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LloydsPharmacy Online Doctor Good Also known as Expert Health Limited

Reports


Inspection carried out on 17/9/2019

During a routine inspection

Letter from the Chief Inspector of General Practice

We rated this service as Good  overall.

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? – Outstanding

We previously inspectedDrThom/LloydsPharmacy Online Doctorin May 2017. The full comprehensive reports for these inspections can be found by selecting the ‘all services’ link for on our website atDrThom/LloydsPharmacy Online Doctor.

We carried out an announced comprehensive inspection at DrThom/LloydsPharmacy Online Doctor on 17 September 2019 as part of our inspection programme and to provide a quality rating.

DrThom/LloydsPharmacy Online Doctor are an online (digital) GP service that offers a range of general medical services that include postal testing, remote treatment and remote advice. The service can be accessed through their website, onlinedoctor.lloydspharmacy.com. This is a fee-based service and is available only for patients in the UK. We inspected the online service known as Dr Thom/LloydsPharmacy Online Doctor, we did not inspect the provider’s affiliated pharmacies which are based throughout England.

At this inspection we found:

  • The senior management team demonstrated they were a driving force dedicated to delivering the mission of the service. All staff we spoke to felt valued by the leaders and said there was a high level of staff support, engagement and development.
  • Patients safety was their priority. 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.
  • Patients could access care and treatment from the service within an appropriate timescale for their needs.
  • There was a strong focus on continuous learning and improvement at all levels of the organisation. They effectively used the skills and abilities of their staff team to provide innovative and accessible care, treatment and support to their patients.
  • The service had comprehensive business development strategy and quality improvement plan that effectively monitored the service provided to assure safety and patient satisfaction.
  • There was a commitment and appetite to work with external partners including the NHS and the third sector to share learning and make the service as accessible as possible.

We saw the following areas of outstanding practice:

  • There was a Get-Grow-Keep’ strategy where they developed staff skills, competence and knowledge and encouraged staff development opportunities linked to the strategy. They had sponsored one of their GPs to receive training to develop an algorithm to ensure advice and information is given in digestible bite sized chunks throughout the interactive consultation as well as the information being saved in the patient record for later reference.
  • The provider demonstrated commitment to system-wide collaboration and leadership. The provider was part of the Sexual Health London (SHL) joint commissioning model, which included an NHS Trust and an integrated diagnostic company who provided remote/self-sampling sexual health services. This has allowed them to improve the process of follow-up and referring patients back to NHS clinics. This is the first collaborative commissioning model of its kind across London and in UK as a whole.
  • The provider held quarterly external education activities for GPs free of charge. The most recent education session covered Digital health – the changing face of medicine, Heart Rhythm Disorders and Women’s Health Update. These are usually attended by 30 - 40 GPs.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Inspection carried out on 17 May 2017

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Expert Health Limited on 17 May 2017.

Expert Health Limited provides an online primary care consultation service and medicines ordering service. Patients register for the service on the provider’s website which uses the trading name Lloyds Pharmacy Online Doctor.

We found this service provided safe, effective, caring, and responsive and well led services in accordance with the relevant regulations.

Our key findings were:

  • The service had clear systems to keep people safe and safeguarded from abuse.
  • There was a comprehensive system in place to check the patient’s identity. Checks included, systems that identified duplicate patients, similar names or addresses, gender name checks, payment card checks and IP addresses to ensure the patient was UK based; and requested photographic evidence where necessary.
  • There were systems in place to mitigate safety risks including analysing and learning from significant events and safeguarding.
  • There were appropriate recruitment checks and induction programmes in place for all staff. A new system was being introduced to improve access and management oversight of HR records.
  • Prescribing was monitored to prevent any misuse of the service by patients and to ensure GPs and the independent prescribing pharmacist were prescribing appropriately.
  • There were systems to ensure staff had the information they needed to deliver safe care and treatment to patients.
  • The service learned and made improvements when things went wrong. The provider was aware of and complied with the requirements of the Duty of Candour.
  • Patients were treated in line with best practice guidance and appropriate medical records were maintained. Prescribers from the service met with local specialists on a regular basis to maintain knowledge and skills.
  • The service had a programme of ongoing quality improvement activity, which included clinical and non-clinical audit.
  • Consultation templates had been reviewed by internal and external GPs to ensure quality and consistency.
  • The service shared information about treatment with the patient’s own GP, however, this was not always in line with General Medical Council guidance. The service responded immediately when this was raised and ensured improved processes were put into place.
  • Improvements were made to the quality of care as a result of complaints.There was a clear business strategy and plans in place.
  • Staff we spoke with were aware of the organisational ethos and philosophy and told us they felt well supported and that they could raise any concerns.
  • 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.
  • Systems were in place to protect personal information about patients. Both the company and individual GPs were registered with the Information Commissioner’s Office.

The areas where the provider should make improvements are:

  • Ensure oversight of HR systems and processes are effectively implemented and maintained.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Inspection carried out on 25 October 2012

During a routine inspection

People using the service were invited to give their feedback using various independent companies. There was a high level of satisfaction with the service, particularly for the speed, efficiency and confidentiality of the service. An example was "I found the whole process efficient and discreet". Overall, people were satisfied with the care and treatment received.

We saw that people were given enough information about the service and were involved in making decisions about what care and treatment they would receive. Medical histories were taken for each person and the doctors could seek more information prior to prescribing.

The service had systems in place to ensure that people were protected from the risk of abuse. Staff received suitable training, supervision and appraisal. There was evidence that there was an effective process to review and monitor the quality and safety of the service provided.