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Online healthcare apps/websites still falling short on patient safety

Huge improvements made since last year, but 43% of independent sector providers not up to the mark, says regulator

Caroline White

Friday, 23 March 2018

Many companies that provide digital healthcare services for primary care, such as GP consultations and prescriptions through websites and apps, are still falling short on patient safety, says the healthcare regulator, the Care Quality Commission (CQC) in a report published today.

The report* presents findings from the CQC’s programme of inspections, since November 2016, of all primary health care services provided online by the independent sector in England.

Each company was assessed against five key areas: whether they are safe, caring, effective, responsive to people’s needs and well-led. CQC inspectors also wanted to know how the service ensures they know the identity of the patient and how the patient’s NHS GP is kept informed of any treatment.

Most (97%) providers were meeting the regulations around being ‘caring’ and around being ‘responsive’ to people’s needs (90%).

But 43% of providers were failing to provide ‘safe’ care, although this was an improvement on the first inspections when 86% were not fully compliant.

Specific concerns included:

  • 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
  • inappropriate prescribing of medicines for long-term conditions

“In the future, the delivery of healthcare online has the potential to play a major part in how healthcare is provided. We encourage innovation but it must never come at the expense of quality, said the CQC in a statement on its website.

“As with all healthcare services, patient safety must be at the heart of all decisions around what kind of care is offered and how it is delivered,” it added.

Professor Helen Stokes-Lampard, Chair of the Royal College of GPs, commented:

"It's absolutely right that the Care Quality Commission holds organisations that provide online primary care services to the same high standards as any other healthcare provider, to ensure that they are delivering safe, high-quality, and compassionate care for patients – and it's reassuring to see that a greater proportion are providing safe care than last year.”

But she added: "It's very concerning to see that even now, 43% of online consultation providers have been deemed unsafe in some respect. New services will inevitably experience some teething problems, but when our patients' health is at risk urgent, swift action must be taken to comprehensively address these before the service is rolled out further.

She singled out the inappropriate prescribing of antibiotics, which could have wider societal implications, and the failure to collect and share a patient's data with their NHS GP which could have a detrimental effect on future care.

"As a College we recognise the potential of online consultations to complement traditional GP services, and it's good to see some innovative schemes emerging, which are highlighted in this report – but all new technology should only be implemented on a wider scale if it is safe, effective, and leads to better outcomes for our patients, GPs, and the wider NHS,” she emphasised.

"It is now essential that lessons are learnt from this report to ensure patients are not put at risk and that they receive the high-quality care they need and deserve.”

* The state of care in independent online primary health services. Care Quality Commission, 2018

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