The Care Quality Commission
  • Doctor
  • Independent doctor

BMH Medical Administration

Overall: Good read more about inspection ratings

International House, 24 Holborn Viaduct, London, EC1A 2BN (020) 3900 3209

Provided and run by:
Balance My Hormones Ltd

All Inspections

During an assessment under our new approach

We carried out an announced focused assessment of Balance My Hormones Ltd between 25 February to 5 March 2025 following information that we received, to check the systems and processes in place to manage the service.

The provider, Balance My Hormones Limited is registered to provide the regulated activity of treatment of disease, disorder or injury. This is an exclusively online remote consultation service which has a registered office at International House, 24 Holborn Viaduct, London, EC1A 2BN.

The service primarily provides treatment for testosterone replacement therapy (TRT), alongside HRT hormone and adjunctive treatments for associated conditions . Testosterone deficiency means the body is unable to make enough testosterone.

Patients access the providers services via the Balance my Hormones website: www.balancemyhormones.co.uk and have the option to access assessment and possible treatment from there.

Since the previous inspection on 10 July 2023, the service had experienced considerable growth and transitioned into a fully integrated digital healthcare service.The service is supported by both clinical and non-clinical teams led by a registered manager, with an administrative support team assisting patients and facilitating communication between clinicians and patients. Where relevant, further commentary is provided in the quality statements section of this report. The assessment reviewed the key questions for safe and well-led.

The overall rating for this assessment is Good.

SAFE: The service had a good learning culture and patients could raise concerns. Incidents were investigated to understand and mitigate risks. People were protected and kept safe. There were enough staff with the right skills and experience. Managers made sure staff received training and regular appraisals to maintain high-quality care. Staff generally managed medicines well and involved patients in planning any changes. While some elements of clinical governance and oversight were limited, we found no evidence of patient harm. The provider was responsive in making or planning improvements where issues were found.

WELL-LED: Leaders and staff shared a vision and culture based on listening, learning, and trust. Leaders were visible, knowledgeable, and supportive, helping staff develop in their roles. Staff felt supported to give feedback and were treated equally, free from bullying or harassment. They understood their roles and responsibilities. Managers worked to deliver the best possible care and were receptive to new ideas. There was a culture of making improvements alongside staff to share and implement new ideas. Although we observed improvements from previous inspections, some areas of clinical governance where we had indicated the provider should improve and must improve, had recurred. Further work was required to ensure effective governance and management of clinical risks and the quality and safety of patient care, which we have identified as areas for the provider to improve.

10 July 2023

During an inspection looking at part of the service

This service is rated as Good overall. (Previous inspection October 2022 – Requires improvement)

The key questions are rated as:

Are services safe? – Good

Are services well-led? – Good

We previously carried out an announced comprehensive inspection of BMH Medical Administration in October 2022 as part of our inspection programme. The service was rated requires improvement overall. We rated the service Good for providing an effective, caring and responsive service and requires improvement for providing a safe and well-led service. You can read the full report by selecting the ‘all reports’ section for BMH Medical Administration on our website www.cqc.org.uk.

On 28 June we carried out a desk-based review to confirm that the service had carried out the required improvement plans following the last inspection.

We found that the service had put measures in place for ongoing improvement. The service is now rated Good for providing safe and well-led services and rated Good overall.

We based our judgement on the quality of care at this service on s combination of:

  • What we found when we reviewed the information sent to us by the provider; and
  • Information from our ongoing monitoring of data about services.

We rated safe as Good because:

  • Safeguarding and recruitment policies had been appropriately updated.

We have rated well-led as Good because:

  • Governance structures had changed to include an identifiable clinical lead.
  • Regular clinical meetings were being carried out.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services

5 October 2022

During a routine inspection

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