Channel 4 News ran a story this week on Dr Helen Webberley, a GP in North Wales who runs a private clinic for trans-gender patients. Interestingly, no patients were seen sitting physically in her surgery during the report, instead, she consulted via Skype. Dr Webberley set up her Gender Identity Clinic (GIC) – which is fully compliant with UK laws – because transgender patients in Wales were travelling as far as London to receive treatment and waiting years for help, following an explosion in referrals to GICs in recent years. The NHS is fully supportive of GPs moving more towards online GP services. Since April 2016, all GPs provide patients with online access to their medical records. Ordering repeat prescriptions and booking appointments can also be done via the internet. News of online success keeps growing. PushDoctor, the UK ‘on-demand’ service that enables patients to have a video consultation with a doctor, raised $8.2 million in funding in January this year. The organisation plans to use the money to develop the data side of its offering to improve the way it integrates with other healthcare providers and to significantly bolster marketing.

You don’t need me to tell you GP services are strained. However, the British public are fiercely loyal to the NHS and continue to be positive about its service. The majority of people (85.2%) rate their overall experience of their GP surgery as good, with more than two in five (43.1%) rating their experience as ‘very good’, according to the 2015/16 GP Patient Survey. Trust and confidence in their GP was expressed by nine out of ten patients.

But is this situation sustainable? Medical advancements now keep people alive for longer – but the human body still breaks down with age. The survival rate for those diagnosed with cancer has doubled in the last 40 years, but a person alive in the UK today has a one in two chance of being diagnosed with the disease. Even with a healthier, more active elderly population than ever before, an aging society places enormous strain on health services; and GPs are at the forefront of the battlefield.

Telemedicine offers a solution. As seen in the case of PushDoctor, this technology offers the ability to video call a GMC-registered UK General Practitioner (GP) for a consultation ranging from 10 minutes to 30 minutes. The aim is to get you ‘seen’ within 3 minutes of requesting a doctor and does this via a network of 7,000 or so partner GPs.

Consumers are becoming much more accustomed to on-demand services that can be conjured up via their mobile phone, whilst the need to see a doctor face-to-face is often inconvenient or simply isn’t possible immediately due to limited capacity (at my surgery, all but emergency appointments are gone by 8.30am).

Patients embracing telemedicine providers such as PushDoctor range from pregnant women wanting quick answers to niggling questions and those with ‘embarrassing’ conditions such as erectile dysfunction, to busy professionals. The latter group is an important sector, as this demographic often don’t seek help early on when a condition presents itself due to time constraints. This is especially true for mental health matters. However, if they have a health app such as MeeDoc which allows people to Skype a local doctor through their phone, they are more likely to seek help earlier.

Anyone setting up an online GP clinic or joining an organisation such as PushDoctor or Healthcare Express must be registered with the UK General Medical Council.

Independent healthcare providers in England can be private or voluntary organisations that are not part of the NHS, although their services may be contracted by the NHS. In addition to monitoring the NHS, the Chief Inspector of Hospitals based at Care Quality Commission is responsible for overseeing the regulation of independent healthcare services that deliver secondary and tertiary care.

The fact that online healthcare is in its nascent stages means that regulatory requirements are still evolving — regulation relating to apps is dictated at a European level under the Medical Devices Directive, 93/42/EEC, the primary source of legislation governing health apps across the European member states. This has recently come under scrutiny owing to the lack of guidance available and obscurity within the wording of the legislation itself. The present uncertainty surrounding regulation has been highlighted by the NHS, which is currently working with the US Food and Drug Administration on a bilateral framework for regulations on mobile health apps.

Doctors delivering services through online clinics may also face concerns from both the public and their peers surrounding ethical issues. Dr Helen Webberley has faced harsh criticism for prescribing sex-change hormones to children as young as twelve. And many in the medical profession believe that online appointments cannot replace a face-to-face visit with a GP.

Setting up an online clinic requires expert legal advice. You will need guidance on both regulatory compliance issues and general commercial and IT law matters such as:

• software licences and agreements
• data protection and confidentiality
• e-commerce
• outsourcing IT services

Online GP services are providing new, exciting opportunities for both healthcare providers and patients.

Are you ready to embrace them?

Saracens Solicitors is a multi-service law firm based in London’s West End. We have a dedicated and highly experienced healthcare law team who can advise on all legal matters relating to the online GP services. For more information, please call our office on 020 3588 3500.