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Health care: Using negative feedback to make a positive change

PUBLISHED: 08:30 11 November 2020

Feedback from the regulator combined with agile IT development allowed PrivateDoc to change the way it worked   Picture: PrivateDoc

Feedback from the regulator combined with agile IT development allowed PrivateDoc to change the way it worked Picture: PrivateDoc

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At some point, every business will be told it can improve. PrivateDoc proves that sometimes it can be the best way not only to raise standards but to exceed them.

PrivateDoc co-founder and managing director Paul Marshall   Picture: PrivateDocPrivateDoc co-founder and managing director Paul Marshall Picture: PrivateDoc

Working in a tightly regulated environment can present challenges, especially if the regulator hands down a critical report. That doesn’t have to be entirely negative, though: used correctly, responding to the feedback can transform a business.

When the Care Quality Commission gave a negative rating to online medical clinic PrivateDoc, the team chose to see that not as a problem but as 
an opportunity to refine and improve its systems, making them not only more robust but also more scaleable.

“Our aim is not to just meet the minimum standards required by the regulator but to go beyond and be truly market leading,” explains founder Paul Marshall. “To be given a poor rating based on about 1pc of transactions was unacceptable to us, but it helped us reassess our systems.”

PrivateDoc is not an online pharmacy but an online clinic offering a range of treatments for everything from weight loss and stopping smoking to erectile disfunction and hair loss. This means it is much more strictly regulated. As patients are assessed by doctors, they have access to a range of prescription medications – some of which are not available on the NHS.

Dr Alexandra Phelan, medical director of PrivateDoc   Picture: PrivateDocDr Alexandra Phelan, medical director of PrivateDoc Picture: PrivateDoc

“The PrivateDoc doctors are very proud of the fact that we’re all GPs and we approach this clinic as if it is normal practice,” says Dr Alexandra Phelan, medical director of PrivateDoc. “Even before Covid-19, GPs have been working more digitally and since the pandemic it has been the standard way of working.”

However, working at this higher level means PrivateDoc is subject to the same level of scrutiny from the CQC as any GP practice or care-giver.

“We want to be working at that level, to give patients the reassurance,” says Mr Marshall. “However, the CQC is astonishingly good at identifying inconsistencies. It didn’t matter that we were nailing our standard operating procedure for 99pc of cases – it was the 1pc of exceptions that were the issue.”

One area that had to be adjusted was the system of record keeping. “We took three steps: making staff more accountable; making the software more helpful; and then having quality improvement action (QIA) systems to monitor each record and ensure it gets to the right level,” says Mr Marshall.

“PrivateDoc has the advantage of having a sister company, Kwiboo, that is a dedicated IT business able to quickly produce the necessary programming to update the systems.”

As well as updating the record-keeping process to produce consistent, verifiable, date-stamped logs, PrivateDoc looked to enhance the system. It introduced a feature to allow key information to be pinned to the top of records, to help the doctors pick it up more quickly.

Another area to assess was the ID verification process, which initially was based on a three-step check using the industry-standard GBG Global ID database, the electoral role and the credit database. To develop an even more-robust system, PrivateDoc is introducing ground-breaking biometric checks.

“It’s very similar to the systems used in the automatic gates at airports,” Mr Marshall explains. “We can use a scanned document like a passport and compare that to the patient on the webcam.”

The system is even able to identify fake documents. It’s a radical approach to using tech to solve the problem.

Some of these innovations would not have come about if the CQC report had not flagged up areas that needed to be improved. Mr Marshall says PrivateDoc seized on the opportunity to “show how good we are”.

“Standards can’t be allowed to dwindle and the way we’ve embedded the new processes means they will keep going for every patient,” he concludes. Reacting to the feedback has allowed the business to not only satisfy the regulator but also create a solid platform for growth.

For more information about PrivateDoc, click here


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