Community Health and Eyecare Limited (CHEC - Slough)

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

This meant we looked for evidence that the service met people’s needs.

This is the first assessment for this service. This key question has been rated good. This meant people’s needs were met through good organisation and delivery.

We looked for evidence that people and communities were always at the centre of how care was planned and delivered. We checked that the health and care needs of people and communities were understood, and they were actively involved in planning care that met these needs. We also looked for evidence that people could access care in ways that met their personal circumstances and protected equality characteristics.

We have not awarded this service a score for Responsive.

Find out about when we will not publish a key question score and what we look at when we assess Responsive.

The service made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

The service was committed to the Mental Capacity Act (MCA) 2005 and ensured decisions for people who lacked capacity were person‑centred and in their best interests. Leaders aligned this with organisational values, and staff followed a clear consent policy to support people to make informed decisions. The provider had an MCA policy with procedures and templates for assessing capacity and determining best interests.

The service completed monthly consent audits. Leaders checked that consent was obtained, signed, dated and supported with appropriate information. Staff used findings to improve documentation. We reviewed audits from May to October 2025 and found appropriate consent had been recorded.

The service had systems in place to support patients with complex healthcare needs, sensory loss, mental health needs, learning disabilities and dementia. Staff accessed additional support when needed and completed all required training. Training compliance was 100%, with all staff completing dementia awareness training, equality, diversity and human rights level 1, Mental Capacity Act 2005 training, and learning disability and autism training.

Staff communicated with patients in ways that supported their understanding of care and treatment. They adapted communication methods to meet individual needs, particularly for patients with communication difficulties.

Staff used visual aids, translation applications, and interpreters for patients who did not speak English as their first language. They also provided a hearing loop system for patients with hearing impairments, promoting inclusive and accessible communication across the service. Leaders set expectations through the provider Interpreting and Translation policy.

Patients with specific needs—such as those living with dementia were prioritised on theatre lists, demonstrating a proactive and inclusive approach to care planning. Families could remain with patients, fostering a supportive environment that acknowledged emotional and social needs alongside clinical care. This approach promoted dignity, reassurance, and continuity, particularly for individuals who may otherwise face barriers within standard care pathways.

Leaders reminded staff that they should support patients who could not complete Visual Field (VF) testing (a test of side vision) or Optical Coherence Tomography (OCT) (a scan of the back of the eye), including patients living with dementia. They asked staff to offer patients an additional appointment with a clinician rather than discharging or referring the patient to secondary care. They recorded the plan clearly on the Electronic Patient Record (EPR).

We reviewed 12 patient records and care plans to assess how staff offered choice and involved individuals in decisions about their care. For example, staff explained when a patient might have residual astigmatism (a common condition where the eye’s surface isn’t perfectly round, causing slight blur) and discussed that glasses might still be needed. This showed staff provided clear information to support informed decision‑making.

Leaders ensured self‑pay patients were fully informed of all expected and potential costs, in line with Royal College of Ophthalmologist guidance. Staff provided written details of fees, payment terms and any additional charges before treatment began. The provider also supplied clear information on its website and in advance letters, explaining what was included and not included in the self‑pay package. The service carried out limited self‑pay activity at this hospital.

The service provided patients with an information booklet before cataract surgery. This included clear advice and a decision‑making tool that explained the available options. Patients were asked questions about what mattered most to them to help decide whether to have surgery, use aids and adaptations, or choose to do nothing. The booklet also outlined the potential benefits and risks so patients could make an informed choice.

The service also provided links to trusted sources for further information, including the Royal College of Ophthalmologists, the Royal National Institute of Blind People (RNIB), and NHS resources. The service also gave patients clear discharge instructions after cataract surgery, including what to expect, when to seek help, and the provider’s 24/7 emergency contact number.

The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

The provider planned and provided care in ways which met the needs of local people, and the communities served. They worked with others in the wider system and local organisations to plan care where relevant. For example, leaders had met with other organisations to discuss specific needs in their area.

Staff demonstrated a good understanding of the diverse health and care needs of their patient population and the local community and used this insight to offer patients meaningful choices about where and when they received their care. This helped people access appointments sooner, supported attendance, and contributed to managing waiting times more effectively.

They proactively recognised and planned for specific needs, arranging interpreters, providing hearing support, and accommodating patients with reduced vision through large-print materials and clear signage. These measures promoted equitable access, supported patient choice, and enhanced continuity of care.

The service was responsive to people’s needs and managed referrals and appointments in a way that supported timely access to care. Referrals were checked and triaged through the referral management centre, ensuring people were directed promptly to the most appropriate service. Consultants reviewed referrals quickly, and any unsuitable referrals were returned with clear explanations to support shared understanding and prevent delays.

The provider promoted patient choice, offering patients flexibility over where and when they received their care. This enabled people to select appointment locations and times that best suited their circumstances, helping reduce barriers to attendance.

Once accepted, patients followed a well‑structured clinical pathway, with consultant‑led assessment, pre‑operative review, surgery, and post‑operative support. Access to a 24/7 on‑call doctor meant patients could receive timely advice or reassurance if they had concerns after their procedure.

The service had clear processes for managing missed appointments (defined as appointments patients did not attend without letting the service know beforehand). This helped reduce avoidable delays, ensured appointments were used effectively, and supported equitable access for all patients.

The service had introduced patient initiated follow up, which allowed patients to request a follow‑up appointment if they experienced any problems, while avoiding routine appointments when they were recovering well. This approach supported patient autonomy by giving people control over when they sought further care, reduced unnecessary travel, and helped ensure clinic capacity was focused on those who needed it most.

The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Patient information was provided in the most suitable method for each patient. For example, easy-read form and large text. There were clear processes to request interpreters and translators. Staff told us they did not use family or friends to translate and booked interpreters in advance of appointments and surgery.

The service had a range of information leaflets available to support patients’ understanding of cataract care and what to expect throughout their treatment. For example, the cataract surgery booklet provided a clear overview of the procedure, potential risks, and the typical patient experience. Additional information was available on the provider’s website, including guidance on cataract treatment options, eligibility criteria, and what would happen if a patient needed to be transferred to the local NHS trust in the event of complications.

The service kept patient records in both paper and electronic formats, and these were stored securely. Staff retained paper records for 2 years before being scanned onto the electronic system, and the service had a process in place to recall records when patients returned.

We saw that hospital signage was available in English, Punjabi and Urdu, including at the entrance and within patient areas such as the toilets. This helped support accessibility for a significant proportion of the local community. Managers told us that consent forms could be provided in a larger font to support patients with visual impairments, and that the service planned to introduce information leaflets in additional languages to better reflect the demographics of its patient population. However, information leaflets were not yet available in Braille, which limited accessibility for people with severe visual loss.

The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result.

Leaders made it easy for people to raise complaints about their care and treatment. The service used an independent provider to deliver automated patient surveys, with paper options available on request, and also offered, tablets, QR codes, live chat, email, and NHS Choices as additional routes for feedback. When patients complained or raised concerns, they received verbal or written feedback.

The service received 3 complaints between November 2024 and November 2025. Leaders investigated complaints or concern thoroughly, in an open and transparent way. We reviewed a formal complaint and noted it had been fully investigated and responded to within the timeframe set out in the provider’s policy.

Patients were able to escalate any unresolved complaints to an appropriate third‑party organisation, or to the Parliamentary and Health Service Ombudsman if they were NHS patients. The service kept patients informed about how their feedback had been used to make improvements. For example, after feedback from a patient with mobility difficulties, staff arranged to meet them at the entrance for future appointments so their family member could park the car without causing delays. This demonstrated the service’s commitment to responding to individual needs and enhancing the patient experience.

The service received 32 Friends and Family Test responses in October 2025, around 3.5% of the 903 patients seen that month, along with 99.22% positive satisfaction scores from an additional patient feedback platform. The comments we reviewed indicated that patients felt involved in their care. Patients reported being listened to, given clear instructions, and having procedures explained in ways that reduced anxiety and helped them feel reassured.

The provider encouraged staff to gather patient testimonials to help understand individual experiences and identify ways to improve the service. Staff used these testimonials to highlight what worked well for patients and to recognise where adjustments could make care more responsive to their needs.

The service made sure that people could access the care, support and treatment they needed when they needed it.

The service made reasonable adjustments for patients, in line with the Equality Act 2010 and NHS England’s guidance on reasonable adjustments.

Staff used the electronic patient record (EPR) system to flag individual access or support needs at the point of referral, enabling staff to plan appropriately for each patient throughout their pathway. This included requirements such as interpreter support, transport, wheelchair access, mobility assistance, communication needs, learning disabilities and mental capacity considerations.

Staff arranged translation support when needed and booked face‑to‑face interpreters to aid understanding and consent. They also arranged transport for patients who might otherwise struggle to attend and relocated appointments to accessible premises if a site was unsuitable for wheelchair users.

The service identified mobility needs in advance through pre‑appointment courtesy calls, and staff could meet patients at the entrance where required. Evacuation plans reflected individual mobility requirements. The service also provided a hearing loop at reception, supported by clear signage and written communication options for patients who were deaf or hearing impaired.

Patient feedback from the October 2025 Friends and Family Test indicated that a wheelchair user had a positive experience. They reported that staff were welcoming, provided appropriate support with transfers, regularly checked their comfort, and ensured they were not kept waiting due to their mobility needs.

The service had previously been performing well against the 18‑week Referral to Treatment (RTT) standard, meaning most patients were being seen and treated within the expected NHS timeframes. Leaders told us that the Integrated Care Board (ICB) later introduced system‑wide rules, outside of the provider’s control, that required all providers to build in longer minimum waits. These included policies that prevented routine patients from being treated before set time thresholds, even when the provider had the capacity to see them sooner.

As a result of these new rules, some patients experienced delays despite the service’s earlier strong performance. The provider’s staff personally contacted affected patients to explain the changes, reassure them that the delay was not the provider’s decision, and apologise.

Despite the system‑wide restrictions introduced by the ICB, managers continued to monitor waiting times closely to ensure people could still access the service when they needed to and receive timely, appropriate care. They ensured that waiting times from referral to treatment, as well as processes for admitting, treating and discharging NHS patients referred through NHS Choices, remained in line with national standards.

The service averaged 99% 18-week RTT performance from November 2024 to November 2025, significantly exceeding the ICB’s 60% aim. This demonstrated that the provider maintained very strong waiting‑time performance despite the tighter referral restrictions introduced by the ICB. The high performance therefore reflected the service’s continued efficiency and pathway management

Managers worked to keep cancellations to a minimum, and when appointments or operations were cancelled at the last minute, they ensured these were rearranged as quickly as possible and within national targets and guidance.

The service reported 10 same‑day surgery cancellations between November 2024 and November 2025. Staff recorded the reasons as surgeon sickness (3), patient suitability concerns identified on the day (3), lack of an interpreter (1), an allergy issue (1), and a patient requesting a change in lens preference (1). One patient experienced intra‑operative bleeding and pain after the initial incision; the service stopped the procedure immediately and rescheduled surgery to ensure the patient’s safety.

The service supported equitable access by providing patients with clear post‑procedure information, including guidance on when and how to escalate concerns after discharge. Patients were also provided with a dedicated 24/7 telephone number to ensure they knew how to contact the service should they require further advice.

Staff completed mandatory training in learning disability and autism, the Mental Capacity Act (MCA) 2005 and consent. Staff used the electronic patient record (EPR) system to record individual preferences, including pronouns, and displayed chaperone and safeguarding information in consulting rooms, helping to support accessible and inclusive care.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Staff within the service and the wider organisation promoted a culture in which the people using the service felt empowered to give their views.

The provider undertook equality impact assessments of policies and procedures to ensure they did not disadvantage vulnerable people or those with protected characteristics.

Staff received training in equality, diversity, inclusion and human rights, achieving a 100% compliance rate in November 2025, reflecting the organisation’s commitment to foster an inclusive and respectful workplace culture.

The provider reviewed demographic and outcome data to identify disparities affecting patients with disabilities or language needs. The provider updated booking communications to include site‑specific accessibility information and arranged alternative sites or transport where access barriers were identified.

The provider reported that patients with a disability were more likely to express dissatisfaction than those without, with communication and information provision highlighted as areas for improvement.

Leaders reported that, in 2024, the organisation enhanced support for patients with learning disabilities and autism, and that feedback from MENCAP Inclusion Consultants helped improve the accessibility of patient information.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future.

Staff supported people to plan for their surgery, ensuring they had sufficient time to make informed decisions about their recovery. Staff began planning at the pre‑operative stage to promote smooth transitions, with members of the multidisciplinary team, including clinical optometrists and ophthalmic technicians, involved throughout care and treatment.

Staff ensured patients and those close to them understood their treatment, explaining procedures, seeking permission, and providing a detailed discharge booklet reinforced by verbal guidance.

For patients with reduced vision, staff supplied large‑print materials and additional verbal explanations. The provider also offered downloadable information booklets, FAQs and a 24/7 doctor‑on‑call number on its website, ensuring patients and carers could access essential information before and after surgery.

During 2024/25, the organisation strengthened future planning by continuing its partnership with a national sight‑loss charity and its Eye Care Liaison Officer (ECLO), who provided ongoing emotional and practical guidance to help prevent avoidable sight loss and improve the wellbeing of people living with eye conditions. This partnership reflected the organisation’s commitment to anticipating patient needs and developing sustainable support for those with long‑term visual impairment.