Archived: Vir Health Limited

Updated 7 April 2021

Background

Vir Health is a digital health service providing online and telephone consultations on a specified range of health conditions. It is a service aimed at adults; all patients must be over 18 years of age. The service is mainly aimed at men’s health addressing conditions affecting their self-esteem, confidence and lifestyle. The conditions treated are erectile dysfunction, hair loss and premature ejaculation with a combination of medical and non-medical products, supported by informational content that educates men around these issues. Other conditions treated are acid reflux and asthma as well as smoking cessation treatment which are available to both men and women.

People sign up for the service through the provider website, they complete online questionnaires which are reviewed by pharmacist independent prescribers with the support of the chief medical officer and the lead GP. Prescriptions are dispensed by a partner pharmacy and delivered to patients. Patients can also purchase blood test kits which are sent to an independent laboratory for screening. GP consultations following a blood test are provided to patients by a third party.

There are 12 pharmacist independent prescribers with clinical oversight provided by a lead GP and the chief medical officer. There is a management and administration team and a customer services team.

The provider is registered with the CQC to carry out the following Regulated Activities: Transport services, triage and medical advice provided remotely and treatment of disease, disorder or injury.

Vir Health Limited has a registered manager in place. 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.

How we inspected this service

Before the inspection we gathered and reviewed information from the provider. During this inspection we spoke to the registered manager, chief medical officer, lead GP, two pharmacist independent prescribers and members of the management and administration team.

We also reviewed remotely specific documentation including policies and audits. (In light of the current Covid-19, CQC has looked at ways to fulfil our regulatory obligations, respond to risk and reduce the burden placed on practices by minimising the time inspection teams spend on site. In order to seek assurances around potential risks to patients, we are currently piloting a process of remote working as far as practicable. This provider consented to take part in this pilot and some of the evidence in the report was gathered without entering the practice premises).

To get to the heart of patients’ experiences of care and treatment, we ask the following five questions:

• Is it safe?
• Is it effective?
• Is it caring?
• Is it responsive to people’s needs?
• Is it well-led?

These questions therefore formed the framework for the areas we looked at during the inspection.

Updated 7 April 2021

Letter from the Chief Inspector of General Practice

We rated this service as Good overall.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an announced comprehensive at Vir Health Limited on 15 & 17 March 2021 as part of our inspection programme and to provide a quality rating.

Vir Health Limited is a digital health service providing online consultations on a specified range of health conditions. It is a service aimed at adults; all patients must be over 18 years of age. It operates through the following website: www.numan.com

At this inspection we found:

• The service had good systems to manage risk so that safety incidents were less likely to happen. When they did happen, the service learned from them and improved their processes.
• The service routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence-based guidelines.
• Staff involved and treated people with compassion, kindness, dignity and respect.
• Patients could access care and treatment from the service within an appropriate timescale for their needs.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider should make improvements are:

• Improve the information available to patients before they request unlicensed medicines and ensure they acknowledge that they have seen and understood the information
• Improve the website to ensure that medicines without a product licence are described as unlicensed medicines, not as ‘off-label’ medicines which are licensed medicines used outside the terms of their product licence.
• Improve the information collected from patients with asthma to ensure that they limit the number of treatments prescribed prior to an annual review from a clinician trained in asthma management.
• Improve the sign-up process for the service to ensure patients are clear about the associated costs of prescriptions and that they are only prescribing the number of prescriptions they require.
• Improve the process of recording changes which patients have made in their responses to the questionnaires, so that clinicians can take that into account when deciding whether to prescribe.
• Improve the complaints process to include signposting to an arbitration complaints process.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care