Teledoctor HQ

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

This is the first assessment for this service. This key question has been rated Good.

Leaders and staff had a shared vision and culture based on listening, learning and trust. Leaders were visible, knowledgeable and supportive, helping staff develop in their roles. Staff felt supported to give feedback and were treated equally, free from bullying or harassment. Staff understood their roles and responsibilities, although some described some abrupt changes made by senior managers which they had found difficult. Managers worked in partnership with the local community to deliver the best possible care and were receptive to new ideas. There was a culture of continuous improvement with staff given time and resources to try new ideas. The service had entered into a partnership with a UK university for further research into neurodiversity.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a very clear shared vision, strategy and culture despite the challenges of operating as a remote business. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and a clear understanding of the challenges and the needs of neurodiverse people and their communities. All staff contributed to the development of the service and strategy.

Staff knew and understood the provider’s vision and values and how they were applied in the work of their team.

Staff told us they felt comfortable to raise concerns with their manager and that they would be listened to and that any concerns they raised would be addressed. Staff spoke positively about opportunities for professional development. There were development opportunities available for both qualified and unqualified staff.

Staff appraisals included conversations about career progression where relevant and how they could support staff development.

Staff were aware that they could access support for their own physical and emotional health needs through the provider’s medical insurance cover.

The service started as a talk therapy provider and expanded into neurodevelopmental assessments and support, to broaden it’s impact and support those in need.

The service strived to be neuro-affirmative and innovative, noting that an important part of the process was giving patients a chance to tell their stories (oral histories).

The service had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

Leadership development opportunities were available for staff, and staff we spoke with described their progression within the organisation.

There were weekly senior leadership team meetings. Senior management communicated with staff through townhall meetings each month, a quarterly (and ad hoc) staff newsletter, departmental newsletters, and company announcements. There were team away days, informal coffee drop-ins, and a national roadshow led by the CEO to connect with staff across different regions. The chief executive had held 4 meetups around the country so far in 2025, inviting staff within a 50-mile radius. Despite being voluntary, 35% of employees had so far attended.

Leaders made a point of ensuring staff received positive feedback daily, initiated by other staff members. They conducted a biannual culture survey and quarterly pulse survey for staff, and would arrange a senior leaders’ team drop-in meeting on demand from staff.

The service fostered a positive culture where people said they felt they could speak up and their voice would be heard. At the time of the inspection, staff did not report any cases of bullying or harassment and told us that they felt supported by their colleagues. Staff knew how to use the whistle blowing process and how to contact the freedom to speak up guardian.

Prior to the inspection, CQC was contacted by some staff members who had been unhappy with working conditions at the service. It appeared that many of the issues raised had been addressed by the time of the inspection.

The service valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who work for them. Policies and procedures to promote diversity and equality were in place.

Staff did not express any concerns about workforce equality, diversity and inclusion. However, in a recent staff survey staff expressed concerns about uncertainty within the NHS, organisational changes, and the wish for more whole company face to face meet ups. The organisation took steps to address these concerns and provided staff with regular updates on the NHS funding changes, and had been planning a whole company celebration event which happened shortly after the inspection.

In a recent staff survey, staff shared feedback on concerns about the evolving nature of the NHS, the potential for organisational changes and the wish for more whole company face to face meet ups.

A significant proportion of the staffing team had neurodiverse diagnoses. The organisation were using an external consultant to look at reasonable adjustments for staff.

The service had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

There was a clear framework for the discussion of important information such as learning from incidents, complaints, audits and alerts and staff met regularly at business team meetings to discuss these.

The provider had invested in an electronic quality management system to drive the
oversight of clinical and information governance. This reflected the growing business and ensured all staff had access to information needed to take forward continuous improvement.

Monthly business meetings were held for all staff, as well as periodic town hall meetings.

Committees included the business risk meeting (monthly), clinical effectiveness and safeguarding committee (fortnightly), and integrated governance and risk committee (monthly).

As a result of low staff morale and high staff turnover 4 months prior to the inspection, senior managers made changes to systems reducing team sizes from 12 to 8 per team.

Senior managers were aware of challenges to the organisation, such as uncertainty about Right to Choose within the NHS, changes as NHS England ceases to operate, the need for more dynamic relationships, better arrangements for shared care, and improving support post diagnosis, with or without a diagnosis.

The service had contingency plans in the event of incidents affecting the running of the service and kept a risk register of key risks to watch including financial pressures and recruitment from a decreasing pool of specialists, addressed through training some of their own staff.

Strengths of the service included a diverse and experienced staff group, care quality, measuring effectiveness, decreasing waits, safe titration, and provision of post-diagnostic support, good resources online and community links. There were clear contingency plans, auditable and trackable activities, and penetration testing. There was a high standard of training provided to staff, and improved staff support including online yoga, and mental health first aiders.

There were weekly staff newsletters for autism and ADHD. Quarterly board meetings were held, alongside monthly business review meetings, and webinars.

Managers met with staff regularly to complete supervision, appraisals and performance reviews. Staff could access all relevant policies and procedures. Staff took patient confidentiality and information security seriously.

The service understood their duty to collaborate and work in partnership with the NHS, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement. Staff at the service worked in partnership with local integrated care boards, and NHS trusts, GPs, interpreters, schools, prisons and children in secure accommodation. The service had agreed to work collaboratively on a research project with a UK university.

Staff, patients and carers had the opportunity to give feedback on the service, influencing its future direction.

The chief executive and clinical team regularly delivered neurodevelopmental awareness sessions to carer advisory groups and wider stakeholder audiences. Examples included providing educational talks to large workplace organisations, aimed at improving understanding of neurodiversity in professional settings. These sessions have helped employers better support neurodivergent individuals in the workplace and enhanced awareness of how to facilitate access to appropriate assessment and treatment services. This voluntary outreach reflected the service’s commitment to increasing community awareness, reducing stigma, and promoting inclusive practice beyond their direct clinical work.

The service focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, and outcomes for people. They actively contributed to safe, effective practice and research.

The services priorities included providing a more neurodiverse friendly pathway and building on the advantages of exploring a transdiagnostic approach. They were involved in codesigning elements of the service framework with practitioners and external experts with lived experience, including use of text-based content. The service had a research and development intranet site, and library resource.

The service had developed a research department alongside clinical pathway development and planned work with a UK university. Research included employing a PHD student to work to improve the spread of data, and work to improve this information for staff webinars.

The research included profiling patients as well as assessment, and support for patients up to 5 years after diagnosis, and the normalisation of neurodiversity within society. The service was also looking at developing dual pathways, and more complex work such as with patients with other conditions. The organisation has committed resources to research and development, actively encouraging engagement of all members of the business. 10% of clinicians contributed to the research and development steering group - a multidisciplinary forum. Outputs included: practitioner-authored content, a curated research library, regular expert panel discussions with clinical and academic researchers, and a dedicated intranet. This had allowed the organisation to build strong systems for learning and cross-functional collaboration. A talk on deafness for staff within the organisation was planned shortly after the inspection.

The service undertook regular internal reviews to support all new initiatives, including external review from an independent quality improvement organisation and internal audits of the service.

The service played a central role in establishing the Independent Health Providers Network for Neurodevelopmental Services. This provided a platform to engage with a broad range of stakeholders across the NHS and independent sectors, fostering open dialogue on challenges, shared concerns, and best practices in delivering neurodevelopmental care.