Archived: The London Eye Hospital

Updated 8 February 2018

The London Eye Hospital is a private hospital providing a range of eye treatments and surgical procedures to adults. All patients are self-paying. One of the procedures carried out as part of the service is lens implants for patients with age-related macular degeneration (AMD) which is a progressive disease of the macula (the central area of the retina) and a cause of sight loss. Consultants at this hospital developed a lens implant for patients with AMD.

The London Eye Hospital is operated by London Eye Hospital Limited. There are two locations linked to London Eye Hospital Limited, namely, 4 Harley Street and 29a Wimpole Street. Both locations are named ‘The London Eye Hospital’. Patients attend the 4 Harley Street location for an initial consultation, optometry tests and aftercare. Surgery is carried out at this hospital (29a Wimpole Street). The department is open Monday to Friday 9am to 5.30pm.

We carried out this unannounced inspection in response to concerns received in August 2017 about the some aspects of care and treatment provided at this hospital. There were also concerns about the safety of the type of lens implanted in surgery at this hospital .We also carried out an unannounced inspection was of the outpatient ( 4 Harley Street) and findings will be reported on in a separate report.

Prior to this inspection, we had last inspected the service in December 2016 using our comprehensive inspection methodology.

For the unannounced inspection, we did not carry out a comprehensive inspection but focused only on the issues raised by the information received. We categorised these concerns into safeguarding, consent, complaints, patient outcomes, and governance arrangements.

There had been no registered manager for this service since July 2017 at the time of our inspection. The hospital was in the process of recruiting staff to be registered as the registered manager.

During the inspection, we spoke with four members of staff including a clinical manager, and consultants. We also spoke with three patients, two relatives and observed two consultations. We reviewed ten patient records and ten complaints.

Updated 8 February 2018

The London Eye Hospital is a private hospital that provides a range of eye treatments and surgical procedures to adults who are self- funding. They specialise in providing cataract treatment and lens implants. Their location at 29a Wimpole Street, which this report refers to, is their surgical site where all surgical procedures take place.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led? We rate services’ performance against each key question as outstanding, good, requires improvement or inadequate.

Throughout the inspection, we took account of what people told us and how the provider understood and complied with regulations.

The main service provided by this hospital was surgery. Where our findings on surgery – for example, management arrangements – also apply to other services, we do not repeat the information but cross-refer to the surgery core service section.

We rated the surgical services as good overall. However, we found that the hospital required improvement in well-led domain. It was unclear how the medical advisory committee (MAC) functioned and how consultants might play an active role within it.

We rated this hospital as good overall because:

• Staff spoke with compassion about patients. Doctors were kind and respectful towards the patient and took time to ensure they answered questions and concerns in full.

• Local management of the surgery site was robust and well-led.

• Staff told us they were confident to raise any issues with senior management. They told us the London Eye Hospital was a good place to work.

• Procedures were scheduled to accommodate patient’s travel times or specific needs related to other illnesses. There was a 24 hour telephone support line available to patients.

• There was a clearly defined patient pathway. Consultants were available to patients post-operatively.

• There was a clearly defined complaints process.

• Care was delivered in line with relevant national guidelines.

• Staff had up to date training in the use of machines used at the hospital. We saw completed competencies for all staff directly employed by the provider.

• There was evidence of good internal multidisciplinary working.

• Staff understood their responsibility with regards to ensuring there was patient consent to all procedures.

However:

• There was a nine months waiting list for a particular ophthalmic procedure.

• The hospital did not have a written long term strategy.

• Clinical governance meeting minutes did not have an attendance list and there was no update on actions from the precious meeting.

• The risk register lacked consistency and detail. The incident log was not always updated to indicate how the incident was resolved.

• There was no data available to assess clinical outcomes in line with the Royal College of Ophthalmologists Cataract Surgery Guidelines September 2010.

• There was no provision for doctors to meet with each other on formal basis to share common themes.

• Two consultants’ intermediate life support training was overdue at the time of our inspection. There was no record kept of consultant’s competencies or any mandatory training done by them.

Following this inspection, we told the provider that it must take some actions to comply with the regulations and that it should make other improvements, even though a regulation had not been breached, to help it move to a higher rating. Details are at the end of the report.

Professor Sir Mike Richards

Chief Inspector of Hospitals

Updated 12 April 2017

We rated surgery as good because:

• Staff spoke with compassion about patients. Doctors were kind and respectful towards the patient and took time to ensure they answered questions and concerns in full.

• There was a clearly defined patient pathway. Consultants were available to patients post-operatively.

• Procedures were scheduled to accommodate patient’s travel times or specific needs related to other illnesses. There was a 24 hour telephone support line available to patients.

• Local management of the surgery site was robust and well-led.

• There was evidence of good internal multidisciplinary working.

• Staff understood their responsibility with regards to ensuring there was patient consent to all procedures.

• Staff told us they were confident to raise any issues with senior management. They told us the London Eye Hospital was a good place to work.

• Staff had up to date training in the use of machines used at the hospital. We saw completed competencies for all staff directly employed by the provider.

• There was a clearly defined complaints process.

However:

• There was no data available to assess clinical outcomes in line with the Royal College of Ophthalmologists Cataract Surgery Guidelines September 2010.

• Two consultants’ intermediate life support training was overdue at the time of our inspection. There was no record kept of consultant’s competencies or any mandatory training done by them.

• There was a nine months waiting list for a particular ophthalmic procedure.

• The hospital did not have a written long term strategy.

• The risk register lacked consistency and detail. The incident log was not always updated to indicate how the incident was resolved.

• There was no provision for doctors to meet with each other on formal basis to share common themes.