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Volume: 5 Issue: 4
(April 2018)

Keywords:
cqc report online primary health services shows progress uks care quality commission (‘cqc published report state care independent

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England

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CQC report on online primary health services shows progress

The UK’s Care Quality Commission (‘CQC’) published a report on ‘The state of care in independent online primary health services’ on 23 March 2018, which presents the findings from a programme of inspections carried out by the CQC into online primary health services in England and which puts forward a set of next steps for improving online care. The CQC states in the report that it has learned a lot about the strengths and limitations of primary health care provided online and it accepts that the “advancement in technology has outpaced the evolution of the regulations.”

Since November 2016, the CQC has inspected every company in England that provides online primary care services, assessing them against five areas: whether they are safe, caring, effective, responsive to people’s needs and well led. The CQC’s report on these inspections, which includes a partial series of re-inspections in early 2018, finds that although there are contextual differences between services delivered remotely and in person, the fundamentals of good clinical practice apply and that overall 97% of the providers were meeting the regulations around being ‘caring’ and 90% of the providers were meeting the regulations around being ‘responsive’ to patient needs.

“The CQC ran a formal inspection of all such providers during 2017 and clarified the terms on which they inspect and assess. It was remarkable to see this exercise taking place and being completed within a matter of months by an organisation which has a high workload and limited resources - this demonstrates the level of concerns and perceived risk,” said Louise Fullwood, Legal Director at Pinsent Masons LLP. Safety is the area in which the CQC found the greatest concerns but is also the area in which the greatest improvements were made. The concerns identified include: inappropriate prescribing of antibiotics and 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.

“The report illustrates some of the teething problems in the inspection system, particularly when applied to online healthcare,” said Brian Kelly and Raj Gathani of Covington & Burling LLP. “For example, the report concludes that last year a majority of registered online primary care providers delivered ‘unsafe’ and/or ‘ineffective’ services. This approach seems a little unsophisticated and does not do enough to distinguish genuine, high quality operators who are dealing with a developing regulatory landscape from less rigorous providers. This should be put into the context of the number of unregulated services available on the web and the risk that patients turn to those instead. That said, the report points to improved compliance by a number of providers by early 2018.”

The CQC report concludes that technological innovation is crucial to ensuring that health and social care services are sustainable in the future and acknowledges the importance of its role as regulator in supporting innovation and allowing providers to implement innovative ways of improving care.

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