Archived: ZoomDoc

Updated 5 November 2019

ZoomDoc Ltd (the provider) offers a private acute care GP service, initially by telephone and online video consultations bookable via a secure mobile application (app.). GPs may visit patients at their homes, office or hotels, having triaged and accessed the patients’ condition and healthcare needs, or at the patients’ request. Patients can book a 10-minute telephone or online video consultation or a 25-minute face-to-face visit with a GP 24 hours a day and seven days a week. Although telephone and online consultations are not limited geographically, most home visits are restricted to the London area, as many of the GPs are based there. However, a few of the GPs work in the Midlands. Patients can book appointments at a time to suit them with a doctor of their choice and must pay for a consultation by credit or debit card only via the ZoomDoc service app. Where appropriate, GPs may issue prescriptions, but this is only done following online video or face-to-face consultations, having checked and established the patient’s identity. Notes of consultations are available for patients to access. The service is not intended to provide care in relation to patients’ long-term health conditions. Patients requiring such care are referred to their own GPs. Nor is it an emergency service; patients with emergency healthcare needs are advised to call 999 or are directed to their local Accident and Emergency (A&E) department.

To be eligible to register for an account a patient must be aged 18 or over. Parents or legal guardians may later add children under 18 years old as patients to their primary service account after the initial registration. The provider told us around 6,500 people had registered as patients, of whom roughly 30% were children registered on their parents’ primary accounts. The service has carried out 515 consultations since early 2018; of which 225 had been telephone consultations, 104 by online video and 186 visits had been conducted. At the time of the inspection there were on average five consultations per week.

The provider is registered by the Care Quality Commission under the Health and Social Care Act 2008 in respect of the regulated activities Transport services, triage and medical advice provided remotely and Treatment of disease, disorder or injury.

The provider does not directly employ any clinical staff. The Registered Manager is the lead GP, who undertakes patient consultations as part of the service, in addition to 28 self-employed GPs who operate as sub-contractors. We confirmed that all the GPs working in the service are registered with the General Medical Council (GMC) with a licence to practice and are on the GP Register. The GPs operate from home and so their opportunity to carry out visits to patients’ homes is limited by distance.

Details of the service are available on the provider’s website - www.zoomdoc.com

The provider has office space available at 29-30 Wakley Street London EC1V 7LT, but no clinical work takes place there.

How we inspected this service

Before the inspection we gathered and reviewed information from the provider. During the inspection we spoke with the lead GP, who carries out patient consultations and is also the Registered Manager. 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 reviewed the provider’s governance policies and looked at eight sets of healthcare records of patients using the service. We did not speak with any patients or otherwise receive any direct feedback, but we did review feedback submitted by 16 patients via the service app. regarding their experience of 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.

Updated 5 November 2019

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? – Good

We had inspected the service at another location in February 2018 using our previous methodology and had not applied a rating. We had identified some areas of non-compliance with regulations, relating to safe and effective care, including issues regarding the service’s medicines and prescribing protocols, infection prevention and control audits and evidence of staff training. ZoomDoc Ltd (the provider) sent us a plan of the action it would take to address the issues and comply with the relevant regulations.

The provider had moved its business to the new location in January 2019. We carried out an announced comprehensive inspection on 10 September 2019 to follow up on the breach of regulations and to assess a rating for the service. We found that the provider had taken appropriate action to meet the requirements of the regulations.

The provider offers a private GP service, initially by telephone and online video consultations bookable via a secure mobile application (app.). GPs may visit patients at their homes, office or hotels, having triaged the patients’ condition and healthcare needs, or if specifically requested by the patient. Patients can book a 10-minute telephone or online video consultation or a 25-minute face-to-face consultation with a GP 24 hours a day and seven days a week.

At this inspection we found:

• The provider had good systems to manage risk so that safety incidents were less likely to happen. There were processes in place to ensure when incidents did occur they were investigated and learned from.
• The provider routinely monitored the effectiveness and appropriateness of the service.
• Patients could access care and treatment from the provider within an appropriate timescale to meet their needs.
• Staff involved and treated people with compassion, kindness, dignity and respect.

The areas where the provider should make improvements are:

• Review the arrangements for holding regular clinical meetings with GPs, to ensure effective communication on matters relating to the service.
• Review the arrangements for conducting regular clinical audits to drive improvement.
• Continue to monitor prescribing within the service to ensure appropriate prescribing of broad-spectrum antibiotics.
• Maintain evidence of GPs’ ongoing Mental Capacity Act training relating to patients’ consent to treatment.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care