Archived: London Bioidentical Hormones

Updated 29 December 2017

On 15 November 2017, our inspection team was led by a CQC Lead Inspector. The team included a GP specialist advisor.

Pre-inspection information was gathered and reviewed before the inspection. We spoke with the registered manager. We looked at records related patient assessments and the provision of care and treatment. We also reviewed documentation related to the management of the service. We reviewed patient feedback received by the service.

To get to the heart of patients’ experiences of care and treatment, we always 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 29 December 2017

We carried out an announced comprehensive inspection on 15 November 2017 to ask the service the following key questions; Are services safe, effective, caring, responsive and well-led?

Our findings were:

Are services safe?

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

Are services effective?

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

Are services caring?

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

Are services responsive?

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

Are services well-led?

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

Background

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the service meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

This was the first inspection undertaken at this service.

London Bioidentical Hormones is an independent clinic in the central London, which provides a range of bespoke healthcare service to adults and specialises in individualised bioidentical hormone replacement therapy and functional medicine for women. The service is renting a consultation room in a shared premises at The Hale Clinic. The service is run by a principal GP and did not employ any staff. Lolavista Limited is a private limited company and the provider of this independent healthcare service. The principal GP is performing duties as a medical director and responsible for the management and day to day running of the patient service.

The principal GP is the registered manager. 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.

Two patients we spoke with on the telephone were positive about the care and treatment offered by the principal GP. Patients said they were satisfied with the standard of care received and thought the principal GP was approachable, committed and caring. As part of our inspection, we also asked for CQC comment cards to be completed by patients prior to our inspection. However, we did not receive any completed comment cards.

Our key findings were:

• The provider had specialised in individualised bioidentical hormone replacement therapy and functional medicine for women. Patients were treated with unlicensed compounded medicines and systems were in place to ensure this was carried out safely.
• Consent procedures were in place and these were in line with legal requirements.
• Systems were in place to protect personal information about patients. The service was registered with the Information Commissioner’s Office (ICO).
• Identity checks relied on a verification of bank account (via PayPal) or credit card details, provision of a date of birth and UK address, and by email verification.
• Appointments were available on a pre-bookable basis. The service provided consultations face to face, via telephone and video calls. All initial consultations were face to face.
• The service did not employ any staff and they had a contract with an external organisation to provide the administration services through virtual secretaries.
• There was some evidence of quality improvement activity including clinical audit.
• Prescribing decisions were monitored by the principal GP to prevent any misuse of the service by patients. Overall clinical outcomes had been monitored.
• Information about services and how to complain was available.
• The service had proactively gathered feedback from the patients.
• Safety systems and processes were in place although no infection control audits had been carried out.

There were areas where the provider could make improvements and should:

• Carry out an infection control audit.
• Review the contents of the service’s website and include the information about the risks associated with the use of an unlicensed medicine.
• Review quality improvement initiatives which may include completed clinical audits.
• Review the gaps in the following training: fire safety awareness, infection control and health and safety.
• Consider arranging a translation service and review the information available for patients who do not speak English.
• Consider how to improve access to patients with hearing difficulties.