Archived: iPrimaryCare Head Office

Updated 17 January 2020

iPrimary Care Limited provides online video based consultations which can include the issuing of private prescriptions. On the day of our inspection, the clinical team consisted of a male doctor and a female physician associate (physician associates work under the direct supervision of a doctor and carry out many similar tasks, including patient examination, diagnosis and treatment).

The physician associate was also the operations manager for the service and an outsourced IT team provided technical support.

The provider offers consultations to individuals or to businesses which can opt to provide their employees with an annual budget to use in a way that best suits their needs and the business. For example, the service currently provides bespoke medical advice to a company arranging overseas expeditions. The majority of iPrimary Care Limited’s patients are on individual contracts who can opt for a one off consultation or sign up to a monthly or annual plan. The provider does not have clinical premises where patients can visit.

Consultations are available between 7:00am and 7:00pm Monday to Friday and 7:00am to 12:00pm at weekends (subject to availability) but access via the website to request a consultation is available 24/7. Services are provided to children however we were told that any patients under the age of 18 years would need a parent or legal guardian to request a consultation and set up the user specific remote access. This access is then password protected to prevent unauthorised use. All initial GP consultations are carried out by video link, however subsequent consultations can be made by telephone. A protocol was in place to verify identity whereby patients presented their photographic ID to the camera.

How we inspected this service

Before the inspection we gathered and reviewed information from the provider. During this inspection we spoke to the Registered Manager and a member of the management team.

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.

iPrimary Care Limited is registered for the following Regulated Activities: Transport services, triage and medical advice provided remotely and Treatment of disease, disorder or injury.

Updated 17 January 2020

Letter from the Chief Inspector of General Practice

We rated this service as Good overall. This service was previously inspected in July 2017 under a different location registration (which has since been deregistered). We did not identify any breaches of regulation and at that time, the service was not rated. The full comprehensive report on the July 2017 inspection can be found by selecting the ‘all services’ link for iPrimary Care Head Office on our website at www.cqc.org.uk

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 iPrimaryCare Head Office on 20 November 2019, as part of our inspection programme.

The service provides medical consultations via video link, through its website www.valahealth.com. Patients can request a GP consultation for assessment, diagnosis and management of non-urgent primary health care problems. Where deemed clinically appropriate, consultations also include a prescribing service. iPrimary Care Head Office is a low volume service with a clinical team currently comprising a doctor and a non-prescribing physician associate (physician associates work under the direct supervision of a doctor and carry out many similar tasks, including patient examination, diagnosis and treatment).

At this inspection we found:

•The service had good 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 routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.

•Quality improvement activity (such as clinical and internal audit) supported the delivery of safe and patient centred care.

•The service had developed a bespoke protocol to ensure that staff involved and 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 was a strong focus on continuous learning and improvement at all levels of the organisation.

We saw one area of outstanding practice:

•The service had created a set of online, induction training videos for new clinicians and which aimed to provide detail and context to areas such as video consultations, online prescribing and managing online emergencies. Leaders spoke positively about how the videos were part of a range of activities aimed at strengthening clinical governance, in advance of a service upscaling programme.

The areas where the provider should make improvements are:

•Take action to ensure a written policy is in place regarding patients’ consent to share information.

•Take action to implement a prescription monitoring protocol, monitoring against any form of abuse such as excessive prescription requests.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care