Letter from the Chief Inspector of General Practice
We rated this service as Requires improvement overall. (Previous inspection August 2018, when we found the provider was meeting the relevant standards).
The key questions are rated as:
Are services safe? – Requires improvement
Are services effective? – Requires improvement
Are services caring? – Good
Are services responsive? – Good
Are services well-led? – Good
We carried out an announced comprehensive inspection at Alto House on 2 May 2019, as part of our inspection programme,
Alto House (Polypill) is an online health programme for the prevention of cardiovascular disease, aimed at patients aged 50 and above. The programme combines the prescribing of medicines with the provision of lifestyle advice. Patients initially complete a free online assessment, and if suitable for the programme patients can then order a prescription for the medicines, which are sent to Polypill’s designated pharmacy who dispatch them to the patient’s address. When patients require a further supply of medicines they complete another online questionnaire before a repeat prescription is issued.
At this inspection we found:
- The service did not have sufficient safeguards in place to ensure all patients and applicants to join the programme were aged 18 or older.
- The service had a limited system to confirm patients’ identities when registering with and contacting the service.
- Not all patients consented to information sharing with their NHS GPs to avoid any risks associated with interactions of the medicines it prescribed with other medicines prescribed
- There was a lack of completed, two-cycle, audits together with limited evidence of other quality improvement activities, to demonstrate the medicines being prescribed were effective in preventing in the conditions for which they were prescribed.
- The service collected and monitored information on patients’ care and treatment outcomes.
- Staff involved and treated people with compassion, kindness, dignity and respect.
- Patients could access care and treatment from the service within an appropriate timescale for their needs.
- There were policies and IT systems in place to protect the storage and use of all patient information.
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.
(Please see the specific details on action required at the end of this report).
The areas where the provider should make improvements are:
- Consider how to make clear to patients that not all medicines being prescribed were licensed for use as preventative of the conditions for which the service was prescribing them.
- Consider requiring a signature for receipt of medicines posted to patients to ensure medicines are delivered to the correct recipient.
- Consider requiring all clinical staff to receive an appropriate level of child safeguarding training to level three.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care