A GP practice in West Yorks is confused by the private online PushDoctor treatment of one of their patients, 999 Call for the NHS (Calderdale and Kirklees) has been told.
Push Doctor, a private online GP service that promises “fast, confidential, expert advice and treatment in minutes, on any device”, via £20 video consultations using their app or website, sent the patient’s GP practice a letter saying that they consulted with the patient and advised them to go to their nearest walk in centre for a face to face consultation because of suspected gastroenteritis. Apparently the patient didn’t do this and Push Doctor gave them a sick note.
The GP practice have no info about if or how Push Doctor examined the patient. They are seeking advice from their Local Medical Council about how to respond to online GP services when they advise patients to see a GP the same day, when they are not really sure how that decision was made and if they would make the same assessment.
In comparison with NHS111, which has some consistency in its advice to patients – although GPs might not agree with the “urgency” which it advises patients to see a GP, the online GP services have left GP practices in the dark about the basis of their advice to patients.
The Royal College of GPs tweeted recently that they are very concerned that 40% of private online GP providers have been deemed unsafe by the Care Quality Commission.
One of the ways in which the Care Quality Commission found that many private online GPs are unsafe was precisely:
“not collecting patient information or sharing information with a patient’s NHS GP, who should have an accurate and up to date record of their previous and current treatments and health problems”
The Care Quality Commission website says
“As of 28 February 2018, 43% of the providers CQC inspected were found not to be providing ‘safe’ care in accordance to the relevant regulations. This is an improvement from 86% not fully meeting these regulations on their first inspections. Specific concerns CQC had included:
inappropriate prescribing of antibiotics, including lowered thresholds for antibiotic prescribing as a physical examination was not possible, and prescribing high volumes of opioid-based medicines without talking to the patient’s registered GP
unsatisfactory approaches to safeguarding children and those who may not have the mental capacity to understand or consent to a consultation
not collecting patient information or sharing information with a patient’s NHS GP, who should have an accurate and up to date record of their previous and current treatments and health problems
inappropriate prescribing of medicines for long-term conditions, including failures to monitor the volume of asthma inhalers being prescribed to individuals when their condition should be regularly checked.”
The Care Quality Commission Report is downloadable here.
In 2016 Push Doctor raised $8.2 million via equity funds to develop the data side of its “offering”, to improve the way it integrates with other healthcare providers and to significantly bolster marketing.