• CQC report finds GP video consultation app Push Doctor is not well led, safe or effective
  • GP inappropriately prescribed modafinil over the app to help a patient stay awake for work
  • Company says the regulator’s report contains inaccuracies
  • CQC is inspecting 39 digital providers for the first time

The Care Quality Commission has uncovered unsafe prescribing practises at another digital health provider, including a doctor prescribing sleeping disorder drug to keep a person awake for work.

A CQC report on Push Doctor, a private GP video consultation app with some NHS business, said the service was not providing safe, effective or well led service.

Company founder Eren Ozagir said the report had a “large number of factual inaccuracies, which we are working on with the CQC currently to correct”.

Push Doctor is primarily a private paid subscription service but had been running a trial for free NHS access with Woodlands Practice in Greater Manchester since 2014. It has also designed a specific “Push NHS” version to sell to NHS commissioners.

It is one of 39 digital providers facing CQC scrutiny for the first time.

Digital health providers are growing part of the private health market but are also viewed by NHS leaders as potential tool for relieving pressure on the public system.

Push Doctor competitor Babylon Health, which passed a similar CQC inspection last year, has already been picked by NHS England to trial a new NHS 111 app with clinical commissioning groups in north London.

However, in March the CQC warned that early inspections showed some of these services were not providing safe care. Since then, several other digital provider inspections have been published raising serious failings in care, mostly around verifying patient identity and health when prescribing medicines.

Inspections into these services are ongoing.

The CQC’s report on Push Doctor raised concerns about GPs prescribing drugs from the company’s “do not prescribe” list, including strong sedatives and painkillers.

Inspectors uncovered 137 instances in the past 12 months where a “do not prescribe” drug was prescribed. Push Doctor was found to have had an “ineffective system” for identifying and acting on these errors.

In one instance, a patient was prescribed modafinil, normally used to manage narcolepsy, to help them stay awake for work.

On several occasions, GPs were prescribing high risk drugs, such as blood thinners or mental health medication, without ensuring the patients were being monitored or had received the appropriate blood tests, the report said.

Push Doctor also had no specific safeguards in place for treating and prescribing children, including properly verifying their identity. The company has since introduced this service.

The CQC said there was little evidence of “quality improvement activity”. Push Doctor responded that it was planning to hire a GP to monitor quality.

Mr Ozagir said the CQC criteria against which Push Doctor was assessed were “completely new” and not shared with the company before the inspection. Changes were made within 24 hours to address some of CQC’s concerns, he said.

He added: “We will continue to work closely with the CQC to ensure our service continues to meet the necessary guidelines.”