Online Health Care Business Consultant Report

1. Introduction
   

Khan's Obesity and Skin Online Clinic (KOSOC) is a collaboration of committed dermatologists and obesity specialists working online to provide low-cost and effective health care only for users in United Kingdom (UK). The objectives of this collaboration are to provide awareness and give treatment of Obesity and Dermatosis, which are two very common diseases in our society. Internet is the most accessible and easy to use service for everyone. Moreover people do not have time to visit doctors to discuss their health conditions. The specialists at KOSOC want to use internet to bring medical consultants closer to their customers, which will be 50% cheaper than the traditional general practitioner. Furthermore, the conventional time consuming process for getting an appointment and waiting in a queue for the turn, no more remains.
This is an instant service where patients have to log in and fill a medical form about their symptoms and get instant reply from the doctors with required prescription. They can order medicines from the same website. This service will not and should not replace your general practitioner but it is instant access which brings doctors closer to patients. Some of the medical conditions require face to face meetings where this service fails. However there are many others medical conditions, such as obesity and dermatosis which can be safer to prescribe remotely.

Services and Products are divided in to these two ranges. There are online obesity control programmes which will guide customers how to use health diet plan, which will differ from individual to individual .On the other hand, our skin clinic have many product for skin toning, anti ageing and specific skin diseases. This website will also supply skin and obesity related medicines which will be delivered by post.

1. Choosing a company name for registration
   

As the board of governors has already decided the company's name as Khan's Obesity and Skin Online Clinic, it is recommended to register the same name so that clinic must have legal grounds for 'identity fraud'. According to Companies Act 2006 (Commencement No. 6 and Commencement nos. 3 and 5 (Amendment)) Order 2008, there are several regulations applied when choosing a company name. Act states that company name must end with the prescribed statutory indicator such as "limited", "public limited company" or "community interest company" etc. The name must not be used by already existing company or shouldn't be offensive .Some names require the approval of the Secretary of State if they suggest any connection with the Her Majesty's Government or local government (Companies House, a, no date). The name of the company which sounds similar with any other but have different spellings will be accepted. However, we should avoid the name which is misleading to the public or used as trademark by another company. It is recommended that before choosing the name of the company we must search the name from companies' House website www.companieshouse.gov.uk as well as from UK Intellectual Property Office www.ipo.gov.uk/cna so that any legal action of passing-off will not happen. Even if the companies' house does not raise any objection to the company name this does not give you defence from trade mark infringement or passing off claim.

Keeping in view all these regulations, the company's name Khan's Obesity and Skin Online Clinic private limited is the most appropriate, according to all the clauses on the Companies Act. This
name is coined after researching according to the above mentioned procedure.

1. Process of registering the company's name
   

Under the UK Companies Act 2006, any business organization must register with the Registrar of Companies at Companies House, located in their respective regions (England, Wales, Scotland, and Northern Ireland). To establish a company, we have to file an application accompanying following documents to UK Companies Act 2006 (Companies House, b, no date)

• Memorandum of association which must be authenticated by each subscriber,
  
• Application for registration must contain the company proposed name; it must state that the company is limited by share or by guarantee and the company is private or public. If the company is limited by share, then it requires a statement of capital and initial share holding or in case of limited by guarantee, a statement of guarantee is required. Application must contain the name and address of person who is the first director or directors of the company. The application also contains name of the first secretary (or joint secretaries) of the company
  
• Statement of compliance
  

All these forms are available at companies' house website as Form 10 and Form 12. We need to attach Memorandum of Association and Articles of Association also. Furthermore Form 12 must be signed in the presence of the Solicitor, Commissioner for Oaths, and Notary Public.

 

With the reference to above Act, fill Form 10 with our company name is Khan's Obesity and Skin Online Clinic private limited and address of the company office 171 Colin Crescent Colindale NW9 6ET, name and address of the agent if the documents of company registration are submitted by the agent such as solicitor etc and Name, Address, Date of birth, Nationality of the first Secretary and Directors. This form must be signed by all the members in the memorandum of association.

The form 12 is an announcement of agreement with the UK Companies Act 2006 which must be signed by the members in the memorandum of association in the presence of Solicitor, Commissioner for Oath, Notary Public.

The standard fee of registration is £20 and will require about 8 to 10 working days for processing, if the application is complete and no objection is raised by the company house. Furthermore if urgent registration is required in one day, then urgent fee of £50 has to pay.

The companies' house will register the company name and provide a Certificate of incorporation which state that company with mention name has been created according to the Companies Act. It is compulsory that company must compile annual returns and update all the accounts. Private limited must have at least one director as it is in our case.

1. License
   

According to Medical Act 1983, all medical practitioners must register to General Medical Council (GMC), but before16 November 2009 the doctors need to register for new license called 'The License to Practice'.
This license requires medical practitioners to demonstrate the best practices defined by the GMC in the Medical Act. All those doctors already register with GMC must reregister themselves and fee of The License to Practice is £410

 

1. License for Pharmacy
   

Under the Medicines (Registration of Pharmacies) Regulations Medical pharmacy must register with Health Sciences Authority and must display the Certificate of Registration of a Pharmacy. But in case of online pharmacy, Royal Pharmaceutical Society of Great Britain has recommended the code of ethics (Royal Pharmaceutical Society of Great Britain, 2004) which states that every online pharmacy must display name and address of pharmacy at which they are conducting business. Royal Pharmaceutical Society of Great Britain also introduces a logo containing registration number, which must be displayed on their website. It shows that they are registered to the Royal Pharmaceutical society and have lenience to see medicines. This logo can be obtained this logo by filling am online application form and paying annual fee is £50 each, after assessing your application Royal Pharmaceutical Society of Great Britain will issue html code for the logo which is used in website and green online pharmacy logo must be visible all the time on the website (Royal Pharmaceutical Society of Great Britain, 2004)

 

1. Intellectual property
   
   1. Trade mark
      

After registration with Companies House it is strongly recommended that this company must apply for a trade mark. According to Community Design Regulation (council regulation (EC) 6/2002) every trading or service provider company should also consider their trade mark registered before trading and providing any services so that customer can recognise the product and service of a particular trade. It is strongly recommended that KOSOC should register its trademark so that it should have strong legal grounds against trademark infringement according to Trade Mark Act (1994). This also helps trading standards officers or police to bring criminal charges against counterfeits that use your trademark. This does not mean that only registered trademark can be protected under the Law, (Clarke, 2005) trademark can also be protected without registering by using TM with your trademark. You can also take action against the unregistered trade under the Passing off Law, Trade Mark Act (1994).

Trademark under Trade Mark Act 1994 is defined as any sign which distinguishes the goods or services of one trade from another. Customers can recognize the product and service of a particular trade. Trade mark can be a word, logo, slogan, three dimensional shapes etc. Internationally trade mark is divided in to 45 classes and the most likely classes regarding medical clinic are 01-2, 05-2, 09-2, 10-1, and 44-5. Any one can search these classes from intellectual property office website http://www.ipo.gov.uk/types/tm/t-os/t-find-class.htm

It is also recommended that the KOSOC should register its trademark in the region in which services is being provided. In KOSOC's case, it should only be in UK because each country has its own trademark registry which is only valid in that particular area. Before applying for trade mark, it is necessary to carry out a research for similar trademarks to avoid the conflict with pre-existing national right. Even in case of a website, which is globally accessible, but KOSOC will only provide service in the UK. So search should be carried out in UK trademarks, European Community trade marks (CTMs), or International trademark's database if needed. We can search it from the private website which contains database of all the UK companies' trademarks and domain name, for e.g. http://www.anewbusiness.co.uk/trade_marks/search.php.

Before applying for trademark, KOSOC needs to create a distinctive word, logo, picture or other sign otherwise the application will be rejected. It is also mentioned in the Trademark Act 1994 that the trademark should not look and sound same or similar to any of the trademarks already registered, it should not be offensive, against the law or deceptive. There are some trademarks which are protected against international agreements such as Article 6 of the Paris Convention for the Protection of Industrial Property. If we have a distinctive trade mark and have verified it from the trade mark database, then we can apply for trade mark in the Intellectual Property Office.

 

 

KOSOC can apply for a trade mark at Intellectual Property Office http://www.ipo.gov.uk/ and can also submit a trademark application form or fill a form online from http://www.ipo.gov.uk/types/tm/t-os/t-apply-online.htm.

1. Application
   

Form TM3 is the used to apply for trade mark which is available online http://www.ipo.gov.uk/tm3.pdf. Information required to fill this form is the illustration of your mark, colour, trade mark class number and list of goods and services traded under this mark. Name and address of the person applying for trademark is necessary and it is also included in trademark journal and could be used for notification of infringement of trademark.

Form FS2 is used for payment of fee.

1. Trade Mark registration Fee
   

Application fee of trade mark is £200 for one class of services or goods and £50 extra is charged for other class.

Trademark office examines our application to ensure that goods and services are correctly classified and trademark is distinctive. They will search it in UK trade marks, European Community trade marks (CTMs), or International marks database for similarities. If the examiner objects to our mark due to existence of similar mark, we will have two month to resolve the objection other wise they will reject our application. If there is no objection in the trade mark, they will advertise our application in the Trade Marks Journal. One trade mark is publishing in Trade mark journal any one can oppose this trade mark within two month time. If no one opposes this trademark, IP Office will provide the registration certificate.

1. Domain name
   

Domain name is a unique and easy way to remember alphabetic form of internet protocol address which is used to represent a unique computer on the internet. Users type the domain name in browser to access a particulate website. Domain name provide an address to company's website which can be used by customer to access service and product of your company. Domain name is provided by the domain name registrar on first come, first serve basis. We can not register a domain name which is already registered; we have to find availability of our select domain name from whois search http://www.whois.net

 

We can register the domain name through an ISP, which will deal as an agent on our behalf or we can directly apply for domain name on 'Nominet', which is a registered authority only for UK domain only.

We recommend you to register domain through ISP because they will provide you with website hosting, email address and website development service as well. Therefore, in registering the domain name, you will, in effect, be entering into two contracts; one between you and ISP and the other between you and registrar of the registration authority (Clarke, 2005).

Moreover, you need the following details before going into this contract: name, address and contact detail of the company for queries, billing address.

The cost of registration of .co.uk is £40 and .com is £50. But when applying through an ISP, cost variance depends upon the additional service provided by the ISP. It takes 24 to 48 hours to register your domain name but your website will be fully visible in 36 hours to 5 days on the internet.

When selecting an ISP for domain name registration and website hosting, it is recommended that the ISP selected for this purpose must be the member of an industrial association such as (ISPA).This industrial association is useful when launching any complaints against selected ISP. It is also important to verify the following key factors when signing an agreement between you and the ISP for buying a domain name.

• Prices
  
• Reliability of service and service availability
  
• Security provided against attack on your website
  
• Support and service level agreement
  
• Law enforcement requirement
  

 

1. Competitor Survey
   

Before starting any new business, it is always recommended to identify the competitor and analyse their strategies, services and product line to understand the requirement of the customers and find gaps in the market which you can fulfil to get the competitive advantage. For that purpose, this survey has been conducted. There are many online clinics in UK and mostly they treat obesity and skin, the two most common problems in our society. People are ready to spend money on their appearances. Most of the website only provides the consultation and appointment but we are also providing online pharmacy. But skin treatment also covers cosmetic surgery which is not included in this survey.

We have selected Home Clinic http://www.homeclinic.co.uk/ and The Online Clinic
http://www.theonlineclinic.co.uk/default.asp because both provides treatment for Obesity and online pharmacy and we selected Spire Health Care http://www.spirehealthcare.com/ and Elan Medical Skin
http://www.elan-medical-clinic.co.uk/ for skin treatment but we are not including the Cosmetic Surgery section in the Survey. The reason of selection four websites with two of each type is that it will provide a fair sample of each kind. There are very few website which provides both obesity and skin care services together, Moreover, Home Clinic and The Online Clinic provide medical treatment for obesity and also provide an online pharmacy whereas Spire Health Care and Elan Medical Skin are skin clinics.

We are assessing these sites on the basis of advertising and marketing campaigns, customer care and website design and will try to find gaps in customer service and product line which we will fill to achieve the market share.

Both the websites Home Clinic and The Online Clinic have comparable marketing strategy. On the main page, they both emphasise on the quality and standard they follow, which is the key aspect of medical business which will help them to increase the patients' trust at the beginning of consultation. Furthermore, they also advertise the payment methods for medicines and consultation fee, the delivery method of their medicines, their contact number and address. This reflects that they are genuine and hence, enhance more trust of the users. The Online Clinic explains the legal detail of buying medicines online, which is a good step as Obesity is a common problem and is spread across a wide range of population. On the other hand Spire Health Care and Elan Medical Skin are very fancy websites. It could be because they target slightly posh markets which are popular of its spending on beauty product. Both the skin clinic websites only provide consultation and book appointments online but do not sell any medical products. Spire Health Care introduces very attractive offers of 'medical loans' and 0% finance which is the good method to attract the customer during this credit crunch. Like the previous two obesity websites, these websites also provide the contact details, quality and standard they maintain to ensure the patient's trust.

1. Customer Care
   

Home clinic provides 'Question Chat Now' sections where you directly ask questions from the doctor for instant reply. On the other hand, Elan Medical Skin Clinic adopts another strategy to contact doctors. There is a simple form to fill with details of the symptoms of the disease that is e-mailed to the doctors and they reply back. Home Clinic and The Online Clinic offer their customers to have an online account, which is used to consult their doctors and keep the treatment and payment record. This helps patients to securely and secretly communicate with their doctors, thus increasing their trust and confidence on the doctor. The entire four websites display their price list online and provide absolutely free consultancy, which is another superior move to satisfy the customer. All websites provide comprehensive information about their services and products online and explain all the procedures of treatments available.

1. Website design
   

All four website are built on simple and easy-to-navigate design. They use natural colours which does not distract the customers' eyes. The layout of Spire Health Care, Elan Medical Skin and Home Clinic
are centre-aligned and the main page contains brief information about the product and services. Clicking on a particular link will lead to separate page with detailed information about the disease. However, The Online Clinic follows the same technique of presenting information but the website is left-aligned and it wastes large space which could be used for advertisement. Terms and Conditions, Privacy Policy are visible on the entire four website and explain detail method of there data protection.

The success of a medical business lies in gaining the trust of the patient. To achieve this, we will provide the names, professional qualification and experience of our consultant on our medical panel which is missing in all four sites. We will also introduce a 24/7 help line which can be used any time for consultation. We will advertise the customized treatments for each of our patients depending on their conditions. We will offer special delivery of medicines on holidays too, along with standard deliveries. We will offer group treatment programmes in obesity which will encourage patients' motivation. These offers are not given in any of the websites discussed above. The design of our website will be similar to the above-discussed websites because we don't want users to waste time in finding required information. We will provide audio narrator for blind persons if they access our website. The user can also change the font of our website for easier reading. None of these options are found in the discussed websites. Links for terms and conditions, legal requirements and privacy policy will be visible in all pages of our website. We will adopt the same style of availability of information about treatment and the diseases which all the mentioned websites use. We will not advertise our product range, but prescribed medicines will be available to our registered user only.

1. Privacy and Data protection
   

Once a company starts online activities, which includes the processing of personal data and credit card detail for payment of products and treatments, it automatically has to become obligated to the Data Protection Act 1998. This act governs the processing of information about a living individual in UK and failure to comply with this Act is punishable. It is significant for business that contains sensitive information about their customers like in medical business to comply all the rules of this Act. Online business is base on customer's trust, so it recommended that privacy policy should be remain posted all the time on the web and all users have to tick check box with consent statement of reading term and condition and privacy policy when submitting their personal information online.

Information Commission Office oversees the data protection Act and all the businesses which store or process the personal data of their customers should register with Information Commission and must notify the types and processing of personal data. There are eight practices which must be opted for, when processing any personal data. "

    1. Personal data should be processed fairly and lawfully.

2. Personal data should be obtained only for one or more specified purposes, and should not be further processed in any manner incompatible with other purposes.

3. Personal data should be adequate and relevant.

4. Personal data should be accurate and where necessary, kept up-to-date.

5. Personal data processed for any purpose or purposes should not be kept for longer than is necessary.

6. Personal data should be processed in accordance with the rights of data subjects under the Act.

7. Appropriate technical and organisational measures should be taken against unauthorised or unlawful processing of personal data and against accidental loss or destruction of, or damage to, personal data.

8. Personal data should not be transferred to a country outside the European Economic Area unless that country ensures an adequate level of protection. "(zedbank, N.D.)

(http://www.zedbank.com/A7-dataprotection.php viewed on 09-June-2009)

These are more general concerns regarding Data Protection Act (DPA) 1998. In case of health care and medical record, it is treated as sensitive data in DPA Section 68. According to Data Protection Act, in processing sensitive information, following are the three main concerns which you will encounter regarding the collection of personal detail.

• The patient must give explicit consent before processing his or her personal data.
  
• If the information processed is medical diagnosis, then only the health professional or the person who owes a duty of confidentiality can process this information.
  
• If data is transferred to a third party like a call centre or for billing purpose, then a written undertaking must be obtained from the third party confirming that they will only use the data as instructed to do so.
  

  
   

To resolve the first concern, website must force the user to read the privacy policy to tick the consent check box before submitting personal details when filling the registration form, signing for a medical treatment or submitting the symptoms of diseases. Secondly, website should enforce a security policy in which every server room where the data of the patients is stored must have access control doors and CCTV cameras. Only authorized person can access that room. Moreover, all the doctors who read patients' record must owe a duty of confidentiality .Thirdly, when the personal data is handed over to the third party for billing purpose, they have to give an undertaking stating that they will only use this data for the purpose required and will not forward it to any other party.

The issues which website must address in our privacy policy include:

• Full contact detail of our company for user's concern.
  
• General detail of how the user data is handled.
  
• Date of the latest updating of information in privacy policy.
  
• Information to disable the cookie technology and how this technology is used in the website.
  

 

1. Advertising and Marketing
   

To start online advertising on website is highly profitable for business but there are some legal and regulatory requirements which we should bear in mind before advertising and marketing. Although there is no single legislation which applies to advertisement, there are some industrial self-regulated codes which need to be measured. Advertising Standard Authority (ASA) has some code of practices which applies to online advertisement and their main objective is to provide truthfulness, transparency, morality and decency in advertisements and to protect against unfair competition and misuse of intellectual property.

There are serious offences against false, misleading and misrepresentation advertisement. The laws applicable against these crimes are described in the Trade Description Act 1968, specially Misleading Advertisements Regulations 1988 (as amended in 2000 and 2003) and Consumer Protection Act 1987, s. 20.(?) In case of advertising medicines, The Medicines (Advertising) Regulations 1994 S. 7 states that no person can advertise medicines which are supplied by prescription. Slimming and cosmetic products can be advertised but it is good to check your advertisement from Medicines and Healthcare Products' Regulatory Agency by sending an e-mail at advertising@mhra.gsi.gov.uk. In case of marketing medical services, it is recommended that the wording and images of ads must not be a misrepresentation or contain offensive images which come under Obscene Publications Act 1959 or Child Protection Act 1978.

In case of direct marketing by sending unsolicited e-mails for advertising and marketing purpose, there are various implications which must be considered before sending e-mails. In the Privacy and Electronic Communication Regulations 2003, it is stated that explicit consent must be required by the consumer before sending any unsolicited e-mails. It is suggested that when the user is registered on the website, there must be a check box to get opt-in request from the user. It is also stated in the regulation that e-mail must contain name, geographical location and details of any supervisory authority which represent this e-mail and it should be clearly identified as advertisement. According to Direct Marketing Association which governs the code of practice for E-commerce, best practice is that unsolicited e-mail must contain mechanisms which help customer to get away from unsolicited e-mail list.

If a company wants to start a monthly lottery for the customers, there are some regulation which should be given due importance. According to the Lotteries and Amusements Act 1976, private lottery is illegal but there are some exemptions which include lottery for charity. Small lotteries are allowed only when the prize money is less than £50 or when the prizes are not in the form of cash. Private lottery "shall not be exhibited, published or distributed with any written notice or advertisement of the lottery" (Lotteries and Amusements Act 1976), prize of each ticket must be written on the ticket and the purpose of the lottery must also be mentioned.

1. Taxation
   

The taxation structure of an online company is not different from any other companies. As this company is based in UK, all UK tax regimes for business companies will be applicable on this company too. Corporation tax is the first tax that is to be paid by this company on all its taxable profits which is 28% of income profit and capital profit. If the company qualifies as small company between £50,000 and £300,000 profit, then tax rate will be 21%, which is calculated in accounting period of 12th month, but for newly formed companies, filing the first return can be more than 12 months. All the taxes in the UK are collected by HMRC. From 1st April 2011, we will be able to pay corporate tax online but now we can only fill our returns online (HM Revenue & Customs, N.D.). Since April 2002, there are certain tax exemptions on starting a new business. For example; tax relief is available on intangibles like intellectual property, information technology and goodwill. Capital allowance allows the business to write off certain kinds of capital expenditure against the income profits, which is 25% of a reducing balanced basis, will be writing off. Every UK Company must run a PAYE scheme to deduct income tax and national insurance for its employees and directors' salaries and must file P11d returns to HMRC at the end of the each year.
HRMC department might visit the company to see the procedure of PAYE scheme. These are the standard taxes which each company in the UK has to pay. But in case of online business, according to OECD (Organisation for Economic Co-operation & Development) Ottawa conference 1998, there are no further tax liabilities other than applicable to standard trading companies in their respective country. Tax is applicable on selling of products and services on internet. It is also applicable on the selling of digital products like prescription in case of an online clinic. Value Added Tax (VAT) is the tax which is applicable on supplies of goods and services on a taxable person or business in the UK or EU in some cases. Each company must register for VAT and it must charge amount equal to VAT from the account of customer when goods and services are supplied. There is no difference in case of online transaction regarding VAT but there are some important considerations when dealing with business in UK or EU and private customers of UK and EU. For example, if the material goods are supplied to a VAT-registered business or a customer, there will be zero rate of VAT. But if a UK-based business is supplying goods or services to any private customer in EU, the UK VAT will be applicable. In case of digital goods, for example; software or internet service package, the supply of website housing is treated as services and you are no longer required to report VAT on supplies to the business in EU or any member of the state or the rest of the world. In case of customer in the UK, the payment of UK VAT is applicable on any of the two services or goods.

 

Reference

Companies House, a, http://www.companieshouse.gov.uk/about/gbhtml/ca_gba7.shtml (accessed 25-05-09)

Companies House, b, http://www.companieshouse.gov.uk/about/gbhtml/gbf1.shtml (accessed 25-05-09)

Royal Pharmaceutical Society of Great Britain, http://www.rpsgb.org/pdfs/coun0412-C-88.pdf (accessed 25-05-09)

Clarke, O, 2005, A Practical Guide to E-commerce and Internet Law 2nd edition, Publisher ICSA Publishing, ISBN 1860723055.

Zedbank, N.D.

http://www.zedbank.com/A7-dataprotection.php (viewed on 09-June-2009)

HM Revenue & Customs, http://www.hmrc.gov.uk/ct/basics/intro.htm (viewed on 09-June-2009)

Legislation

Companies Act 2006 (http://www.opsi.gov.uk/acts/acts2006/pdf/ukpga_20060046_en.pdf)

Medical Act 1983 (http://www.gmc-uk.org/about/legislation/medical_act.asp)

Trade Marks Act 1994 (http://www.opsi.gov.uk/acts/acts1994/Ukpga_19940026_en_1.htm)

Data Protection Act 1998 (http://www.opsi.gov.uk/Acts/Acts1998/ukpga_19980029_en_1)

Trade Descriptions Act 1968 (http://www.opsi.gov.uk/acts/acts1968/pdf/ukpga_19680029_en.pdf )

Consumer Protection Act 1987 (http://www.opsi.gov.uk/acts/acts1987/pdf/ukpga_19870043_en.pdf)

The Medicines (Advertising) Regulations 1994 (http://www.opsi.gov.uk/SI/si1994/Uksi_19941932_en_1.htm)

Obscene Publications Act 1959 (http://www.opsi.gov.uk/acts/acts1959/pdf/ukpga_19590066_en.pdf)

Protection of Children Act 1978 (http://www.opsi.gov.uk/RevisedStatutes/Acts/ukpga/1978/cukpga_19780037_en_1)

Lotteries and Amusements Act 1976 (http://www.opsi.gov.uk/RevisedStatutes/Acts/ukpga/1976/cukpga_19760032_en_1)