• CQC GP inspections will cover the safe use of triage apps
  • Change in regulator’s stance follows legal advice 
  • Comes as NHS England says all patients now have access to digital triage services

The Care Quality Commission will inspect the safe use of triage apps in the NHS after receiving legal advice.

The regulator published new guidelines late last month about how providers, particularly GPs, can assure inspectors they are using these digital tools safely. This will include proving they have sought assurances from the supplier that the app was “safe and effective”.

Triage apps are designed to allow patients to self-report symptoms to a piece of software, often in the form of a text conversation, and receive advice on the next best course of action, such as booking a GP appointment or attending an emergency department.

Their use is increasingly common in the NHS. Last year, NHS England ordered all clinical commissioning groups to deploy NHS 111 Online, essentially a triage app, ahead of this winter. According to the NHS long-term plan, “100 per cent of the population” now have access to NHS 111 Online.

The CQC has previously said it was not responsible for regulating the use of triage apps, or other medical software, and referred any concerns raised by the public to the Medicines and Healthcare Products Regulatory Agency.

For instance, HSJ reported in June last year that the CQC had received complaints about the safety of Babylon Healthcare’s triage app and had passed this onto MHRA.

In a blog post late last month, CQC chief inspector of general practice Steve Field revealed the regulator had altered its position following legal advice received in September last year.

Triage apps would now be classified as an “ancillary activity” and the CQC would regulate how providers used them to provide care, like other medical technology. The regulation of the safety of medical software itself would remain with MHRA.

Responding to questions from HSJ, CQC deputy chief inspector of general practice, Ruth Rankine, said: “Where we see new technology becoming linked with direct patient care, the way people access services is changing. As new systems develop, we need to make sure that people are still able to access the appropriate, high-quality care that they deserve.

“As a regulator, it is important that we continually adapt our approach so that regulation takes account of the different ways that care is delivered to people, and our reports provide a clear picture of the care that people can expect.”

Concerns have been raised by both the industry and within government about regulatory oversight of medical software, as the NHS increasingly uses digital tools to deliver health services.

In September, the government said it would introduce a new “trusted approval” scheme for digital technology. Further details of the scheme will be included in a tech code of conduct, expected to be published early this year.

Update: This article was updated at 13:30 on 12 February to correct a spelling mistake