We carried out an announced comprehensive inspection of DocTap on 19 and 20 June 2018 to ask the service the following key questions; Are services safe, effective, caring, responsive and well-led?

Our findings were:

Are services safe?

We found that this service was providing safe care in accordance with the relevant regulations.

Are services effective?

We found that this service was providing effective care in accordance with the relevant regulations.

Are services caring?

We found that this service was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found that this service was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found that this service was providing well-led care in accordance with the relevant regulations.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

This service has not been previously inspected.

DocTap Limited, established in July 2016, has its non-clinical, operational head office at 36 Woodstock Grove, London W12 8LE. The service provides face-to-face GP consultations from eight London clinics:

• DocTap Bond Street (John Bell & Croyden, 50-54 Wigmore Street, London W1V 2AU).
• DocTap Chancery Lane (330 High Holborn, London WC1V 7QD).
• DocTap Canary Wharf (1 Canada Square, Canary Wharf, London E14 5AB).
• DocTap Liverpool Street (63 Mary Axe, London EC3A 8NH).
• DocTap Monument (68 King William Street, London EC4N 7DZ).
• DocTap Victoria (83 Victoria Street, London SW1H 0HW).
• DocTap Kings Cross (Hamilton House, Mabledon Place, London WC1H 9BB).
• DocTap Goodge Street (48 Charlotte Street, London W1T 2NS).

We inspected the head office and the clinic at Liverpool Street on 19 June 2018 and the clinics at Victoria and Bond Street on 20 June 2018.

The service offers face-to-face GP appointments for children and adults. Services include blood tests, referrals and medical certificates. Appointments are available from 9am to 6pm, Monday to Sunday. A standard GP consultation is 15 minutes duration at a cost of £29 to £49 dependant on the day of the week, time of the appointment and whether the appointment was booked in advance or on the day.

Data for the 12-month period prior to our inspection showed that the service had seen approximately 11,000 patients at its eight current locations. The provider told us that data showed that 32% of patients reused the service.

The day-to-day running of the service at all locations was overseen by the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The registered manager is supported by a management team which consists of a clinical director, a managing director and an operations manager. In addition, the service employs two receptionists and a facilities manager. Clinical services were provided by 24 regular sessional GPs.

The provider is registered with the Care Quality Commission (CQC) for the regulated activities of Treatment of Disease, Disorder or Injury, Diagnostic & Screening Procedures and Maternity and Midwifery Services.

As part of our inspection, we asked for CQC comments cards to be completed by patients during the two weeks prior to our inspection for each clinical location. Fifty-seven comments cards were completed, 56 of which were positive about the service experienced. Patients commented that the service was excellent, professional and appointments ran to time. Patients said staff were friendly, caring and informative and they felt they were treated with dignity and respect.

The provider proactively sought patient feedback after each consultation on experience of the booking process, the GP consultation and the premises using a rating of one to five stars. Data for the period June 2017 to June 2018 showed that 1,212 patients had given feedback of which 93% had given a five-star rating of their experience with the booking process, 93% had given a five-star rating for their experience with the GP and 75% had given a five-star rating of their experience of the premises.

Our key findings were:

• There were systems in place to safeguard children and vulnerable adults from abuse and staff we spoke with knew how to identify and report safeguarding concerns. All staff had been trained to a level appropriate to their role.
• The service had systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the service learned from them and improved their processes.
• The practice carried out staff checks on recruitment, including checks of professional registration where relevant.
• Clinical staff we spoke with were aware of current evidence-based guidance and they had the skills, knowledge and experience to carry out their roles.
• There was evidence of quality improvement, including clinical audit.
• Consent procedures were in place and these were in line with legal requirements.
• Staff we spoke with were aware of their responsibility to respect people’s diversity and human rights.
• Systems were in place to protect personal information about patients. The service was registered with the Information Commissioner’s Office (ICO).
• Patients were able to access care and treatment from the clinic within an appropriate timescale for their needs.
• Information about services and how to complain was available.
• The service had proactively gathered feedback from patients.
• Governance arrangements were in place. There were clear responsibilities, roles and systems of accountability to support good governance and management.

There were areas where the provider could make improvements and should:

• Consider the arrangements in place for non-clinical staff who act as a chaperone to have the appropriate Disclosure and Barring Service (DBS) check in place which reflects their specific duties as a chaperone and the contact they have with patients, particularly children and vulnerable adults.
• Consider how patients with a hearing impairment would access the service.