Pharmacy2U Limited

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Pharmacy2u Limited on 14 February 2017. Pharmacy2u Limited has been established since 1999. The company operates an online clinic for patients providing consultations, prescriptions and medicines. Pharmacy2u Limited contracts GPs on the GMC GP register to work remotely in undertaking patient consultations when they apply for medicines on-line. GPs have the opportunity to ask for additional information not supplied on the patient’s application should they require it.

We found this service provided caring, and responsive services but not safe, effective or well led services in accordance with the relevant regulations.

Our key findings across all the areas we inspected were as follows:

• There were systems in place for recording and learning from significant events or clinical alerts and a form for reporting significant events was in place. No significant events had been recorded to date.
• Systems were in place to protect personal information about patients. Both the company and individual GPs were registered with the Information Commissioner’s Office.
• Staff induction and training was comprehensive and effective. 
• The service managed patients’ applications for medicines in a timely way.
• The provider used an external service (Trustpilot) to measure customer satisfaction; it was rated as 8.9 out of 10 at the time of the inspection based on over 20,000 reviews. Other customer satisfaction surveys were conducted by the provider which demonstrated high levels of satisfaction. Patient survey information showed that they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available on the provider’s website. Improvements were made to the quality of care as a result of complaints.
• There was an ethos of continuous improvement and innovation. Staff were encouraged to become involved in making suggestions and attended a number of structured meetings.
• There was a clear leadership structure. The service proactively sought feedback from staff and patients.
• The provider was aware of the requirements of the duty of candour.

The areas where the provider must make improvements are:

• Ensure capacity and consent policies make reference to the Mental Capacity Act (MCA) 2005 and clarify staff responsibilities in relation to this. 
• Update medical questionnaires in order to capture all potential relevant information and ensure all are based on current best practice guidance.
• Ensure there is focus on quality improvement and system of audit.
• Ensure medical emergencies procedures and protocols are effective.
• Maintain contracted GPs’ training records.
• Ensure contracted GPs are assessed and appraised for their work within Pharmacy2u Limited.
• Ensure recruitment processes for non-clinical staff include medical fitness declarations.
• Ensure there is an effective patient identification process.

The areas where the provider should make improvement are:

• Update the safeguarding policy to include details of how to escalate concerns to relevant local authorities.
• Strengthen the advice provided to patients around account security.

We have asked the provider to take action and report on what they have done in order to meet the regulations.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice