Archived: London Bioidentical Hormones

Updated 13 October 2021

London Bioidentical Hormones is an independent service, which provides a range of bespoke healthcare treatments to adults and specialises in individualised bioidentical hormone replacement therapy and functional medicine for women.

Lolavista Limited is a private limited company and the provider of this independent healthcare service. The service is run by a principal GP and did not employ any staff. The service had a contract with an external organisation to provide administration services through virtual secretaries. The principal GP is performing duties as a medical director and is responsible for the management and day to day running of the patient service. In 2020 the service became fully remote.

The service is open between 9am to 5pm on Monday, Tuesday and Wednesday. Telephone calls are answered by virtual secretaries from 8am to 6pm Monday to Friday and from 9am to 2pm on every Saturday.

The service is registered with the Care Quality Commission to provide the regulated activities of diagnostic and screening procedures and treatment of disease, disorder or injury. This service is registered with CQC under the Health and Social Care Act 2008 in respect of the services it provides.

How we inspected this service

We reviewed a range of information we hold about the service, any notifications received, and the information given by the provider at our request prior to the inspection.

During the inspection we:

• Looked at the systems in place for the running of the service.
• Explored how clinical decisions were made.
• Viewed a sample of key policies and procedures.
• Reviewed feedback from patients about their experiences of 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 13 October 2021

This service is rated as Good overall. (Previous inspection 7 February 2019 – we found that the service was not providing safe care in accordance with the relevant regulations. We issued a requirement notice for Regulation 12 Health and Social Care Act 2008, Regulations 2014 Safe care and treatment.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an announced comprehensive inspection of London Bioidentical Hormones on 23 September 2021. This inspection was planned to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

London Bioidentical Hormones is an independent service, which provides a range of bespoke healthcare treatments to adults and specialises in individualised bioidentical hormone replacement therapy and functional medicine for women. 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.

This service is registered with CQC under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. There are some exemptions from regulation by CQC which relate to particular types of regulated activities and services and these are set out in Schedule 1 and Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. London Bioidentical Hormones Limited provides nutritional therapy which is not within CQC’s scope of registration. Therefore, we did not inspect or report on this service.

Our key findings were:

• There was evidence of quality improvement activity including clinical audit.
• The provider had a clear vision to provide a safe and high-quality service.
• Appointments were available on a pre-bookable basis. The service provided consultations via video and telephone calls.
• The service had proactively gathered and acted on feedback from their patients.
• Information about the service and how to complain was provided to patients.
• Recruitment checks were carried out appropriately and the provider monitored the training of staff associated with the service.
• Consent procedures were in place and these were in line with legal requirements.
• The provider had access to interpretation services for patients whos first language was not English.
• Systems were in place to protect patients’ personal information. • Information about services and how to complain was available and easy to understand.
• The provider was aware of and complied with the requirements of the Duty of Candour.
• Thirty-three people provided feedback about the service. Thirty-one were wholly positive about the care and treatment offered by the service. They were satisfied with the standard of care received and thought the principal GP was approachable, committed and caring. Two of the 33 were pleased with the care and treatment they received; however, they also made a complaint. One person mentioned the cost of consultations being too high, and the other stated they felt rushed during consultations.

The areas where the provider should make improvements are:

• Update the service’s prescribing policy to include medication which should not be prescribed.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care