Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Boots Company PLC on 23 June 2017. The Boots Company PLC provides an online primary care consultation service and medicines ordering service. Patients register for the service on the provider’s website.

We found this service provided safe, effective, caring, and responsive and well led services in accordance with the relevant regulations.

Our key findings were:

• The service had clear systems to keep people safe and safeguarded from abuse.

• Patient identity checks were limited; other than via a credit/debit card check. The provider could not be sure they were consulting with the person who owned the card.

• There were systems in place to mitigate safety risks including analysing and learning from significant events and safeguarding.

• There were appropriate recruitment checks in place for all staff.

• Prescribing was monitored to prevent any misuse of the service by patients and to ensure pharmacist independent prescribers were prescribing appropriately.

• There were systems to ensure staff had the information they needed to deliver safe care and treatment to patients.
• The service learned and made improvements when things went wrong. The provider was aware of and complied with the requirements of the Duty of Candour.
• Patients were treated in line with best practice guidance and appropriate medical records were maintained.
• The service had a programme of ongoing quality improvement activity.
• An induction programme was in place for all staff who also had access to all the provider policies.
• The service shared information about treatment with the patient’s own GP in line with General Medical Council guidance.
• Survey information we reviewed showed that patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Information about services and how to complain was available.
• Improvements were made to the quality of care as a result of feedback and complaints. There was a clear business strategy and plans in place.
• Staff we spoke with were aware of the organisational ethos and philosophy and told us they felt well supported and that they could raise any concerns.
• There were clinical governance systems and processes in place to ensure the quality of service provision.
• The service encouraged and acted on feedback from both patients and staff.
• Systems were in place to protect personal information about patients. The company was registered with the Information Commissioner’s Office.

The areas where the provider should make improvements are:

• Review systems for identity checking to ensure patients are safeguarded from abuse and harm and to minimise the risk of potential fraud.

• Improve identification of significant events to ensure appropriate action is undertaken and learning is shared with all staff.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Patients who had used the online prescription service told us they were happy with the information provided online and that the service was, "Brilliant". They told us they were given enough information before they needed to give their consent for their order and for the medication to be prescribed.

We found that appropriate information was taken from patients as an initial assessment to determine if the medication could be prescribed and if it was appropriate for that patient.

We spoke with two patients who had used the online prescription service. They told us they were happy with the information provided online. One patient said, “The information was very good and comprehensive.” They were pleased with the service they had received. One patient said, “Very, very good. No complaints.” They were both happy that they could provide feedback to the service if appropriate.

We found that patients were treated with dignity and respect and received care that met their needs. Patients were safe and staff received induction, training and appraisal. We also found that the provider took steps to assess the quality of the service being provided.