As the growth of technology continues to drive increased accessibility and an ‘on demand’ culture, questions for the NHS services and its ability to progress with advancing technologies are looming. Online GP consultations like those now provided by Babylon or Push Doctor are for the most of us, a natural progression. However, with this advance comes scepticism. Can an online consultation give safe and effective healthcare?
The recently published inspection report of Babylon’s online GP consultation services by the Care Quality Commission on 8 December 2017 examines five key areas: Is the service safe, effective, caring, responsive to people’s needs, and is it well led?
In three out of the five areas listed above: caring, responsive, and well-led, their service was found to be providing a good standard. Consultations can be requested in a range of languages, 24 hours of the day, seven days a week and video recordings of those consultations are available shortly after the call, allowing for transparent care. What’s not to like?
Certainly, reviews have suggested that users rate the service highly; out of 21,930 people who have used and reviewed the service, 18,323 rated it five out of five stars and 2,112 patients rated the service four out of five stars. The comments of the minority who rated the service three stars or below are analysed by Babylon and GPs are given feedback accordingly. Care seems to be accessible, and the supporting governance and organisational structure of the service seem clear to staff and to the CQC during an inspection.
However, when it came to the assessment of safe and effective practice, it did not meet the current standards. The limitations of the service surround the clarity of patient data and the restrictions of the provider. Health records of the patients were not always accessed and consultations were not always shared back with the primary physician. This meant that there was a strong ‘reliance on verbal information…instead of obtaining evidence such as blood test results’. Without the ability or desire to test patients before treatment, it meant that Babylon was providing a service where prescribing was not done on evidence-based practice and records were not checked to ensure that it was safe or appropriate.
Evidently, there are areas of this service that need improving to achieve safe treatment via the touch of a button. However, the newly established medium of online consultations is just that – new. Time will lead to further developments and with increased understanding and knowledge of what can go right, and what can go wrong, a refined and effective tool is just around the corner.
The inspection report can be found here: http://www.cqc.org.uk/sites/default/files/new_reports/AAAG6526.pdf