Howell Medical Group Ltd

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

We looked for evidence that the service met people’s needs, and that staff treated people equally and without discrimination.This is the first inspection for this service since its registration with CQC. This key question has been rated as good.

This service scored 64 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider ensured that all patients were placed at the centre of their own weight loss care journey.

Patients could choose to undertake self-directed treatment, this was reviewed by a clinician, and if there were concerns or contraindications they would be offered the clinician led service for safety with the additional nurse support.

Staff completed initial consultations following a comprehensive template to take individual circumstances into consideration and treatment was led by patient feedback. If a patient wanted or needed to change medicine dose, this was discussed and an individual arrangement worked out.Staff understood how central obesity and excess weight were to people's self-esteem and the wider cardio-vascular, respiratory and wider health risks linked to obesity. Staff listened to each patient's situation and ensured care was delivered in a way that suited each patient.

For patients who had diabetes, the provider offered a bespoke diabetes nurse specialist led service with consultant endocrinology oversight where required.

The service had seen a significant increase in patient demand for weight loss medicines which had impacted on the service as they adapted to meet this demand.

This was a specialist treatment service, staff and leaders clearly understood the needs of the patients who approached them for care. We saw that care provided was flexible and supported choice and continuity. For example, we were told that appointment dates and times were flexible if there was clinical capacity and availability and nurses offered patients reviews with themselves to maximise the rapport and trust built during initial consultations and assessments.

As a private slimming clinic service, engagement with wider community services did not underpin the service provision. However, the service shared patient records with their NHS GPs or provided information for the patient to share directly. Where there were individual patient complex health needs, the consultant endocrinologist would offer to liaise with other clinical or medical specialists in the patient’s interest.

The website for this service was actually a service with a different name, and all medicines were dispensed and sent out by an online pharmacy provider with whom Howell Medical Group had a service level agreement with for medicines provision. These business relationships were not clear on the main website, which was in the name of another service which increased confusion for patients and members.

Feedback from patients indicated not all patients understood they had signed up to a subscription service to receive several injections. This was a cheaper option compared with buying the medicines as a single purchase. The provider had ensured this was clear on their website and was looking at whether they could make any further changes to prevent this misunderstanding in future.

Staff communicated and provided information in ways that supported people to understand their care. They gave patients details about their health and treatment options to enable informed decision-making. Staff also presented information in the patient’s preferred language when required. The provider used systems to share patient information effectively across services. Staff offered safety netting advice to patients who were at risk of deterioration.

Prices were clearly displayed on the website; however, the website did not offer information in other languages for non-English speakers and not all information displayed on the service website was accessible to people with protected characteristics.

Leaders used information relating to incidents, complaints, patient feedback and other healthcare professional feedback to inform performance, safety and effectiveness and to identify and drive improvements.

The rapid growth of the service had impacted on service provision and customer satisfaction. Systems to listen and act following patient feedback had only recently been implemented. The provider did not have a clear policy in place or guidance for patients on the website for complaints.

In July 2025, the provider identified the following were the main themes for patient complaints for the previous 6 months: delays and issues in delivery of medication; difficulties getting to speak with customer service staff; product concerns including incorrect dosages and damaged items; clinical processes such as wellbeing questionnaire completion and prescription accuracy and appointment scheduling and cancellations. While the provider had taken action to mitigate these concerns, actions were too recently implemented for us to effectively assess their effectiveness at this inspection.

The service subsequently implemented actions to address these concerns, which included recruitment into the customer service team, improved processes and working with the pharmacy, as well as guidance and training for staff. However, it had taken several months and a high number of complaints before the provider acted.

Leaders now had daily oversight of incoming correspondence, including where patient expectations has not been fully met to try and address issues before they became complaints.

The provider shared details of 60 patient compliments made via a national online review community, these are not independently validated. However, the provider had previously offered a financial incentive for patients to make positive 5* reviews on this site which undermined the reliability of this feedback.

The provider had processes in place to review complaints and offered apologies where errors occurred, or patients were not eligible for the treatment. The provider introduced a complaints standard operating procedure following the inspection. We noted that they were not part of any independent sector complaints adjudication service.

The provider shared various testimonials and scoring from their email system on customer service. There was not an effective process in place for collating reliable patient feedback on all aspects of their care and outcomes.

As this service was a private slimming clinic service, access was provided to people who met the nationally published criteria for weight loss medicines, at the patient's own cost. The service website was not easily accessible to patients with protected characteristics such as learning disabilities, sight impairment or people whose first language was not English. Appointments were offered evenings and weekends, and the customer service team were open between 10am and 4pm every day.

The service was provided on a remote model, including video calls, allowing patients from throughout the country were able to sign up for this, with face to face appointments available for people living in the Liverpool region. The provider was in discussion with wider health system partners regarding the possibility of providing some NHS commissioned slimming service to support reducing health inequalities in Cheshire and Merseyside.

The service offered treatment to people aged over 18. People over 75 were only offered the clinician led service so that they could safely monitor potential increased risks such as potential muscle loss and frailty.

The provider was clear about the health inequalities around obesity and excess weight and had clear guidance for all nurses on which different ethnicities or nationalities or specific health conditions meant that a lower BMI threshold should be considered for weight loss treatment. We saw the team committed to helping give patients better health outcomes and describing some of the significant improvements in patients' other conditions including cardiovascular disease.

The provider could only demonstrate that 60% of nurses had completed training in supporting patients with learning disabilities or Autism. The initial patient questionnaire for self-directed treatment did not have specific questions for people who had learning disabilities or autism, but nurses did cover this in their assessment.

The service actively discussed patients’ treatment with them. This included discussions around suitability, treatment options, and expectations regarding outcomes. Feedback provided by patients who had used the service, both to the provider as well as to CQC, was positive. The service treated patients equally and without discrimination.

If after initial assessment it was felt the provider could not meet the needs of the patient, the service discussed alternate care and treatment options and signposted patients accordingly.

Leaders did not currently use any patient outcome data to review their service provision and monitor equity in experiences and outcomes.

Patients were supported by the service throughout their care and treatment journey. Treatment options were outlined to patients and were aligned to their needs moving forward. Advice was also given to patients regarding aftercare.

Nurses demonstrated a clear focus to help people decide on what their hopes were for the future around their weight loss and maintenance when they reached their weight goals.