Archived: Central Medical Solutions

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We looked for evidence that people were protected from abuse and avoidable harm.

This is the first inspection for this service since its registration with CQC in April 2021.

This key question has been rated as Good.

This service scored 67 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service culture promoted safety based on openness, honesty, and learning.

People felt supported to raise concerns. There was a system to record and investigate complaints, and when things went wrong, staff apologised and gave people support.

Learning from incidents and complaints resulted in changes that improved care for others. For example, the provider improved its systems for verifying people’s image file submissions. This included enhanced cross-checking and the use of metadata to confirm that photographic images matched official identification and were contemporaneous.

The service worked with people and healthcare partners to establish and maintain safe systems of care, including when people moved between different services.

People accessed the service by submitting their information through either the provider’s secure online dermatology portal or its secure partner pharmacy portal. Assessment questions asked by the service were appropriate for the treatment people sought.

Most of the care and treatment provided by the service related to people’s weight loss interventions using medicines such as Mounjaro and Wegovy, which carry a higher risk of misuse. There was also a risk of misinformation being shared between people using the service and the staff prescribing these medicines, as initially there was no reliable method for prescribing clinicians to independently verify the information people provided before making a prescribing decision. Due to this, important considerations such as people’s mental health needs, limited health literacy, undisclosed clinical conditions or vulnerabilities, or intentional misreporting could not be reliably identified or taken into account to inform safe and effective prescribing decisions.

To improve safety, the provider had piloted arrangements so that prescribers could independently verify people’s information before prescribing these types of medicines. This was by prescribers accessing these patients NHS Summary Care Records (SCR), with the individual patients’ consent. Staff confirmed that full SCR checks had been implemented for all new weight-loss prescriptions during the inspection process, and this was due to include all repeat prescriptions by of these medicines by December 2025.

Clinical and non‑clinical staff were trained in child and adult safeguarding; however, some were not trained to an appropriate level in line with GMC and NMC competency frameworks guidance for staff working in healthcare roles. This included non‑clinical staff being trained to Level 1 instead of Level 2, clinicians to Level 2 instead of Level 3, and the named safeguarding to Level 3 when Level 4 was required.

The service had audited HR files and was updating safeguarding training during our inspection. Leaders informed us the clinical decisions for 16‑ and 17‑year‑olds (which was limited to dermatology care and treatment) would only be made by clinicians trained to in safeguarding children to Level 3 or above; and that the deputy safeguarding lead doctor was booked to complete Level 4 training in February 2026.

Leaders had also introduced an annual safeguarding audit and planned improvements to ensure consistent staff training to the appropriate level and improving how people’s potential vulnerabilities were identified.

We saw that safeguarding concerns were recognised and acted on appropriately, including contacting a person’s GP when necessary.

The service had systems to assess, monitor, and manage its patient’s safety risks. It provided supportive care to meet people’s needs and helped patients to achieve what mattered to them.

Staff were trained to identify deteriorating patient’s and respond appropriately. A ‘critical note’ feature highlighted essential clinical information, such as contraindications, comorbidities, previous adverse reactions, allergies, and any red-flag findings or concerning symptoms requiring urgent review.

Patients were informed about risks related to their condition and advised on what actions to take if their health worsened. Systems were in place to notify a patients’ GP for certain medicines prescribed where necessary.

We did not look at Safe environments during this assessment. There is no previous rating for the Safe key question so we cannot yet publish a score for this area.

Arrangements to ensure enough qualified, skilled, and experienced on the rota were generally effective, and staff worked together to provide safe care that met people’s individual needs. However, some arrangements to provide leaders with assurance of safe and effective staffing needed further development.

A random sample of staff files we inspected showed that checks to ensure the safe recruitment of staff were mostly undertaken. However, systems to ensure leaders oversight of necessary HR arrangements including staff DBS, photo ID and staff training were not fully effective, they were in the process of being improved.

The process for staff prescribing weight loss medicines effective access to people’s summary care records and staff training was being developed and implemented, pending evaluation and review. Staff were working within their agreed areas of competence.

We did not look at Infection prevention and control during this assessment. There is no previous rating for the Safe key question so we cannot yet publish a score for this area.

Prescribing protocols were designed and used to ensure medicines were used safely and appropriately. The service made sure that medicines and treatments were safe and met people’s needs and preferences.

Systems were in place to support medicines optimisation (a patient centred approach to the safe and effective use of medicines). Patients’ treatment was regularly reviewed. Patients were routinely asked if they were experiencing side effects whilst on treatment. They could contact the service if they had any concerns about their medicines where they would be reviewed further. A standard operating procedure for prescribing that we reviewed included steps to ensure prescribing was appropriate.

Protocols designed by relevant specialist doctors were used to support prescribers in ensuring safe and effective prescribing. The service had an escalation process for managing people’s higher risk prescribing where they would be reviewed by a more senior member of staff.

There was a secure, auditable process for managing electronically generated prescriptions, which could only be issued by authorised staff.

There were safe protocols for ensuring the safe prescribing of medicines that were unlicenced. (These are medicines that do not have a licence from the Medicines and Healthcare products Regulatory Agency. They can only be used when licenced products cannot meet the individual need of a patient). The service reviewed the prescribing of these medicines liaised with the service partner dispensing pharmacy to enhance safety. There were regular meetings between staff which discussed prescribing, incidents, and learning.

The service had effective systems to manage and respond to safety alerts and medicine recalls and it did not prescribe or controlled drugs.

People were given relevant information about their medicines.