Letter from the Chief Inspector of General Practice
We rated this service as
Requires improvement
overall.
The key questions are rated as:
Are services safe? – Requires improvement
Are services effective? – Good
Are services caring? – Good
Are services responsive? – Good
Are services well-led? – Requires improvement
We carried out an announced comprehensive inspection at BMH Medical Administration on 5 October 2022 as part of our rated inspection programme.
BMH Medical Administration, is registered to provide the regulated activity treatment of disease, disorder or injury. They are an online provider who deliver clinical care remotely.
The service provided treatment for both men and women who had hormonal imbalances.
The service consisted of a registered manager, an operations manager, three doctors. A team of non-clinical staff from another organisation were also involved in the provision of the regulated activity.
A registered manager is a person 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 runs.
Clients are introduced to BMH Medical Administration through an online platform called Balance My Hormones, which is a separate service owned by the provider. That platform is not within CQC scope of registration as determined by the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and the registration regulations 2009.
All appointments offered by BMH Medical Administration are provided remotely. There was, at the time of our inspection, no physical premises where consultations could take place. However, the provider told us that this was something they were considering.
At this inspection we found:
- Patient records showed that the provider had systems in place to ensure safe prescribing.
- The care and treatment documented in the patient records that we reviewed showed that the provider adhered to current practice and guidelines.
- Patient and staff feedback was positive.
- There were systems to verify patient identity and share information with a patient’s GP where appropriate.
- Patients could get appointments easily and were supported by a team of case managers.
However:
- Not all staff had completed appropriate training and recruitment checks had not been completed for all staff.
- There was limited quality improvement activity using clinical audit; though the service had identified areas for improvement and had acted on these.
- The service’s safeguarding policy did not include contacts for safeguarding teams across the country.
- Clinical governance was lacking as there was no clinical lead, no evidence of clinical meetings, no system for a clinician to review clinical consultations to ensure care and treatment adhered to current guidelines and no centralised clinical oversight of safety alerts on behalf of the provider.
The provider must
- Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
The provider should
- Consider the needs of service users who may require language translation.
- Develop a programme of quality improvement activity which focuses on the improvement of clinical care.
- Appoint a member of clinical staff working in the organiation to oversee safety alerts.
- Implement a system that provides a full audit trail in respect of access to patient records
Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA
Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services