SpaMedica Sittingbourne

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• 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 there was an inclusive and positive culture of continuous learning and improvement that was based on meeting the needs of patient who used services and wider communities. We checked that leaders proactively supported staff and collaborated with partners to deliver care that was safe, integrated, person-centred and sustainable, and to reduce inequalities.

The service demonstrated effective leadership, a positive and inclusive culture, and strong governance arrangements. Staff understood the service's aims and their roles, felt supported by visible and approachable leaders, and were encouraged to provide feedback and contribute to service improvements. Equality and inclusion were actively promoted, and there was a clear commitment to continuous learning, collaboration, and the delivery of high-quality care.

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

We have not awarded this service a score for Well-led.

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

The evidence showed an exceptional standard. The service had a clear shared vision, strategy and culture that built on the organisational vision and strategy. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and an exceptional understanding of the challenges and the needs of patients and their communities.

The service had a vision for what it wanted to achieve and a strategy to turn it into action. This vision reflected the overarching provider aims and objectives.

Staff understood the organisation's vision and objectives and could describe how these related to their day-to-day roles. The provider's 2026 strategy focused on three key priorities: securing cataract capacity, diversifying services and managing costs, underpinned by the principle of 'every patient, every time, no excuses, no exceptions'.

Leaders actively involved staff in delivering these objectives. Teams discussed the organisational priorities and developed local pledges describing how they would contribute to achieving them.

Staff felt motivated about the future and planned changes for the service. We saw several examples where staff had identified opportunities to improve the service and had been supported to do so. Examples included opportunities to reduce unnecessary costs through improved stock management and by reducing waste. They also promoted the correct use of recycling and waste streams and challenged unnecessary spending on items such as travel, taxis, and postage. Staff also identified opportunities to support community outreach and strengthen relationships with local optometrists to increase access to services.

Staff and leaders demonstrated a positive, compassionate and inclusive culture. Staff told us they felt respected, supported and valued, and that leaders listened to feedback and responded to suggestions where possible.

Staff consistently described being very proud to work for the organisation and committed to delivering high-quality care. Staff described leaders as highly approachable and transparent. Survey results showed 100% of respondents believed the organisation identified learning from patient safety incidents, complaints and feedback, and 100% felt they were treated as a valued member of the team regardless of their role.

Leaders regularly communicated organisational updates and improvement initiatives. We saw examples of communications about new digital systems and service developments designed to improve efficiency, reduce administrative burden and support staff in their roles. Staff told us they felt well informed about organisational priorities and changes affecting the service. This was reflected in staff survey results, where 100% of respondents said they were kept informed about important issues affecting the organisation.

The provider promoted a culture of recognition and appreciation. Staff contributions were celebrated through initiatives such as the 'Feel Good Friday' newsletter, the 'Above and Beyond' register and an 'Appreciation Station', where colleagues could recognise and thank one another for their contributions.

The service worked in partnership with the NHS and local healthcare providers to respond to increasing demand for ophthalmology services. Staff understood the needs of the communities they served and remained focused on improving patient access, experience and outcomes.

The evidence showed a good standard. The service had leaders who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders usually had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty and understood the impact their behaviours and leadership had on patient outcomes and experience.

Leaders were visible, approachable and had the skills and experience needed to lead the service effectively. Staff told us they felt supported and comfortable raising concerns, and that leaders listened and acted on feedback where appropriate.

There were effective processes to ensure leaders were suitable for their roles. Staff had regular appraisals and opportunities to develop their skills and knowledge.

Leaders promoted a positive and inclusive culture where staff felt valued and respected. Staff consistently described leaders as supportive and told us they felt able to speak up and contribute ideas for improvement. This was reflected the staff survey results, where 100% of respondents said managers listened to suggestions and ideas and kept them informed about important issues

Leaders took appropriate action when incidents, concerns or complaints were raised and encouraged learning and improvement across the service.

The evidence showed an exceptional standard. The service was exceptional at fostering a positive culture where people knew they could speak up and their voice would be heard.

The service promoted a positive and open culture in which staff felt able to speak up and be heard. Systems were in place to support openness and transparency, including clear processes for raising concerns through local leadership teams and human resources. Whistleblowing and Freedom to Speak Up policies were established, and staff received training to ensure they understood how to raise concerns.

Feedback from staff reflected a strong speaking-up culture. Staff we spoke with during the assessment told us they felt encouraged and supported to raise concerns and felt confident leaders would listen and take appropriate action. This was supported by staff survey results, which showed 100% of respondents felt management genuinely sought and responded to suggestions and ideas, 100% felt involved in decisions affecting their work, and 100% felt informed about important issues and changes within the organisation.

The service had three Freedom to Speak Up Champions who provided staff with valuable additional support and guidance if they wanted to raise concerns. Staff had access to anonymous reporting routes and were aware of the different options available to them. Staff told us they felt comfortable using these processes and were fully confident concerns would be acted upon appropriately.

Staff survey results reported 92% of respondents said they felt confident speaking up if they had a patient safety concern and believed they would be listened to.

Leaders maintained continuous oversight of concerns through established governance processes, including risk registers and management reporting systems, and took immediate action when concerns were raised. The provider had highly effective Freedom to Speak Up arrangements in place and staff demonstrated a deep understanding of how to access support and raise concerns.

The service demonstrated an exceptionally open and inclusive culture in which staff felt valued, listened to and empowered to raise concerns. Multiple speaking-up routes, including Freedom to Speak Up Champions and anonymous reporting mechanisms, supported a culture of openness, learning and continuous improvement.

The evidence showed a good standard. The service valued diversity in their workforce. Staff work towards an inclusive and fair culture by improving equality and equity for everyone.

The service valued diversity and promoted an inclusive and fair workplace. The provider had an overarching equality, diversity and inclusion (EDI) strategy, which leaders used to promote an inclusive culture and support fair treatment for staff and patients.

Staff told us leaders were supportive of individual needs and made reasonable adjustments where required. Examples included providing access to quiet working areas and supporting staff who needed time away from work to manage long-term health conditions. Staff also had access to mental health first aiders, a Wellbeing Hub and an employee assistance programme.

The provider monitored staff experience through regular surveys. Results were highly positive, with 100% of respondents reporting people were treated fairly, regardless of race, gender, sexual orientation or other protected characteristics. Staff also reported feeling respected, valued and included within the workplace.

The service recognised and celebrated diversity throughout the year and promoted understanding of different cultures, faiths and communities. These arrangements helped create a culture where staff felt included, respected and able to be themselves at work.

The evidence showed a good standard. The service had clear responsibilities, roles, systems of accountability and good governance. Staff used these to manage and deliver good quality, sustainable care, treatment and support. Staff act on information about risk, performance and outcomes, and shared this with others when appropriate.

The service had clear responsibilities, roles and systems of accountability to support the delivery of safe, effective and sustainable care.

Staff understood their roles and responsibilities, and there were effective governance arrangements to oversee quality, safety and performance. Leaders reviewed information from a range of sources, including audits, incidents, patient feedback, complaints and clinical outcomes, to identify trends and support continuous improvement.

The service had a structured governance framework supported by regional governance leads and regular local, regional and provider-level meetings. Learning, risks and performance information were shared through governance updates, weekly communications and team meetings, helping staff remain informed and engaged.

Leaders used a range of audits, quality assurance processes and performance measures to monitor the safety and effectiveness of the service. Clinical outcomes were reviewed regularly and benchmarked against national standards, including the National Ophthalmology Database, and against other services within the provider network to identify opportunities for improvement.

Leaders used a dashboard to monitor clinical outcomes and surgeon performance in real time. This allowed managers and clinical leaders to review performance data, identify trends, benchmark outcomes and respond promptly where additional support or improvement was required.

The service also had access to provider level clinical governance through the Medical Advisory Committee (MAC). The committee reviewed clinical performance, governance matters and learning across the organisation. Information, updates and learning were shared with surgeons through regular communications and meetings, helping to ensure consistency of practice and awareness of emerging risks, guidance and improvement opportunities. The service maintained a comprehensive risk register supported by a risk management policy. Risks had identified owners, executive oversight and review dates. Leaders monitored operational, clinical, workforce, information governance and environmental risks and reviewed the effectiveness of controls put in place to reduce risk. We saw risk ratings were regularly reviewed and reduced where mitigating actions had been implemented.

Leaders used a balanced scorecard to monitor performance across quality, safety, workforce, activity and efficiency measures. This included indicators such as patient satisfaction, complaints responses, mandatory training compliance, theatre cleanliness, workforce metrics and operational performance. The scorecard provided oversight of performance and supported timely action where improvements were needed.

The service used information effectively to support decision-making and improve quality. Secure electronic systems maintained the availability, integrity and confidentiality of patient information and performance data. Learning from incidents, complaints, audits and patient feedback was shared with staff to support continuous improvement and reduce the likelihood of recurrence.

The evidence showed a good standard. The service understood their duty to collaborate and work in partnership, so services work seamlessly for patient. Staff share information and learning with partners and collaborate for improvement

The service actively engaged with patients, local communities and partner organisations to promote wellbeing and provide support beyond clinical care. Staff worked closely with local charities and community groups, including organisations supporting people affected by macular disease.

Staff attended local macular support groups to engage with patients and the wider community. In addition, they hosted support events at the hospital, providing patients and their families with opportunities to access information, share experiences, and build supportive networks. The service participated in community fundraising activities and had raised money for a range of charitable organisations.

The service encouraged engagement with the wider community through educational and outreach activities. Staff supported careers and education events, hosted work experience placements for local students and promoted awareness of career opportunities within healthcare and ophthalmology.

The service also maintained good relationships with local organisations, including a care home, and organised fundraising events such as bake sales to strengthen community links. These activities demonstrated the service's commitment to engaging with and supporting the communities it served.

The evidence showed an exceptional standard. The service had a strong focus on continuous learning, innovation and improvement across the organisation and local system. They always encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contribute to safe, effective practice and research.

The service demonstrated a strong commitment to continuous learning, improvement and innovation. Leaders promoted a culture where staff were encouraged to develop their skills, contribute ideas and identify opportunities to improve patient care and service delivery. The senior leadership team and staff shared a wide range of innovation and research across all locations.

Staff told us managers were approachable, receptive to suggestions and supportive of professional development. Learning was shared across the organisation to promote consistency and continual improvement.

Leaders had implemented innovative approaches to support positive patient outcomes. For example, the service offered intraoperative steroid injections for selected patients undergoing cataract surgery as an alternative to post-operative steroid eye drops. Leaders explained this could benefit patients who may experience difficulties administering eye drops following surgery. Appropriate risk assessments and clinical decision-making processes were used to determine patient suitability for this treatment pathway.

The service demonstrated a strong commitment to workforce development. Staff were committed to learning and improving. We were told by several staff that they were encouraged to undertake training and pursue opportunities for career progression. Managers supported staff to attend courses and development programmes that enhanced their knowledge and skills and contributed to service improvement. Staff described opportunities for progression as accessible and available to all employees. The service also offered an apprenticeship programmes to allow staff to gain external accredited qualifications to further their development.

The provider had invested in a comprehensive learning and development programme through its online platform. This provided staff with access to induction resources, onboarding materials, clinical training, leadership programmes, mentoring opportunities, appraisal support and a range of learning resources to support ongoing professional development. Staff spoke positively about the support available to help them develop throughout their careers.

The service also offered apprenticeship programmes to support staff in gaining externally accredited qualifications. These opportunities supported both personal and professional development and contributed to building a skilled and sustainable workforce.

Leaders demonstrated a commitment to developing the wider ophthalmology workforce. The service supported NHS trainee ophthalmic surgeons through the Surgeon Training and Education Programme for Surgeons (STEPS). During the assessment, we observed trainee surgeons being appropriately supported and supervised within clinical practice. The service also facilitated learning and development events for employed and community optometrists, helping to share knowledge, promote best practice and strengthen professional networks across the local healthcare system.