This is a brief alert to readers that the CQC has publicised its initial recommendations from its review of the use of digital triage services.

The CQC defines digital triage tools as software that tells a patient what to do or where to go next in their care pathway. It can be software that:

• supports clinicians to make decisions
• supports non-clinical staff to interact with patients
• people interact with themselves

This is an important area requiring regulatory clarification as it sits at the interface between medical devices regulated by the MHRA and medical services regulated by the CQC…and patients are increasingly being impacted by it.

Key findings are:

• care providers and local systems need better guidance and support from national bodies when they commission technology suppliers and set up contracts – a standard test of the effectiveness of triage algorithms would help providers and systems choose the best products
• digital triage tools should help people to get care in the right place at the right time, and should not prevent this – clinicians should be able to override the recommendations from these tools when they think it is in a person’s best interest
• people need to understand the difference between a digital triage tool that checks their symptoms and one that directs them to a regulated healthcare service – they also need clearer guidance on how to use them.
• there is a need to understand how safeguarding can work when people are using digital interfaces instead of humans
• technology suppliers that don’t need to register with CQC should meet all other relevant regulatory requirements when developing clinical pathways for triage tools – this area has limited assurance or regulation, reinstating the accreditation scheme from NICE or something similar would help
• the insight and data from digital triage tools provide an excellent opportunity to improve care – there is a need to work collectively to understand how best to do this

The full report is here.

This is the first use by the CQC of the “regulatory sandbox” approach: a way of testing how best to regulate new types of services by working collaboratively to find out about them. As someone who was briefly engaged in the process, this Editor considers it to be potentially an extremely impressive way of coming up with practical regulations, and avoiding unworkable proposals.

The next step will be to develop the detailed proposals based on the above.