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.