The controversial digital-first service was inspected by the CQC in January. In a report published this week it was found to be ‘good’ in the safe, caring, responsive and well-led categories, but rated ‘requires improvement’ for effectiveness.
Ratings awarded for the service offered to different age groups within the practice's overall registered list show that GP at Hand scored ‘requires improvement’ for 'working age people, including students and those recently retired' - a cohort that accounts for 98.5% of its 51,596-strong patient list.
The CQC report comes two months after some of the UK’s top GPs raised alarm over the watchdog’s failure to report on the fast-growing video consultation service, warning that all providers must operate on a level playing field to ensure patient safety.
GP at Hand was previously inspected by the CQC in November 2017 and rated ‘good’, but the then-brand new digital element of the service - which offers video consultations with a GP to out-of-area patients via an app - was not included in the regulator’s assessment.
Although updated guidelines mean that the CQC is now able to take into account digital tools and ask how practices assure themselves that apps such as GP at Hand’s are 'functioning as intended', the latest report states that the ‘symptom checker software’ remains outside the CQC's remit.
‘The symptom checker does not triage patients, it is an optional tool that provides health information, rather than a prerequisite for accessing online GP consultations,’ the report reads. ‘The symptom checker software is regulated as a class one medical device and registered with the Medicines and Healthcare Regulatory Agency (MHRA).’
In their assessment, inspectors wrote that GP at Hand ‘provided care in a way that kept patients safe and protected them from avoidable harm,’ adding that the practice ‘had clear systems to manage risk so that safety incidents were less likely to happen.’
They added: ‘The practice demonstrated that the smartphone app used to support online consultations conformed to the requirements of NHS digital standard DCB0160 (a mandatory UK safety standard describing a set of assurance activities for healthcare organisations to manage clinical risk in the health IT systems they implement).’
Notes published alongside the report read: ‘The practice was focused on providing convenient high-quality healthcare available to all by combining the best of a traditional GP service with the best of modern technology.’
The report also notes that ‘staff treated patients with kindness, respect and compassion’, and ‘feedback from patients was positive about the way staff treated people’.
Patients said that the appointment system for booking online consultations was ‘easy to use’ and reported being able to ‘access care when they needed it’. However, some patients said they had experienced delays with face-to-face appointments.
Uptake of cervical screening by GP at Hand patients and its performance on delivery of childhood immunisations were both found to be significantly below national target levels, while the practice’s uptake for all cancer indicators - including screening for cervical, breast and and bowel cancers - was below CCG and national averages - prompting ‘requires improvement’ ratings for the working age and families, children and young people population groups.
Overall, the watchdog said it found ‘no breaches in regulations’ and said that ‘there was evidence of a strong focus on continuous learning and improvement at all levels of the organisation’.
Dr Matt Noble, medical director of UK clinical services at Babylon, said: ‘Every GP practice will know the rigour and scrutiny that comes with a CQC inspection, so we are very pleased to have been rated as "good", that they recognised just how quickly people can get an appointment and how satisfied our patients and staff are.
‘We have transformed how people can see a GP and this is independent confirmation that we are doing so safely in a caring and responsive manner. We are focused on building a GP practice that delivers care in a way that works for patients and we are working with the NHS to make this digital-first service available for everyone who wants it.’
A separate report commissioned by Hammersmith and Fulham CCG to evaluate the impact of GP at Hand on patients, the primary care workforce and the wider healthcare system is currently 'being finalised' after its publication was pushed back for a third time.