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GPs raise complaints about 'inappropriate prescribing' by leading online provider

A group of GPs in Wales have raised concerns about the private online GP provider Push Doctor after seeing examples of 'poor prescribing'.

Bro Taf LMC, which represents GPs in the wider Cardiff area, said a number of its members had brought the issue to their attention, with 'inappropriate prescribing of antibiotics' mentioned as a 'common theme'. 

GPs said the issue was also increasing their workload, as they were having to call patients in for review after they had used the service.

Push Doctor said no problems had been raised with them, that they apply the 'same or higher standards for prescribing' as the NHS, and that the CQC report identified no concern in this area.

The provider charges £20 per 10-minute appointment and promises access to an ‘NHS-trained’ GP in six minutes.

It recently told Pulse that it is seeking ways to provide NHS services and had approached GPs in Birmingham about the plans.

In its May newsletter, Bro Taf LMC asked GPs to come forward to report incidents involving Push Doctor via the incident reporting system as well as forwarding to the LMC any examples they may have.

The newsletter said: 'Concerns were raised regarding the behaviour of the online prescribing service Push Doctor.

'LMC members had witnessed examples of poor prescribing, along with an increased workload due to the requirement to recall some patients for review after using this service. It was agreed that any incidents regarding Push Doctor should be reported using the incident reporting system.

'Practices are asked to forward to the LMC any examples/concerns regarding Push Doctor for further investigation.'

LMC chair Dr Steve Davies told Pulse: ‘The complaints seemed to be around prescribing on the limit of what is appropriate, or sometimes past it. There were common themes one of which was antibiotics’.'

Dr Davies had seen one patient who had been prescribed antibiotics by Push Doctor for an inner ear infection but when he came to see him a week later because it was not improving it turned out to be an outer ear problem that should be treated differently.

‘How you can make an assessment without seeing the patient I don’t know,’ he said.

‘The point we made was that if you see prescribing that is beyond reasonable you have a duty to report it to the company or maybe even the GMC.’

Dr Davies added: ‘In out of hours they now have access to the clinical record because it is so much safer. If you have got someone who is only taking a history and the patient might not tell them the truth, that is worrying.’

A spokesperson for Push Doctor said no concerns had been raised with them directly.

‘No problems have been raised with us, no evidence provided, and we are confident that our robust procedures and monitoring ensure that our doctors consistently apply the same or higher standards for prescribing when they are working for us or the NHS.

‘Our previously published CQC report identified no concern in this area yet regardless, as a nationally important issue we continuously strive to use the power of digital to improve antimicrobial stewardship working in partnership with the regulator and academic bodies.’

A CQC report into the safety of online GP providers earlier this year found many were prescribing high volumes of antibiotics, inhalers and opioids without talking to patients’ registered GPs.

Some 43% of online prescribers were deemed 'unsafe', the CQC said. Pulse also revealed that the GMC was investigating 30 doctors, including 19 GPs, in cases connecting to online prescribing.

Readers' comments (11)

  • I have seen a patient being diagnosed as having orchitis without examination and being prescribed prolonged courses of antibiotics when they were not required. Poor service

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  • Is this the future!Sad

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  • The doctor takes the risk, the company makes the profit. Don't touch it with a barge pole folks.

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  • Pish doctor.

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  • Vinci Ho

    (1) Utilitarianism
    (2) Slippery slope : changes in quantity will ultimately lead to changes in quality. More becomes better .
    (3) Quality is too ambiguous and expensive. Same money can buy more quantities, otherwise.

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  • Vinci Ho

    Populism enhanced by technology. Aren’t we seeing enough?

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  • DrDec1

    I would love to see the clinical and prescribing notes from the practices in question - telephone consultations, patient 'requests'for medication, perhaps indications for their prescribing with difficult patients. "Let he, who is without sin, cast the first stone..."

    Our learned colleagues are confusing a likely one off "duff" consultation from an individual clinician with their distain of a system.

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  • oh because no on eover prescribes abx elsewhere. ive just seen a patient who has had 2 courses of antibiotics and prednisolone without being seen just on phone. Really there is nothing new with these online providers just teleconsult but at least can see patient and upload HI res photos. theres a risk like in any clinical practice and ew would all prefer to see all patients without duress but I think theres a bit of a witch hunt going on here.

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  • It’s like out of hours but slightly less risky because there’s a video as well as a digital voice connection.

    Risk is therefore somewhere between ooh and routine in hours face to face.

    Do indemnity costs reflect this?

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  • I am afraid, whether we like it or not, this is the way to go and many of our patients are very happy to be treated and dealt with in a more contemporary format. I can see why people may have concerns but we also have significant variability of quality resulting from face to face consultations. Video adds a little more safety over and above telephone consults and the provider can ensure via their procedures and policies that risk is being reduced further.

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