Doctor Now Limited T/A (trading as) Doctor Now and The Beaconsfield Clinic

Updated 30 June 2023

Doctor Now Limited T/A (trading as) Doctor Now and The Beaconsfield Clinic provides regulated activities from the following location:

• Little Hall Barn, Windsor End, Beaconsfield HP9 2JW

Details of the service can be found on their website – https://doctornow.org/

The service is open with appointments available:

• Monday to Friday 8:30am to 8pm and Saturdays 9:00am to 4pm.

The service was registered with CQC in March 2020 to provide the following regulated activities;

• Surgical procedures;
• Diagnostic and screening procedures;
• Treatment of disease, disorder and injury;
• Transport services, triage and medical advice provided remotely;
• Family planning.

The service operates from a purposefully converted period property.

The service offers a membership scheme or a pay-as-you-go option. The membership is limited to 2,600 patients and there are different membership types which determine the services a member can access. One-off consultations can be accessed on a pay-as-you-go basis.

The service provides blood tests and pathology, ear syringing and microsuction, paediatrics, care of long term conditions and monitoring of chronic disease, musculo-skeletal medicine, gynaecological services, obstetrics, travel health and vaccinations, referrals to specialist services, medicals and screenings, family planning and minor surgery.

The independent GP service is provided by 8 GPs, 2 practice nurses and 2 healthcare assistants. The service is supported by subcontracted GPs and consultants, a leadership team, senior management team and an administrative support team including medical secretaries, quality assurance and patient services.

How we inspected this service

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site. This was with consent from the service and in line with all data protection and information governance requirements.

This included:

• Requesting evidence from the service in advance.
• Conducting staff interviews with a variety of clinical and non-clinical staff both virtually before the site and in person during the site visit.
• A site visit to review a sample of patient records and consultations and an interview with the clinical lead.
• A review documentation related to the management of the service.
• We reviewed patient feedback provided to the service by patients.
• We reviewed staff feedback provided directly to CQC.

To get to the heart of patients’ experiences of care and treatment, we always 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 30 June 2023

This service is rated 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 carried out an announced comprehensive inspection at Doctor Now Limited T/A (trading as) Doctor Now and The Beaconsfield Clinic as part of our inspection programme.

Doctor Now Limited T/A (trading as) Doctor Now and The Beaconsfield Clinic registered with CQC on 27 April 2020 under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. There are some general exemptions from regulation by CQC which relate to particular types of service, and these are set out in Schedule 1 and Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Some services at Doctor Now Limited T/A (trading as) Doctor Now and The Beaconsfield Clinic are provided to patients under agreements with their employer or an insurance provider with whom the patient holds an insurance policy (other than a standard health insurance policy. These types of arrangements are exempt by law from CQC regulation and therefore, we were only able to inspect the services that fall within our scope. The majority of the services provided by Doctor Now Limited T/A (trading as) Doctor Now and The Beaconsfield Clinic are regulated by CQC.

Doctor Now Limited T/A (trading as) Doctor Now and The Beaconsfield Clinic provides independent, non-NHS GP services to fee-paying patients at their clinic or at the patient’s home. Appointments are also offered via video consultations.

The registered manager for the service is Dr Brian McGirr who is 1 of the service’s medical directors. 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.

Our key findings were:

• Care and treatment was provided in a safe way.
• The service reviewed the effectiveness and appropriateness of the care provided and there was evidence of quality improvement activity.
• The service had systems and processes in place to ensure that patients were treated with compassion, dignity and respect and they were involved in decisions about their care and treatment.
• Patients were able to access care and treatment within an appropriate timescale for their needs.
• The service had 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 had systems in place to collect, analyse and action feedback from patients and staff.
• Staff had the relevant skills, knowledge and experience to deliver the care and treatment offered by the service.
• There was a clear leadership structure to support good governance and management.
• Staff were proud to work for the service.

The areas where the provider should make improvements are:

• Continue to update and maintain staff records to evidence staff immunisations in line with national guidance.
• Embed the process to ensure cleaning schedules are checked.
• Risk assess and check patients receiving Kenalog to see if the requirements for a steroid card have been met.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services