Define Medical

Updated 16 June 2022

Define Medical Ltd is the medical aesthetic element in a two-location clinic in Beaconsfield, Buckinghamshire. The other service within the clinic is a dental service, known as Define Dental Clinic. Although the premises, governance and some staff work across both services, this report, rating and findings refer solely to the service provided via the medical aesthetics element of Define Medical Ltd.

Define Medical opened in 2019 and provides a small range of treatments for people aged over 18 that come under scope of regulation by the Care Quality Commission (CQC). These treatments are given via pre-bookable appointments. Patients attend for an initial consultation, where a treatment plan is discussed and agreed, and then they are booked in for treatment at a later date. Only specific treatments are regulated by CQC and they include treatment for excessive sweating (hyperhidrosis) and non-surgical treatment for a range of skin conditions, including acne, rosacea and psoriasis.

Treatments are provided from:

• Define Clinic, Wendover House, 24 London End, Beaconsfield, Buckinghamshire HP9 2JH.

The service website is: www.defineclinic.com

Define Clinic is located in renovated Grade II listed premises which comprise of four treatment rooms, two offices and a reception area.

The service is open Monday to Friday with core opening hours of 9.30am to 6pm. Saturday and evening appointments are available on request. This service is not required to offer an out of hours service. Patients who need medical assistance out of corporate operating hours can access out of hours support via the service and this is detailed in patient literature supplied by the service.

Regulated activities (treatments regulated by CQC) are provided by a cosmetic surgeon (who is the Medical Director) and two aesthetic therapists, all of whom have extensive qualifications in aesthetic medicine. An operational manager, practice manager and a team of reception, administration and coordinator staff undertake the day-to-day management and running of the service.

How we inspected this service

Throughout the pandemic CQC has continued to regulate and respond to risk. However, taking into account the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently. This inspection was carried out in a way which enabled us to spend a minimum amount of time on site. This was with consent from the provider and in line with all data protection and information governance requirements.

We carried out this inspection on 30 May 2022. Before visiting the location, we looked at a range of information that we hold about the service. During our visit, we interviewed staff, reviewed documents and clinical records, and made observations relating to the service and the location it was delivered from.

Due to the current pandemic, we were unable to obtain comments from patients via our normal process where we ask the provider to place comment cards in the service location. However, we were shown examples of patient feedback which the provider monitored on an ongoing basis. We did not speak to patients on the day of the site visit.

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 16 June 2022

This service is rated as Good overall.

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 at Define Medical on 30 May 2022. The service was registered with the Care Quality Commission (CQC) in May 2019. We carried out this first rated inspection as part of our regulatory functions. The inspection was undertaken to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

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.

Define Medical provides a range of independent dermatology services, including non-surgical cosmetic interventions, which are not within CQC scope of registration. We did not inspect, or report on, those services that are outside the scope of registration.

Define Medical is registered with the CQC to provide the following regulated activities:

• Treatment of disease, disorder or injury

Therefore, we only inspected treatments relating to medical conditions which include treatment for excessive sweating (hyperhidrosis) and non-surgical treatments for a range of skin conditions.

The service was founded in 2019 by a cosmetic surgeon who is also the medical director and CQC registered manager. A registered manager is a person who is registered with the CQC 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.

Our key findings were:

• The service had clear systems to keep people safe and safeguarded from abuse. The service used recognised screening processes to identify patients who could be at risk of body dysmorphic disorder (BDD) or dysmorphophobia, a preoccupation with an imagined defect in one’s physical appearance.
• Patients received effective care and treatment that met their needs. The way in which care was delivered was reviewed to ensure it was delivered according to best practice guidance. Staff were well supported to update their knowledge through training.
• Patients were provided with information about their health and with advice and guidance to support them to live healthier lives.
• Feedback from patients was consistently positive, feedback highlighted a strong person-centred culture. Staff respected patients’ privacy and dignity and adapted the service to strengthen existing privacy systems.
• Patients had timely access to services. Patients interested in commencing treatment were given relevant information and booked their consultations as part of a planned programme. Feedback from patients was positive with regards to booking appointments and access to treatment.
• The service had a culture of high-quality care and put their patients first before financial gain. The service focused on the needs of their patients, in turn, patient satisfaction from various sources was positive.

The service should:

• Formalise the recording of identity checks on patients’ clinical record.

Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care