Archived: Push Dr Main Office

Updated 22 June 2017

Push Doctor is an online service that patients can use to access a GP on line by using video calling seven days a week from 7am to 10pm. Each appointment lasts 10 minutes and according to the website costs £20. If a patient requires a prescription then this costs £7. There is also an option for subscription membership which costs £20 per month and includes appointments and prescriptions. Patients are able to use the service relating to any health issue they may have and if issued a prescription, this is issued to a pharmacy of the patient’s choice. Push Doctor carries out around 10,000 consultations a month.

Push Doctor employs a team of 72 GPs and has a large team of non-clinical staff made up of clerical staff and customer service staff.

A registered manager is in place. (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).

How we carried out this inspection

To get to the heart of people’s experiences of care, we always ask the following five questions of every service and provider:

• Is it safe?
• Is it effective?
• Is it caring?
• Is it responsive to people’s needs?
• Is it well-led?

Our inspection team was led by a CQC Lead Inspector. The team included one GP specialist adviser, a second CQC clinical advisor, a second CQC inspector, and a CQC pharmacist specialist.

Why we carried out this inspection

We inspected this service as part of our comprehensive inspection programme. We carried out a comprehensive inspection of this service under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. The inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service.

Updated 22 June 2017

Letter from the Chief Inspector of General Practice

Push Doctor is an online service that patients can use to access a GP appointment by using video calling seven days a week.

We carried out an announced comprehensive inspection at Push Doctor Limited on 1 March 2017. We found that the service was not providing safe, effective, or well-led services but was providing caring and responsive services.

Our key findings across all the areas we inspected were as follows:

• There were effective systems in place for recording, reporting and learning from significant events.
• The service did not have a process in place to ensure patient and medicine safety alerts were disseminated to staff.
• Systems were in place to protect personal information about patients. Both the company and individual GPs were registered with the Information Commissioner’s Office.
• Staff induction and training was comprehensive and effective. However staff had not had training on equality and diversity.
• The provider measured customer satisfaction by patient feedback and satisfaction surveys these demonstrated high levels of satisfaction.
• Information about how to complain was available on the provider’s website. Improvements were made to the quality of care as a result of analysis of patient comments and incidents.
• Staff were encouraged to become involved in making suggestions, but there were limited formal meetings. Staff were updated on information verbally and via email.
• There was a clear leadership structure. The service proactively sought feedback from staff and patients. Patient’s survey information showed that they were treated with compassion, dignity and respect and they were highly satisfied with the ease of access to the service.
• The provider was aware of the requirements of the duty of candour.

The areas where the provider must make improvements are:

• The service must have protocols in place that are followed to ensure the health and safety of service users.
• The service must assess the risks to the health and safety of service users and do all that is practicable to mitigate any such risk.
• The service must maintain an accurate and complete record of each service user.
• Ensure that all prescribing decisions are based on best clinical practice and GMC guidelines
• Ensure the service has an effective system in place for quality improvement.

The areas where the provider should make improvement are:

• Introduce structured documented meetings programme
• Introduce a training needs assessment and recording system
• To provide equality and diversity training for staff

We took urgent action to prevent the provider treating children without all the appropriate checks being made in relation to their identity by imposing a condition on their registration. The provider quickly responded and introduced new systems and protocols to mitigate risks to patients and we removed this condition. We have told the provider that additional improvements must be made. We will be checking that these improvements have been implemented.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice