• HSJ analysis shows significant improvement in safety of digital providers
  • Safety concerns still raised about two providers working in the NHS at their last published CQC inspection 
  • Outstanding concerns focus on inappropriate prescriptions

Digital health providers have drastically improved their quality of care a year after the Care Quality Commission deemed nearly half not safe, an HSJ analysis shows.

Of the 37 digital health providers currently registered with the CQC, 25 were deemed to be providing safe care at their last inspection. This included 11 providers that were previously deemed not to be providing a safe service.

The providers all offered some form of remote GP consultation, either via text or video, and prescribing services, in some cases linked to an online pharmacy.

The results mark a significant improvement since March last year when the CQC published its first review of the sector. Of the 35 providers registered and inspected then, 16 were found to be not providing safe services to patients. Areas of concern at the time were inappropriate prescribing, including high volumes of opiates, not sharing information with patients’ regular GP and unsatisfactory safeguarding for child patients.

But despite improvements, an HSJ review of CQC reports shows that six providers were still found to be not safe, or not safe in some areas, at their last published inspection. Those providers include two – Push Doctor and Babylon Healthcare – that hold NHS contracts.

Push Doctor has both a private video GP consultation service and an NHS contract with Modality GP partnership, which covers 400,000 patients in the West Midlands. The CQC’s last published inspection in August 2018 found some improvement but said that overall Push Doctor was still not providing a safe service.

This included the overprescribing of antibiotics, with less than one in five scripts issued in line with best practice.

Responding to HSJ, Push Doctor chief executive Wais Shaifta said the report acknowledged “our continued and significant improvements”.

Mr Shaifta added: “The report confirmed a well-led service and one taking great strides to protect patients, while also remaining at the forefront of innovation. The appointment of a new chief medical officer last summer also further strengthened our clinical governance arrangements.”

Babylon Health provides a private video consultation service but also has several NHS contracts. These include effectively running an NHS GP practice, known as Babylon GP at Hand, in London.

The last published inspection of the company’s private service, not GP at Hand, was published in December 2017 and found Babylon Health was not providing safe care in “some areas”.

Specifically, the report found that in 12 cases of prescribing checked by inspectors, a Babylon GP had not adhered to the company’s own policy around checking a patient’s identity.

GPs had also prescribed medication outside “of their licensed indications”, the CQC said.

A CQC spokesman said Babylon had since been reinspected and a new report would be published “in due course”.

Responding to HSJ, a Babylon spokesman said: “The December 2017 CQC inspection report was of Babylon’s private services and the inspection took place before GP at Hand existed. The CQC has stated that the Babylon report was in ‘the top quartile of most favourable reports carried out by the CQC’.

“We are working closely with the CQC as they develop a regulatory model that ensures high-quality care from all providers, whether digital-first or not, and which supports innovation.”

Other providers that were found to be either not safe or not safe in some areas included Escripts Marketing Limited, HR-Healthcare Limited, Anytime Medical Limited and VideoDoc Ltd.

When contacted by HSJ, Escripts said it was no longer providing online consultation services and had asked to be deregistered.

Four of the 37 registered digital providers have yet to be inspected by the CQC, including Livi, which holds several contracts to provide NHS services.

Ruth Rankine, CQC deputy chief inspector of general practice and lead for online services said: “Delivering primary care online has an important place in the future of healthcare provision and it is really encouraging to see providers engage with CQC, reflect on the findings of our inspections and improve the care that they offer to people.”