Archived: Healthsteer Limited

Updated 6 October 2021

Healthsteer Limited is an online GP consulting service. Patients can access consultations by registering with the service via the provider’s website. Once registered patients can select a time for their video consultation. The GP will then call the patient at the agreed time. The service is available on a pay as you go basis or by signing up to one of the providers subscription plan arrangements.

The provider is registered with CQC to deliver the regulated activity: Treatment of disease, disorder or injury. The provider registered in May 2019 under the current location at 112 Main Street, Dickens Heath, Shirley, Solihull. B90 1UA. Prior to this, the provider had been registered at a different address in Hall Green, Birmingham. The address in Solihull is the provider’s administrative office.

There is a registered manager in place who is also the Managing Director for 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.

The service is managed by the Managing Director (non-clinical) and five founding doctors (who developed the service). The founding doctors are all secondary care consultants with the following specialisms; acute medicine, general medicine, respiratory, orthopaedics and diabetes/endocrinology).

There are five doctors who provide remote consultations with patients (four are GPs and one a doctor specialising in internal medicine). The doctors are all of self-employed status working for the provider as locum GPs (one female and four male). There are three directly employed administrative staff who provider customer service and IT support.

The majority of patients seen were adults however the provider also saw children.

The service is open 8am to 8pm Monday to Friday and 8am to 1pm Saturday and Bank Holidays for appointments.

How we inspected this service

During this inspection we gathered and reviewed information from the provider. We spoke to the Registered Manager, one of the founding consultants, a locum GP and the customer services lead and reviewed a sample of clinical records.

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 6 October 2021

Letter from the Chief Inspector of General Practice

We rated this service as Inadequate overall.

The key questions are rated as:

Are services safe? – Inadequate

Are services effective? – Inadequate

Are services caring? – Good

Are services responsive? – Requires improvement

Are services well-led? – Inadequate

We carried out an announced comprehensive inspection at Healthsteer Limited on 13 August 2021 as part of our inspection programme.

Healthsteer Limited is an online GP consulting service. Patients access the service by completing an online form and choose a time for their video/telephone consultation with a GP.

At this inspection we found:

• The service did not have effective systems to manage risks. There was a lack of clear systems for managing incidents, patient safety alerts and complaints to support learning and improvement and mitigate future risks.
• The practice had policies and procedures in place but these were not always service specific, and what we were told was happening was not always evident in the records seen.
• Staff training required by the provider had not been identified or monitored to ensure staff had received that which was relevant and up to date.
• The provider did not have effective systems in place for ensuring safe prescribing or for the sharing of information about consultations with the patients GP where it is in the interests of patient safety to do so.
• The provider did not have effective quality assurance processes in pace to assess the effectiveness and appropriateness of the care it provided.
• Staff treated people with compassion, kindness, dignity and respect.
• Patients could access care and treatment from the service within an appropriate timescale for their needs
• There were effective processes for confirming the identity of patients they consulted with.

The areas where the provider must make improvements as they are in breach of regulations are:

• Ensure care and treatment is provided in a safe way to patients.

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

I am placing this service in special measures. Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.

The service will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to remove this location or cancel the provider’s registration.

Special measures will give people who use the service the reassurance that the care they get should improve.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care