23 September 2019
During a routine inspection
Letter from the Chief Inspector of General Practice
At our previous inspection on 5, 6 March 2018, we found, in addition to providing a service for patients through the provider website, www.e-med.co.uk; the provider was also providing consultations, private healthcare referrals and prescriptions for five external companies; ‘Health Express Healthcare’; ‘Menscare UK Ltd’; ‘Pharmacy Direct GB’; ‘Healthwise’; and ‘Uk-med’. On 8 March 2018 the provider was issued an urgent Notice of Decision under Section 31 of the Health and Social Care Act 2008, to impose conditions on their registration as a service provider as we found the provider was not providing a safe, effective, caring, responsive and well led service for patients.
We imposed the following urgent conditions on the registration of e-med Private Medical Services Ltd:
- The registered provider must not provide online doctor consultations or prescribe any medicine or medicinal product that contains a medicine, for service users for any companies or websites other than www.e-med.co.uk.
- The registered provider must not prescribe to any service user any medicine, or medicinal product that contains a medicine, other than Naltrexone.
We carried out an announced comprehensive inspection at e-med Private Medical Services Ltd on 1 November 2018 to follow up on breaches of regulations. Where we found the provider was following the urgent conditions. We found the provider was providing a safe, effective, caring, responsive and well-led service in accordance with the relevant regulations.
We carried out an announced comprehensive inspection at e-med Private Medical Services Ltd as part of our programme to rate independent digital services on the 23 September 2019.
At the time of our inspection the service only offered the prescribing of Low Dose Naltrexone (LDN) to patients. (LDN, which is used as a regulator of the immune system, providing relief to patients with autoimmune diseases, and central nervous system disorders). The service provided regular treatment to approximately 116 patients.
This report outlines our findings in relation to the service with the above two urgent conditions imposed:
The overall rating for the service is Requires Improvement
The key questions are rated as:
Are services safe? – Requires improvement
Are services effective? – Requires improvement
Are services caring? – Good
Are services responsive? – Good
Are services well-led? – Requires improvement
At this inspection we found:
- The service did not always provide patients with information that was appropriate for their condition or easily understood when they prescribed medicines.
- The staff had not completed training to ensure they were competent for their role. The service did not have a failsafe system in place regarding the co-ordination with the patient’s GP.
- The provider did not ensure patient and public had up to date information to help them make an informed decision about their care.
- The provider did not have systems in place to ensure the policies and procedures were updated in response to changes. The providers website did not accurately reflect the services provided.
- Suitable numbers of staff were employed and appropriately recruited.
- Quality improvement activity, including clinical audit, took place.
The areas where the provider must make improvements as they are in breach of regulations are:
- Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
(Please see the specific details on action required at the end of this report).
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care