Howell Medical Group Ltd

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

We looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

This is the first inspection for this service since its registration with CQC. This key question has been rated as requires improvement.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Leaders told us of their aim to offer the best possible weight loss treatment to patients, and staff told us they understood the service's vision, and meetings included focus on continual improvement. The provider was not able to provide written evidence of this and how this had been shared formally with staff.

Staff and leaders understood the wider national context in which their service was delivered and the challenges their model of care and treatment presented and those who we spoke to or heard from as part of the inspection were highly positive about the culture of the service.

There was a plan to move into the provision of nutrition, hydration and mineral supplements as part of business development for the service.

Senior leaders worked closely together and understood the context in which they delivered care and treatment. They demonstrated during the assessment that they had the skills, knowledge, experience and credibility to deliver safe and effective care, however the service had grown significantly and did not always have enough leaders/ managers to have comprehensive oversight of the whole service. Staff told us that leaders were accessible and supportive and passionate about their service. Patient feedback was not always positive, and we were unable to assess the impact of changes made following the review of complaints in early July 2025.

The service told us they fostered a positive culture, and the directors felt that as individuals they could speak up to their peers, and their voices would be heard. They had a freedom to speak up policy but no named staff member for this. We received feedback from a number of staff, half of whom said they knew the service’s speak up arrangements, the other half did not. However, all staff told us they were confident they could raise concerns that would be acted upon and some gave us examples of where improvements had been made in response to feedback.

The provider valued diversity within the workforce and actively promoted an inclusive and fair culture by supporting equality and diversity among staff. Reasonable adjustments were made to help staff carry out their roles effectively, many nurses worked remotely and flexibly around other employment. The practice had an established equality, diversity, and inclusion policy in place. However, only 40% of nurses had provided details of their equality and diversity training. The provider supported staff with caring responsibilities through flexible working arrangements and adjusted schedules to meet their needs. Customer service staff had completed training in equality, diversity, and inclusion and demonstrated awareness of how to support individuals with protected characteristics, such as age, gender, religion, and disability. There were no concerns reported regarding workforce equality.

The service had clear responsibilities, roles, systems of accountability and some good governance arrangements. Whilst many policies and processes were fully embedded at the time of this inspection, some risks had not been identified, and the provider began to act on these action following the inspection. Risks included: information technology security; lack of formal induction processes and records, poor provider oversight of required training for nurses and lack of evidence patient outcomes or cyclic audit processes.

Leaders acted on the best information about risk, performance and outcomes and shared a risk register with us where they identified and prioritised their highest organisational risks. We saw action had been taken to address some of these but not all.

Senior staff met for regular governance meetings and discussed issues such as clinical concerns, emerging risks, and service developments. We discussed areas of concern around governance with the provider during the inspection and have requested an action plan on how they will address these risks.

At the time of our inspection, the registered manager had recently resigned, and the provider was actively recruiting to replace them.

As a private service the provider had limited partnership working. However, they did share information about a patient's weight loss treatment with the patients' GPs if the patient consented. The provider was not able to provide us with the data showing how many patients had given consent for this to happen.

The consultant endocrinologist provided a range of training and development sessions on diabetes and weight management across the health care community. They had recently attended a local conference on obesity and excess weight locally and had started conversation with commissioners regarding developing an NHS commissioned service to help patients from more deprived communities.

The service focused on continuous learning, innovation and improvement across the organisation. Leaders acknowledged they had grown quickly following national interest in weight loss treatment. The provider stayed up to date with NICE and General Pharmaceutical Council updates and developments and they recognised they had more work to do to fully reflect all best practice guidance.

Leaders ensured that concerns, incidents and opportunities for learning and improvement were discussed openly in the daily team meetings to share learning.

Following increased patient concerns and complaints over delayed medicines, a single medicines tracking system was introduced to improve the patient experience.

Customer service staff told us this had significantly improved the patient experience.