SpaMedica Sittingbourne

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We looked for evidence that patients and communities had the best possible outcomes because their needs were assessed. We checked that patient’s care, support and treatment reflected these needs and any protected equality characteristics, ensuring patient were at the centre of their care. We also looked for evidence that leaders instilled a culture of improvement, where understanding current outcomes and exploring best practice was part of their everyday work.

Staff assessed patients’ needs and involved them, and where appropriate their families, in care planning. Care and treatment followed national guidance and recognised good practice, with effective teamwork supporting coordinated care. Staff helped patients understand their treatment options and make informed decisions. Patient outcomes were positive, care was largely free from harm, and the service monitored performance to drive improvement. Staff also ensured patients received clear information about treatment options and risks to support informed consent.

This is the first assessment for this service. This key question has been rated as good. This meant patient’s outcomes were consistently good, and patient’s feedback confirmed this.

We have not awarded this service a score for Effective.

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

The evidence showed a good standard. The service usually made sure patient’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

The service assessed people’s health, wellbeing and communication needs and involved them in decisions about their care and treatment.

We reviewed patient records and found staff assessed and recorded people’s needs. Staff carried out appropriate checks, considered any risks and recorded in line with guidance. Communication needs were clearly documented, and information was provided in a way people could understand.

Patients’ communication needs were assessed to support effective care and treatment. Interpreters, translators and signers, including British Sign Language (BSL) support, were available and booked when required. Information booklets in different languages were also available. The service had access to a hearing loop to support patients with hearing impairments.

Patients were supported to make informed decisions about their care and treatment. Records showed they were involved in decisions about their care.

Staff explained treatments, including cataract surgery, clearly and discussed the benefits, risks and what to expect after treatment. Patients’ needs were reviewed at different stages of their care, including during assessments, before surgery and at follow-up appointments.

Patients having cataract surgery attended a pre-operative assessment to make sure the procedure was suitable for them. This included reviewing their health, medical history and any factors that could affect treatment. We saw staff discussing individual needs and alternative treatment options with patients.

Staff shared important information when care was passed between services. Following appointments and surgery, relevant information was sent to patients' GPs and referring optometrists to support ongoing care.

Staff discussed patients’ communication needs during theatre safety briefings to make sure people received appropriate support. Information about the Mental Capacity Act was displayed in theatre areas, helping staff to understand how to support patients who may have difficulty making decisions.

Patients received written information when they left the service, including details of their procedure and advice about their aftercare.

The evidence showed a good standard. The service usually planned and delivered patient’s care and treatment with them, including what was important and mattered to them. Staff did this in line with legislation and current evidence-based good practice and standards.

The service planned and delivered care with patients and took account of what was important to them. Staff provided care and treatment in line with current best practice and nationally recognised standards.

Polices and processes took account of changes to the Royal Colleges guidelines and National Institute for Health and Care and Excellence (NICE) guidelines, and the National Safety Standards for Invasive Procedures (NatSSIPs). NatSSIPs provide a framework to produce Local Safety Standards for Invasive Procedures (LocSSIPS).

Staff followed up-to-date policies to plan and deliver high-quality care according to best practice and national guidance. All policies we looked at contained a creation and review date, and clear references to current national guidelines. Updates regarding evidence-based care and treatment was filtered through the governance meetings and shared with staff at monthly team meetings and morning huddles.

The service followed local criteria for cataract surgery based on NICE guidance. Staff recorded decisions clearly, and the service carried out regular audits to make sure these criteria were applied consistently. We reviewed 5 patient records and found that staff assessed people's needs and any risks. Care and treatment were planned appropriately and tailored to each person's circumstances.

Cataract surgery was provided as a day-case procedure, meaning patients returned home on the same day. Before surgery, staff carried out assessments to make sure treatment was suitable and safe. After surgery, patients received clear advice about their recovery, written information and contact details should they need support.

Staff checked whether patients could manage their eye drops after surgery. When this was not possible, they discussed other treatment options and explained the benefits and risks so patients could make informed decisions about their care.

The service also managed implants and medical devices safely. Staff kept accurate records so lenses and equipment could be traced if needed.

The evidence showed a good standard. The service usually worked well across teams and services to support patient. Staff made sure patient only needed to tell their story once by sharing their assessment of needs when patient moved between different services.

The service worked well across teams and services to support patients. Doctors, nurses, administrative staff and other healthcare professionals worked together effectively to deliver coordinated care and achieve good outcomes.

Staff reported positive working relationships across professional groups, including between clinical and non-clinical teams. We saw effective multidisciplinary working during the assessment, based on mutual respect and trust, which supported the delivery of safe and effective care. We saw positive and professional communication between staff and patients throughout the service.

The service supported the training of future surgeons within a well-managed and supervised environment. During the assessment, we observed 2 trainee surgeons receiving direct training from a consultant surgeon. Patients were informed when trainee surgeons were involved in their care. Trainee surgeons were appropriately supervised to ensure procedures were carried out safely.

Teams and services shared information appropriately to ensure continuity of care. Following each episode of care, clinicians sent discharge summaries or clinic letters to the referring clinician, ensuring relevant clinical information and outcomes were shared clearly and in a timely way. Staff worked effectively with external services, including opticians and other healthcare providers, to ensure patients received coordinated care across the pathway.

Clear processes were in place to escalate concerns and refer patients to other services when needed, supporting safe and responsive care.

The evidence showed a good standard. The service generally supported patients to manage their health and wellbeing to maximise their independence, choice and control. The service supported patients to live healthier lives and where possible, reduce their future needs for care and support.

The service helped people manage their health and wellbeing so they could remain independent, make informed choices and take an active role in their care.

Patients received clear, easy-to-understand information about their treatment and recovery. This included printed leaflets, written aftercare instructions and online resources, such as videos explaining eye conditions and eye surgery, including what to expect before, during and after treatment. Information was presented in a way that was easy to read and understand. For example, leaflets included photographs and limited amounts of text. Some leaflets were printed in black and yellow, which can be easier for some people with glaucoma to read.

Patients were given information about what to expect after surgery, including common symptoms such as blurred vision, mild discomfort and sensitivity to light. They also received advice about when to seek help. A ‘taking care of yourself’ leaflet helped patients understand how to recover safely and confidently after their procedure.

Patients having planned surgery received information about their condition, treatment options and how to prepare for treatment. Staff explained how patients could support their own recovery. During the assessment, we saw staff advising a patient not to bend forwards and not to drive after their procedure. This helped the patient plan ahead and understand their recovery requirements.

The service also promoted healthy lifestyles and good eye health. Information in the waiting area included advice on healthy eating and its benefits for eye health. We also saw information reminding patients about good eye care and hygiene, such as washing their hands regularly. Information about mental health and wellbeing was also available, encouraging patients to look after their overall health.

The evidence showed a good standard. The service monitored patient’s care and treatment to continuously improve it. Staff ensured outcomes were positive and consistent, and they met both clinical expectations and the expectations of patient themselves.

The service monitored patients' outcomes to make sure care remained safe, effective and delivered good results.

Staff monitored the effectiveness of care and treatment through audit and benchmarking to compare with other similar services, and peer reviews. The peer reviews, helped staff share learning, identify good practice and improve the care they provided. Managers used a structured review process based on the CQC assessment framework to monitor quality and support improvement.

During the previous 12 months, the service provided care for 2,276 people. This included 874 cataract operations, as well as laser treatments and eye injections.

The service monitored treatment outcomes and benchmarked its performance against national standards. The service reported no serious infections, and most people experienced improved vision following treatment.

The service monitored surgical outcomes and complications to identify trends and support improvement. This included unplanned returns to theatre, readmissions and other complications following surgery. Leaders reviewed this information through governance processes and compared performance with other services across the organisation's network.

Cataract surgery outcomes were generally in line with expected standards. Data provided by the service showed that, of 874 operations undertaken between June 2025 and May 2026, 99.2% were completed without posterior capsular rent (PCR), which was within national benchmark limits. However, data was unavailable for March and May 2026, which may have affected the overall reported performance. In addition, performance in February 2026 was below both the service's internal target and the national benchmark.

The service reported one case of endophthalmitis, a rare but serious eye infection, and rates of other complications were low. Data between June 2025 and May 2026 showed the visual acuity target of 95% was achieved or exceeded in nine months, with performance slightly below target in two months at 94%. Data for the same period showed patient outcomes relating to dioptre improvement met or exceeded the 85% target in all but one month, with April achieving 82%. Further data reviewed showed that 100% of patients achieved the expected outcome in 4 of the 6 months reported.

Patient feedback and treatment outcomes were reviewed regularly. The service used this information, alongside audit findings and performance data, to make improvements and monitor the impact of any changes made.

Managers used a dashboard to monitor performance and clinical outcomes across the service. This allowed them to identify trends, benchmark results and support continuous improvement.

When appointments or procedures were cancelled, staff worked to rearrange them as quickly as possible. Patients who were temporarily unable to undergo treatment were monitored and rebooked when clinically appropriate. The service also monitored waiting times to help ensure patients received timely care.

The evidence showed a good standard. The service told patient about their rights around consent and respected these when delivering person-centred care and treatment.

Staff supported patients to make informed decisions about their care and treatment. They explained procedures clearly and made sure people understood their options before agreeing to treatment. During the assessment, we observed staff seeking verbal consent before carrying out examinations and checking that patients understood what would happen.

Where possible, staff gained consent from patients for their care and treatment in line with legislation and guidance. Consent for surgery was sought by the most appropriate doctor and included discussion about the benefits, potential complications, the risks and alternative options. Discussions included the benefits, risks, possible complications and alternative treatment options. Patients signed consent forms before their procedure, and staff checked consent again on the day of surgery to make sure it remained valid.

Staff followed the service's consent policy and maintained good records. We reviewed 5 patient records and found that consent had been documented appropriately in every case. We also observed staff confirming consent before procedures took place.

Patients were supported to understand information and take part in decisions about their care. We saw staff supporting a patient whose decision-making involved a Lasting Power of Attorney (LPA). Staff followed the correct process and demonstrated a good understanding of their responsibilities under the Mental Capacity Act. Training figures showed 100% of staff had up to date training on the Mental Capacity Act 2005

The service carried out regular audits of consent documentation and used the findings to monitor compliance and improve practice.