In the CQC March 2018 update, Professor Steve Field shared findings from recent inspections of online GP/primary care services. Online GP services increase access as well as patients’ control over how and when they consult a GP. While these innovative ways of providing services have real potential for patients and for the wider healthcare system their format and the way in which they are delivered should not compromise the quality of care in any way. Online services have been encouraged to add to and strengthen the existing primary care landscape – not provide a second-rate or lower quality product with poorer, riskier outputs.
As with traditional GP/primary care services, patient safety has to be central whatever the type of care or the method of service delivery.
To this end, the CQC is remaining committed to working with the Department of Health and Social Care and its partners abroad to close the gaps in the regulation of online services outside the CQC’s remit in order to prevent people in England being exposed to poor, unsafe care.
The provision and continued development of online health services are recognised as important for the future of health provision. However, based on the findings from the most recent programme of provider inspections, there is still a way to go before there is evidence from inspection findings to show they are consistently delivering the quality required for all patients using online services to receive safe, high quality, accessible and responsive care.
What the CQC found from its inspections of online services as of 28th February 2018:
- 97% of the providers were meeting the regulations around being ‘caring’.
- 90% of the providers were meeting the regulations around being ‘responsive’ to people’s needs.
- Online consultations can improve access and convenience for patients with physical or sensory impairments, those who live in rural areas or have transport difficulties.
- Safety findings caused the greatest concerns but where the greatest improvements are being observed.
- 43% of the providers inspected were found not to be providing ‘safe’ care compared with 86% not fully meeting these regulations on their first inspections, specific concerns being:
- Inappropriate prescribing of antibiotics – lowered thresholds for antibiotic prescribing as a physical examination was not possible;
- Prescribing high volumes of opioid-based medicines without talking to the patient’s registered GP;
- Unsatisfactory approaches to safeguarding children and those who may not have the mental capacity to understand or consent to a consultation;
- Not collecting patient information or sharing information with a patient’s NHS GP; and
- Inappropriate prescribing of medicines for long-term conditions.
Evidently for the CQC there have been substantial improvements in safety findings at inspection and it will continue to share all good practice it finds in order to help other providers in need of ideas and guidance that will improve their quality of service.
In January 2018, the Department of Health and Social Care confirmed it will consolidate the CQC’s approach to inspecting and rating online services with how it regulates physical general practices and other services. Therefore, the CQC is progressing its plans to rate the quality and safety of online services in England in the same way as physical general practice services are rated – based on inspection findings – by giving them the same ratings of outstanding, good, requires improvement or inadequate.
This extension of the general practice rating system to online GP/primary care services is expected to commence in April 2019.