limited on 25 July 2019.
We previously inspected Anytime Medical Limited on 7 March 2018. The full comprehensive report on the 7 March 2018 inspection can be found by selecting the ‘all services’ link for Anytime Medical Limited on our website at www.cqc.org.uk.
At that time CQC asked the provider to make improvements because the service was not being provided in accordance with the relevant regulations. Specifically, we found the provider had breached Regulation 12 (1) (Safe care and Treatment) because in three instances patients had been prescribed medicines without the appropriate tests being undertaken or recorded.
A Requirement Notice was served and shortly thereafter the provider wrote to us to tell us how they planned to make improvements. We undertook this comprehensive inspection to check the service had followed their plan and to confirm they had met the legal requirements.
Anytime Medical Limited (the provider) operates under the trading name of Anytime Doctor. It provides an on-line consultation, prescribing and testing service from the website: www.anytimedoctor.co.uk .
The service offers consultations and prescriptions for various healthcare issues such as male hair loss, smoking cessation and oral contraception. The service also offers testing kits for sexually transmitted diseases and additionally offers consultations and prescriptions for asthma, high blood pressure, diabetes and high cholesterol.
To access the service, patients complete and then securely submit an online consultation questionnaire, appropriate to their healthcare issue. The provider employs two doctors to review these questionnaires and if appropriate, approves the patient for treatment. Both doctors are registered with the General Medical Council (GMC) with a licence to practise, are on the GP Register and are also on the NHS National Performers List.
Patients do not pay for the initial consultation. If approved for treatment, the patient is sent a text message prompting them to log back into their secure patient record. They will then be asked to pay for the prescription using a debit or credit card and to update and confirm their consultation information. The doctor will review the information again, prior to authorising the prescription (which is then sent electronically to the provider’s affiliated pharmacy for dispensing and delivery).
At this inspection we found:
•The service had good 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 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.
•Quality improvement activity supported the delivery of safe and patient centred care. For example, following our last inspection in March 2018, the service had contracted an independent, external doctor to routinely audit the prescribing patterns of its employed doctors. Audit results we reviewed confirmed that all sampled prescribing decisions had been clinically appropriate. Shortly after our inspection we were advised the service was recruiting a medical director to further embed quality improvement and its wider clinical governance activity.
•There was a strong focus on continuous learning and improvement at all levels of the organisation. For example, leaders routinely participated in sector led quality improvement fora.
The areas where the provider should make improvements are:
•Continue to review and refine its quality improvement and wider clinical governance activity.
•Continue to monitor its doctors payment system for prescribing so as to ensure it doesn’t allow unnecessary prescribing.
•Take action to ensure the service’s data protection policy reflects new General Data Protection Regulation (GDPR) relating to the use of personal data.
•Review arrangements for ensuring personnel records are kept up to date.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care