Working for online healthcare providers - BMA guidance

On 11th January 2018 the BMA published guidance for GPs who are thinking about working for an online provider. With patients increasingly wanting access to medical services in a safe, timely and convenient manner combined with the advancement of technology there are numerous online providers of healthcare emerging - including NHS pilots - it is essential that GPs who offer technology enabled care deliver it in a safe and ethical way - as would equally be expected with conventional face-to-face consulting.

As Lantum is a technology based platform, it also provides the opportunity for the GP community to connect to online healthcare providers for remote video consultations and artificial intelligence consultations. We wanted to share a summary of recommendations from the BMA regarding this:

The guidance suggests researching an online GP providers values and aims; understanding their target audiences which can help you as a GP’s awareness of the type of consultations you may encounter. These may include online video consultations, telephone advice and facilitating the booking of face-to-face consultations. Some online providers enable patients to be assessed by NHS and private services so understanding their protocol systems is advisable. Furthermore certain demographics of patients may be only provided as they may be for adults and exclude children. Reviewing useful sources of information about the online provider from the Care Quality Commission (CQC) can help to understand the services they provide, highlight any concerns you may be unaware of

GPs providing NHS care must be on the national performers list. While this is not required if you work exclusively in private practice, some online providers may still insist on this. BMA reminds that if you do not provide any NHS primary care for more than two years, you will be removed from the national performers list.

Working for an online provider still requires GPs to keep up to date with appraisals and revalidation; in particular if your primary role is with an online provider it is mandatory to have a Responsible Officer and ensuring that there is ample opportunity for appraisals to be carried out. This includes having provisions to undertake multi source feedback and quality improvement activities for example. Along with support for appraisals, it is worth ensuring you are happy with day-to-day support that the organisation offers. Examples include debriefing after difficult consultations with peers, provisions to explore significant events and CPD opportunities.

Insurance or indemnity may be included and provided for you as part of the role. However it is important to clarify specific points regarding this - enquiring with whom the cover is with and the level of cover. Further guidance is available about this but cover should ideally be occurrence based rather than claims based and if not sufficient run off cover should be included to protect against future claims. Contacting your own indemnity organisation about the work being carried out is also advisable.

Prior to starting, a full induction should be provided along with an understanding of what your role entails. Particular attention should be paid to IT systems and support networks available especially if working out of hours if problems arise. Exploring possible complications such as running out of time or if a patient needs to be seen face-to-face and how this can be arranged.

Regarding clinical consultations, understanding the level of access to medical records will be helpful and also highly relevant from an indemnity aspect. The BMA believes that it is important for one doctor, usually the patient’s GP, to have a complete record of the individual’s healthcare. If not, being satisfied that sufficient provisions are in place about processes and systems is advisable. This also is relevant to specific policies and procedures including safeguarding, prescribing, data protection and clinical governance. Finally, being aware of what systems are in place when concerns are raised regarding clinical and non clinical care is important.

Lantum is primarily an online platform enabling sessional GPs to connect with practices and filter work via availability, location and rate. Building professional relationships with practices, hubs and federations is one of Lantum’s core values and there are no restrictive clauses for GPs who utilise the technology. Lantum reduces administrative workload saving GPs valuable time through electronic invoicing and newly designed NHS e-pensions forms which are automatically populated and signed.

Lantum has developed some guidance around the use of specific online providers. If you are interested in doing online consultations and wish to find sessions or have any queries please contact anna@lantum.com  

Authors: Dr Hiren Chauhan, Growth Partner and Dr Ishani Patel, Co-founder

Useful resources:

BMA https://www.bma.org.uk/

https://www.bma.org.uk/connecting-doctors/the_practice/b/weblog/posts/indemnity-your-questions-answered

GP Online https://www.gponline.com/online-consultations-medical-indemnity/article/1454334