Archived: iPrimary Care Head Office

Updated 18 September 2017

iPrimary Care Limited provides a range of internet based health and wellbeing services direct to patients in the form of online health consultations, health advice and the issuing of private prescriptions. Patients can book a consultation with doctors, physician associates (physician associates work under the direct supervision of a doctor and carry out many similar tasks, including patient examination, diagnosis and treatment), physiotherapists, dietitians, psychotherapists and fitness trainers. The provider offers these services to individuals or to businesses. Businesses can opt to provide their employees with an annual budget to use in a way that best suits their needs and the business.The majority of the provider’s clients are currently through corporate contracts.

Their website advertises a range of services relating to women’s health; men’s health; travel; mental health; general health; sexual health; diet and nutrition; physical fitness and children’s health. Patients can opt for a one off consultation or sign up to a monthly or annual plan. They do not have clinical premises where patients can visit.

GP consultations are generally available between 7am and 7pm Monday to Friday; and between 7am and 12pm on Saturday and Sunday. Services are provided to children however we were given assurances 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 by telephone.

At the time of this inspection the registered manager role was shared between two of the company founders, although they planned to change this to just one registered manager in the near future. 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.

Operational activities are managed and undertaken by the GP (who was also the medical director and one of the registered managers), a physician associate (the other registered manager) and a (non-clinical) chief executive officer.

How we inspected this service

Our inspection team was led by a CQC Lead Inspector accompanied by a GP specialist advisor and a member of the CQC medicines team.

Before visiting, we reviewed a range of information we hold about the service and pre inspection information provided by iPrimary Care Ltd.

During our visit we:

• Spoke with the three staff currently operating the GP consultation service.
• Reviewed organisational documents, such as policies and procedures and other documentation which the provider held in relation to the provision of services.
• Reviewed staff records.
• Reviewed a sample of patient consultation records.

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.

Why we inspected this service

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Updated 18 September 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at iPrimary Care Limited on 25 July 2017.

iPrimary Care Limited provides online medical services, including prescribing services, through its website www.valahealth.com. Patients can request a GP consultation for assessment, diagnosis and management of non-urgent primary health care problems. The provider’s stated aim is to focus on healthy lifestyle, wellness and prevention, not just acute management of illness or injury.

We found this service provided safe, effective, caring, responsive and well led services in accordance with the relevant regulations.

Our key findings were:

• The service had clear systems to keep people safe and safeguarded from abuse.
• There was a comprehensive system in place to check the patient’s identity.
• There were systems in place to mitigate safety risks including analysing and learning from significant events and safeguarding.
• There were appropriate recruitment checks in place for all staff.
• We found patients being prescribed a range of medicines and these had been assessed to ensure they were safe to provide through an online service.
• There were systems to ensure staff had the information they needed to deliver safe care and treatment to patients. Staff were aware of and kept up to date with National Institute for Health and Care Excellence (NICE) guidance and medical alerts.
• The service learned and made improvements when things went wrong. The provider was aware of and complied with the requirements of the Duty of Candour.
• Patients were treated in line with best practice guidance and appropriate medical records were maintained.
• The service had a programme of ongoing quality improvement activity.
• An induction programme was in place for GPs. Staff, including GPs, also had access to all policies online.
• The service shared information about treatment with the patient’s own GP if the patient gave consent.
• Survey information we reviewed showed that 13 of the 14 patients who responded said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints. There was a clear business strategy and plans in place.
• Staff we spoke with were aware of the organisational ethos and philosophy.
• There were clinical governance systems and processes in place to ensure the quality of service provision.
• The service encouraged and acted on feedback from both patients and staff.
• Systems were in place to protect personal information about patients.

We saw the following area of notable practice:

• The service followed up all patients post consultation/treatment via email, to ensure they had no concerns or had suffered any side effects.

The areas where the provider should make improvements are:

• Maintain a record of recruitment interviews.
• Have a system in place to automatically flag up potential multiple log-ins from the same patient.
• Review and simplify the process to recall archived notes.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice