Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Children’s e-Hospital on 26 February 2019 as part of our inspection programme.

The Children’s e-Hospital is a digital service which provides advice, care and treatment to parents of children aged 0 to 18 years who have a paediatric medical condition. The service is accessible via the service website and video consultations are undertaken.    

The registered manager is Dr Baljinder (Tim) Ubhi. A registered manager is a person who is registered with the Care Quality Commission (CQC) 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 2088 and associated Regulations about how the service is run. 

Our findings in relation to the key questions were as follows: 

Are services safe?

We found that this service was providing safe care in accordance with the relevant regulations.

Specifically:

• Arrangements were in place to safeguard people, including arrangements to check patient identity.
• Prescribing was in line with national guidance.
• Risks were assessed and action taken to mitigate any risks identified.

Are services effective?

We found that this service was providing effective care in accordance with the relevant regulations. Specifically:

• Patients were assessed in line with guidance. Treatment plans were individualised and developed using protocols.
• Following patient consultations, information was appropriately shared with the patient’s own GP in line with guidance.
• Information was available for parents to support the health and wellbeing of their child.

Are services caring?

We found that this service was providing caring services in accordance with the relevant regulations. Specifically:

• Feedback from service users was extremely positive about the service and care they received.
• Parents were involved in decisions about their child’s care and treatment.

Are services responsive?

We found that this service was providing responsive care in accordance with the relevant regulations. Specifically:

• The service had been established in recognition of a need for parental support with children who may be experiencing symptoms indicative of PANDAS (Paediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus) or PANS (Paediatric Autoimmune Neuropsychiatric Syndrome).
• Consent was obtained appropriately.

Are services well-led?

We found that this service was providing well-led care in accordance with the relevant regulations. Specifically:

• The service had clear leadership and governance structures
• Patient information was held securely.

We saw an area of notable practice:

• The clinician provided unique specialist support to parents of children who experienced PANDAS and PANS, who had found difficulty in obtaining a diagnosis and accessing appropriate care and support for their child.

Dr Rosie Benneyworth

BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care