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CQC seeking legal advice over online GP providers evading inspection

The CQC has sought legal advice in a bid to expand its inspection remit to include a number of online GP providers which are currently slipping through the net.

The CQC said some independent providers have ‘removed themselves’ from the scope of inspections by basing their legal operations overseas or using non-medics to prescribe medication.

The CQC said it has also voiced its concerns to the Department of Health and Social Care, which is looking into regulatory oversight generally.

CQC board papers, published today, said: ‘[W]e have sought further advice from external legal counsel on our interpretation of the aspects of the regulations that impact on our ability to regulate online primary care effectively.’

They said this comes as ‘a number of providers are currently out of CQC’s scope or have removed themselves from our scope by employing non-medical prescribing practitioners, for example pharmacist prescribers’.

‘Providers can also operate outside our remit by either using EEA prescribing doctors or subcontracting the regulated activities to a company with an address outside England,’ they added.

It comes as CQC has previously found that nearly half of online prescribers which it did inspect were unsafe.

The report, published earlier this year, found  43% of online prescribing providers were prescribing high volumes of antibiotics, inhalers and opioids without talking to patients’ registered GPs.

In today’s board papers, the CQC said its concerns ‘primarily relate to our approach to the geographical location of providers or those carrying on the regulated activity as well as the regulation of “apps” where they are an integral part of the patient pathway in primary care’.

The CQC added that it will ‘need to further consider whether we wish to extend our interpretation of the regulations and the potential impact on our scope if we do so’.

BMA GP Committee contract and regulation policy lead Dr Robert Morley told Pulse: ‘Whilst there remain very considerable reservations over the entire fitness for purpose and benefits of CQC’s processes for regulating general practice, the fact that digital providers can escape any regulation by using company addresses outside of the country is of enormous concern, so anything which addresses this is to be welcomed.’

BMA GPC chair Dr Richard Vautrey added that the GPC ‘do have serious concerns about the safety of some services, especially when It comes to prescribing’.

He said: ‘It is therefore imperative that, as technology develops and offers new ways of accessing primary care, digital providers are scrutinized and held to the same high standards as any other GP practice. Technology and innovation has much to offer general practice, but this cannot come at the expense of patient safety.’

CQC deputy chief inspector of general practice Ruth Rankine said the CQC expects ‘these services to provide the same quality of care that we would expect to see in a traditional health and care setting’.

She added: ‘We are working closely with the Department of Health and Social Care in respect of the regulations as well as other relevant bodies in the interests of ensuring patient safety and that any regulatory gaps are addressed.’