Archived: Privategp.com Ltd (Private General Practice Services)

This service is rated as Requires improvement overall. (The service was rated as inadequate at our previous inspection in October 2021)

The key questions are rated as:

Are services safe? – Inadequate

Are services effective? – Requires improvement

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Requires improvement

We carried out an announced comprehensive inspection at PrivateGP.com Ltd on 22 June 2022. This was to review the improvements that had been made since the provider was placed in special measures following our inspection in October 2021.

The Care Quality Commission (CQC) inspected the provider in October 2021, and the service was rated as inadequate in the key questions of safe, effective and well-led and therefore received an overall inadequate rating. Three warning notices and a requirement notice were issued. We returned to the provider in November and December 2021 to review compliance with the three warning notices and we found that the service was mostly compliant with these, however some workstreams were ongoing and we therefore issued two further requirement notices. In addition, we placed conditions on the provider’s CQC registration to ensure that standards of record keeping were improved. We asked the provider to make improvements regarding the breaches in regulations, and to comply with the conditions that were imposed. We checked these areas as part of this comprehensive inspection in June 2022 and found that whilst significant improvements had been made, there were still some issues which needed further attention to achieve regulatory compliance. Previous inspection report can be found on our website at www.cqc.org.uk.

This service is registered with CQC under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. There are some general exemptions from regulation by CQC which relate to particular types of service and these are set out in Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Therefore, at PrivateGP.com Ltd, we were only able to inspect the services which fall under the scope of CQC registration and the regulated activities.

The lead GP, who is also the Chief Executive Officer (CEO) and Medical Director, is the registered manager. 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.

Our key findings were:

• We found that there had been significant improvements to ensure compliance with our regulations since the previous inspection. However, some areas required further attention and work was ongoing to ensure that continued and sustainable improvements were achieved.
• We found concerns relating to the provision of safe care and treatment. This included the lack of a robust approach to safeguarding vulnerable patients; the need to ensure patient records were fully accurate and that key information was readily available; letters in patient records received from other health care professionals that had been filed without follow up actions being completed; and the need to embed a process to ensure that all significant events were identified and used as a learning experience to improve the service.
• We found concerns relating to the provision of effective services. This included the need to develop a more established programme of quality improvement and clinical audit to demonstrate the efficacy of patient outcomes.
• We found that the service was caring and compassionate with patients and we observed a range of positive comments received from patients.
• We found that the service was responsive and flexible to patients’ needs.
• We found that the service did not have sufficient governance or assurance processes in place. This had improved since our previous inspection, but some issues required more attention, including a more comprehensive oversight of the work undertaken by contracted professionals, and strengthening of systems to support good governance such as learning from complaints and significant events.

The areas where the provider must make improvements as they are in breach of regulations are:

• Ensure care and treatment is provided in a safe way to patients.
• 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).

The areas where the provider should make improvements are:

• Only supply unlicensed medicines against valid special clinical needs of an individual patient where there is no suitable licensed medicine available.
• The infection control lead should undertake additional training to support their role.

This service was placed in special measures in November 2021. Insufficient improvements have been made such that there remains a rating of inadequate for providing safe services. Therefore we are taking action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. The service will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within six months, and if there is not enough improvement we will move to close the service by adopting our proposal to vary the provider’s registration to remove this location or cancel the provider’s registration.

Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care