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Boots' independent prescribers help it to ace CQC inspection

Boots’ online consultation service – led by four pharmacist independent prescribers and a GP – has passed all of the Care Quality Commission’s (CQC) inspection criteria.

In March, the CQC announced a "programme of inspections" into digital healthcare providers in the UK, which it said would "prioritise those services it considers as potentially presenting a significant risk to patients".

The CQC confirmed to C+D in July that Boots’ online service was one of 39 providers to be inspected by the autumn.

In its latest inspection report, published last week (August 18), the CQC found that Boots is providing “safe, effective, caring, responsive and well-led services” (see summary of the CQC’s findings below).

According to the CQC, Boots’ digital offerings include an online consultation service and development of patient group directions for Boots pharmacists to use in-store.

The service is headed up by a medical director who is a registered GP – and four independent pharmacist prescribers, the CQC noted.

Independent prescribers’ online role

As part of the service, the pharmacist independent prescribers are responsible for reviewing online patient requests for treatment, before issuing a prescription if appropriate. Online consultations are held in a private room, the CQC said.

“Each [pharmacist independent] prescriber assessed patients’ needs and delivered care in line with relevant and current evidence-based guidance and standards,” the regulator concluded.

The CQC highlighted that Boots introduced an information leaflet in Mandarin after recognising an increase in the number of Chinese students registering for the HPV vaccination service.

It also flagged the company’s plans to introduce a system to “improve the patient verification process” and a new protocol “to manage an emergency during telephone [consultations] with patients”.

Two areas were highlighted where Boots “should” make improvements: reviewing the systems around patient identification, and improving identification of “significant events” to ensure all staff can learn from these.

Boots UK chief pharmacist Marc Donovan told C+D he was "pleased" with the CQC's findings.

"We continually review ways to improve, and as a result of the CQC’s revised assessment framework for digital providers, we are looking to implement additional systems to strengthen our service even further, which will allow us to continue to deliver safe, accessible and convenient services,” Mr Donovan added.


The CQC’s key findings from the inspection of Boots' online services

  • The service had clear systems to keep people safe and safeguarded from abuse
  • Prescribing was monitored to prevent any misuse of the service by patients and to ensure pharmacist independent prescribers were prescribing appropriately
  • The service learned and made improvements when things went wrong. Boots was aware of, and complied with, duty of candour requirements
  • Survey information reviewed by the CQC 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
  • The Boots staff who CQC inspectors spoke with were aware of the organisational ethos and philosophy, and said they felt well supported and that they could raise any concerns.

The areas where Boots 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.

Source: The Boots Company PLC inspection report, August 18, 2017

What do you make of the CQC's findings?

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