Optimax Laser Eye Clinics - Southampton

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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

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Staff developed care plans that met patient’s needs identified during assessment. When patients attended their first appointment, they were asked to complete a health assessment on the clinic computer. This included information such as underlying health conditions, personal information and transport needs. Optometrists used a range of routine diagnostic tools such as biometry, topography and retinal scans to assess the condition of a patients’ eyes. Health assessments and diagnostic tools were used to inform recommendations for care and treatment, based on the patients’ individual circumstances and needs.

Staff used strict patient suitability criteria to assess which patients could safely receive care and treatment at this service. For example, patients with certain healthcare conditions such as active ocular disease were not suitable for refractive lens surgeries. When prospective patients were identified as unsuitable for treatment, the clinical reasoning for this was documented in patient records.

The evidence showed a good standard. The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. However, this was not always in line with legislation and current evidence-based good practice and standards.

The service did not always meet national standards for National Safety Standards for Invasive Procedures 2 (NatSSIPS2) 8 steps to safer surgery. Although the local surgical safety checklist mostly reflected NatSSIPs2, there was variation in the standard naming of the three checklist portions. Also, specific checks such as confirmation of accountable items and ophthalmic standard inclusions for biometry and refractive target checks were missing from some portions of the service’s World Health Organisation (WHO) surgical safety checklist. This posed an organisational and human factors risk, especially for staff who worked across multiple providers. Following the onsite inspection, senior leaders immediately updated the surgical safety checklist to the nationally recognised format and included the additional specific checks raised by the inspection team. We observed this being used well by the theatre team during the second onsite assessment.

Additionally, count boards used to record patient details and accountable items did not have specific areas for recording standardised information as required by NatSSIPs2. Accountable items checks must be performed consistently, to ensure that items used during surgery, are removed intact and are not left in the wound or on the patient. However, the risk was low for this type of surgery. Following the onsite inspection, senior leaders immediately consulted with internal teams to confirm adaptations for theatre count boards across all service locations, alongside staff conference calls, meetings and training. The service updated the count board to match best practice guidelines, and we saw this being used by theatre teams during the second onsite assessment. However, this improvement was still being embedded in staff practice.

However, patients received care, treatment and support that was evidence-based and in line with best practice standards. The services’ clinical guidance and standards were informed by the central provider Medical Advisory Board (MAB). The MAB met at least once per year to review best practice guidance and standards, along with the newest international evidence and technological advances. This meant senior leaders could be assured the safety and performance of this service was similar to other services they delivered.

The provider had systems in place to ensure care and treatment followed the most up to date national and international best practice guidelines issued by appropriate professional and industry bodies. These included the Royal College of Ophthalmologists (RCOphth), the World Health Organisation (WHO), and the National Institute for Health and Care Excellence (NICE).

There were hot and cold drinks available to patients visiting the clinic. Patients undergoing a procedure were offered chocolate bars postoperatively if they needed it.

The evidence showed an exceptional standard. The service always worked well across teams and services to support people. They shared thorough assessments of people’s needs when they moved between different services, so people only needed to tell their story once.

The service used theatre scheduling tools effectively to safely manage operating theatre lists. The service booked one type of surgery per operating theatre list. This meant all refractive lens exchange surgery occurred in one session and the theatre team debriefed and re-briefed for subsequent operating theatre lists. This reduced the risk of human error by ensuring a team pause occurred between different types of surgery.

During the team brief, the theatre team discussed each patient individually, including any additional needs such as allergies or specialist equipment and implants. This meant patients received care and treatment by a multidisciplinary team who were well coordinated and worked together effectively.

Teams collaborated well with each other, ensuring information about patients’ needs were communicated seamlessly at each stage of handover. Staff had access to all the information they needed to appropriately assess, plan and deliver people’s care treatment and support. Staff proactively worked with patients' General Practitioners prior to surgery when this was needed. This meant care plans considered any additional needs and reasonable adjustments.

There were supportive systems for staff to access clinical advice from colleagues. Optometrists said they were able to immediately request advice from other optometrists or consultant ophthalmologists, especially when running a clinic list alone. Multidisciplinary team working was further developed by team training days focusing on areas such as clinical complications. Staff and leaders were aware of the steps for escalating complex postoperative concerns up to the central Medical Advisory Board.

All service locations for the provider worked closely together to share learning and make improvements. Leaders and staff worked together across the provider locations to ensure safe levels of staffing and oversight were maintained at all times.

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

Records showed patients submitted information about their health and lifestyle before being assessed for surgery. Optometrists used this information to support discussions around patient expectations for surgery and suitability for different treatment options.

Staff provided relevant information promoting healthy lifestyles and support to patients on an individual basis where this could improve eye health. This included dry eye advice and eye health information.

The evidence showed an exceptional standard. The service monitored all people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they fully met both clinical expectations and the expectations of people themselves.

Outcomes for patients were positive, consistent, and met expectations, such as national standards. The service had a lower-than-expected risk of complications for elective care than the England average. The service monitored individual consultant ophthalmologist performance for different procedures, incidence of complications, type and number of complications both during and after surgery. The service benchmarked themselves against other locations in the provider network and they performed consistently to a high standard.

The service performed better than the national target for posterior capsular rupture (PCR). PCR is a complication that may occur during surgery when the capsular bag that holds the lens breaks. There had been no incidences of PCR compared to the National Ophthalmology Databases' 2025 national average for consultant surgeons of 0.77%. This meant their patients at this service were less likely to experience a PCR complication during lens replacement surgery. Additionally, there were no incidences of stage 2 or higher diffuse lamellar keratitis (DLK) at this service. DLK is a rare inflammatory reaction that can occur after laser eye surgery such as LASIK.

Patients received evidence based and personalised care, where staff used individual assessment information and service outcomes data to manage expectations for likely outcomes of surgery. The service provided a personalised laser eye surgery forecast for each patient, using live data of visual results and satisfaction levels of patients with similar demographics.

The evidence showed some shortfalls. The service did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

Processes were not designed well to safeguard patients with communication barriers from the risk of exploitation or coercion. Central provider policy permitted patients to use family members or friends to translate clinical information during appointments and informed consent discussions. This fell short of the standards for obtaining valid informed consent under best practice guidelines from the General Medical Council and Office for Health Improvement and Disparities. There was a risk patients could receive inaccurate, omitted or mistranslated information. For patients who could not communicate well in English, there was a risk staff might not recognise safeguarding risks such as impaired capacity or coercion. The provider’s policy recognised the risk of misunderstanding or incomplete interpretation but placed this responsibility on the patient and the non-professional interpreter. Additionally, all documents shared with patients were only available in English, including declarations around interpreting needs and patient information. Although, no patients had been consented for surgery in this way in the last year, there remained a risk of harm. When we raised this concern with leaders, they immediately reviewed their systems and processes and made improvements to these to protect patients from risk of harm. The service was now meeting best practice guidelines.

Patients did not always receive information about material risks for treatment options as part of the informed consent process in line with best practice guidelines. Although the service shared information about risks and benefits with patients, documents such as patient guides and standardised consent forms contained limited meaningful information about risks of complications and adverse events associated with surgery. The policy outlining expectations for informed consent did not include the most up to date information, such as older versions of guidelines. Of 3 patient records we reviewed, only 1 of these documented the relative likelihood of complications occurring. Complaint records from 2025 showed a poor experience where a patient felt they had not received informed consent about the likely risk of complications. Within 4 weeks of the first onsite assessment, senior leaders at central provider level audited over 5000 patient records to assess the quality of record keeping of informed consent discussions. The provider used risk assessment tools effectively to prioritise enhanced monitoring and training for the highest risk areas. This meant patients could now be assured they would have meaningful discussions about informed consent for their procedure, at all service locations under the provider.

However, patients were given time to reflect on their surgical decision and could change their mind to refuse treatment if they wanted to. Patients met with their consultant ophthalmologist to discuss their chosen treatment option through a face-to-face appointment or video call, and the formal informed consent document was signed. The service used a routine 1 week cooling off period. This was in line with the Royal College of Ophthalmologists Recommendations for Professional Standards for Refractive Surgery. On the day of surgery, patients re-confirmed consent with the consultant ophthalmologist, countersigning the consent record.

All staff had received annual training for assessment of mental capacity.