SpaMedica Solihull

On this page

• 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

Staff followed a robust audit programme and ensured they were continuously practising safely and in line with national guidance. Leaders were committed to working collaboratively with other services to ensure joined up treatment and care for patients. Patients' needs were thoroughly assessed, and they received individualised care. The service monitored all patients' care and treatment to continuously improve it. Staff ensured patients' outcomes were positive and consistent.

This is the first assessment for this service. This key question has been rated good. This meant patients' outcomes were consistently good, and patients' feedback confirmed this.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service always made sure patients’ care and treatment was effective by thoroughly assessing and reviewing their health, care, wellbeing and communication needs with them.

Patients were involved in the assessment of their needs, and support was provided where appropriate to maximise their involvement. Patients were referred to the service either by their GP or local optometrist. Staff told us about the comprehensive approach to assessing the needs of the patients. Staff were passionate about providing the best and most up to date evidence-based practice in line with national guidance to make sure patients had the best outcomes.

Patients’ needs were individually assessed using a patient questionnaire. Personalised care plans were made if patients needed individualised care. Where this was required, patients were discussed in a multidisciplinary team meeting, to which they were invited. Decisions about treatment were made by a range of experienced professionals about how to deliver the best care for the patient. Patients were confident their individual needs had been appropriately assessed and were fully understood.

Patients’ communication needs were assessed and met to maximise the effectiveness of their care and treatment. Interpreters were booked to attend the hospital with the patient if required; this included British Sign Language interpreters.

One member of staff was training in British Sign Language. The hospital often saw patients who were living with dementia. They encouraged relatives or carers to accompany the patient onto the ward and post-theatre to help them feel settled.

Staff had received specific training to support them to engage with patients with additional needs. All staff had completed training for supporting patients with learning disabilities and 95.5% had completed training on learning disability and autism.

The service planned and delivered patients' 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.

Patients received care, treatment and support that was evidence-based and in line with good practice standards. 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 provider's systems ensured staff were up-to-date with national legislation, evidence-based good practice and required standards. All policies were uploaded onto a database which alerted staff to new policies for them to read. Managers could see who had read the policies and reminded staff who were overdue to read them. We reviewed several policies and saw they were all up to date and referenced national legislation and guidance.

Staff followed established service-wide governance processes to ensure compliance and maintain standards. Staff consistently reviewed performance and compliance using a comprehensive audit schedule. Where compliance was below 95% the frequency of the audit was increased until compliance was regained.

Audits included clinical documentation, consent, laser safety, and infection prevention and control. Clinical documentation audits were completed quarterly, in-line with their schedule, but they had increased their frequency to monthly in February 2024, March 2025 and April 2025 as compliance was below 95%. Compliance improved to 95.9% in April 2025 and a re-audit was scheduled for July 2025. This was monitored by the hospital manager and in clinical governance meetings.

Leaders developed a site action plan which had areas for improvement taken from the results of all the audits performed. An audit result below 95% would result in an action plan which included measures for success and a re-audit more frequently. Audits were repeated to determine progress and compliance. We saw actions were completed and monitored regularly.

Staff engaged in an integrated approach to assessing, planning and delivering care and treatment to all patients who used services. Staff explored what worked with patients who may have additional needs, for example, long-term injections could be offered as an alternative to those unable to administer eye drops. Staff worked alongside community clinicians to help support patients while at home.

Patients' nutrition and hydration needs were met in line with current guidance. The service had hot and cold drinks available and biscuits for patients', post-surgery. If there were long delays to appointments or surgery, the staff provided patients with food.

Staff and leaders were encouraged to learn about new and innovative approaches that evidence showed they could improve the way their service delivered care. The company had a surgeon training programme, which supported NHS trainee ophthalmic surgeons' comprehensive hands-on development through simulated "dry-lab" suites, theatre exposure and supervised cataract practice. This helped to accelerate surgical confidence and competence.

All patients who experienced age-related macular degeneration (AMD) were offered an appointment within 2 weeks of referral as per NICE guidance. In 2023/24 the provider was part of the second national audit for AMD which demonstrated early intervention and timely injections resulted in better visual outcomes and lower rates of vision loss.

The service worked well across teams and services to support patients. Staff worked collaboratively to ensure patients received high levels of care. They recognised the importance of working closely with other services such as optometrists.

Staff had access to the information they needed to appropriately assess, plan and deliver patients' care, treatment and support. Staff requested care summaries from the GP where required. All patients who needed surgery attended a pre-operative assessment to ensure they had all the information they needed and were fit to proceed with surgery.

Information was shared between teams and services to ensure continuity of care, for example when clinical tasks were delegated or when patients were referred between services. The hospital had a daily huddle where they discussed the patients who were due to be seen. They made staff aware of key roles for the day, including the fire warden and person in charge and assigned roles to staff for the day such as tannoy checks, room temperature checks and pharmacy checks. On surgery days there was a surgical huddle at the start of each list where the theatre team discussed each patient individually including any additional needs such as allergies.

When patients received care from a range of different staff, teams or services, it was co-ordinated effectively. All relevant staff, teams and services were involved in assessing, planning and delivering patients' care and treatment and staff worked collaboratively to understand and meet patients' needs. There were multidisciplinary (MDT) meetings involving the patient, when they had specific needs. For example, the staff had reached out to an optometrist who had referred a patient who had additional needs. They had an MDT meeting to ensure they understood the patients' initial requirements and could ensure their hospital visits met their needs.

Surgeons and scrub nurses worked together to make sure patients received the correct lens prior to surgery.

The service had dementia champions on site to support patients living with dementia.

There was a sight support service which offered practical or emotional support to blind people managed by sight support officers.

All SpaMedica Ltd hospitals worked closely together to maximise efficiency and reduce waiting times to benefit patients. Staff were shared across different hospitals working where they were needed the most.

Staff from the company visited optometrists within the area regularly to ensure they were kept up to date on the care the hospital provided.

The service did not always support patients to manage their health and wellbeing to maximise their independence, choice and control. They did not always ensure patients had access to information to improve their health and wellbeing.

The service did not always support patients to live healthier lives and where possible, reduce their future needs for care and support. We saw no information given to patients about the impact of smoking or alcohol on their eye health.

The staff advised patients about how to reduce dry eyes, which was a symptom many patients experienced. We saw leaflets in the waiting room describing how to reduce these symptoms with good daily eyelid hygiene. However, it was not clear how these were made available to patients who were partially sighted and could not read the leaflets.

Patient information and leaflets were displayed in large notice boards throughout the service and were relevant to the holistic needs of the service users but it was not clear how this information was available for people who could not read or were partially sighted. The service told us they were looking into creating a QR code for the noticeboards which read out the information to patients.

Information available to patients was vast and varied and categorised into different groups such as ‘things to do in Solihull’. This board highlighted support networks and things to do in the area. Information included local charity lunch clubs, a welcome Wednesday club, ‘knit and natter’, magic voices choir, Solihull striders and strollers, bus timetable and other useful local amenities.

The service had not considered the demographics of their service users, and the information provided was not best suited to their needs. We did not see information provided in different formats for patients who were partially sighted or blind.

The service monitored all patients' care and treatment to continuously improve it. Staff ensured outcomes were positive and consistent, and they fully met both clinical expectations and the expectations of patients themselves.

There was participation in relevant local and national clinical audits and other monitoring activities such as reviews of services, benchmarking and peer reviews. The peer review process was a mock CQC audit which aimed to improve care for their patients and embed and celebrate good practice. Staff used peer review to identify areas for improvement and obtain support to make changes. There was a comprehensive checklist based on the CQC assessment framework for hospital managers to follow. The service was due to have a peer review a few days after our assessment.

Staff monitored and improved quality and outcomes by taking part in regular audits including national clinical audits. Staff provided data to the National Ophthalmology Database Audit (NODA); the Royal College of Ophthalmologists, who measured outcomes of cataract surgery. The audit looked at common complications that occurred during cataract surgery.

The service had a lower than expected risk of complications for elective care than the England average. SpaMedica Solihull had an average posterior capsular rupture (PCR) rate of 0.42% compared to the national average of 1.1%. PCR is a complication that may occur during surgery when the capsular bag that holds the lens breaks. This meant SpaMedica patients were 2 times less likely to experience a PCR complication during cataract surgery. The service also collected this data for trainee surgeons. For the same time period, the PCR rate was 1.71% which was below their trainee benchmark of 1.85%.

The hospital had low return to surgery rates. No patients had returned to theatre since the opening of the service. There had been no re-admissions following surgery and no unexpected admissions for surgery. The hospital benchmarked themselves against other hospitals in the provider network and they performed consistently to a high standard. Staff told us post-surgery complications were rare.

The service collected data on post-surgery complications including cornea oedema (0.31%), post-operative uveitis (4.6%), and iris trauma (0.31%). These were all compared with other SpaMedica sites and discussed every 6 months to look at any changing trends. Managers and staff used the results to improve patient outcomes. Staff completed regular audits and performed consistently well over a 12-month period, scoring on average over their target of 95%.

Patients reported on the outcomes of their surgery. The service gathered information post-operatively to see if patients were happy with their outcomes. In the 12 months prior to the assessment, 98.7% of patients were happy with the outcome of their treatment.

Audits were conducted on each surgeon to monitor the outcomes monthly to check for effectiveness of treatments. These were reviewed and monitored by the surgeon liaison manager.

There had been a recent theme taken from patient calls to the on-call line regarding dry eyes, post operation. Following this, the service trialled dry eye drops pre-surgery, following the pre-assessment with the nurse, to reduce dry eye symptoms pre-surgery. They found after they had introduced this, the emergency calls had reduced by 4%.

When patients had their appointments, treatments or operations cancelled at the last minute, managers made sure they were rearranged as soon as possible and within national targets and guidance. There was a cancellation rate of 1.7% in the last 12 months. Patients who were cancelled for medical reasons were added to a temporarily unfit waiting list. The team called the patient regularly to get an update on their condition. When they were medically fit for surgery, they were rebooked as soon as possible. At the time of the assessment, there was a 10 day wait for surgery.

The service told patients about their rights around consent and respected these when delivering person-centred care and treatment.

Patients understood their rights around consent to the care and treatment they were offered. There were systems and practices to ensure patients understood the care and treatment being recommended. This helped them make an informed decision.

Staff gained written consent from patients for their care and treatment in line with legislation and guidance. Staff made sure patients consented to treatment based on all the information available. Patients received information about care and treatment in a way they could understand and had appropriate support and time to make decisions. Patients were given information about their proposed treatment both verbally and in written form, to enable them to make an informed decision about their procedure.

Staff understood the importance of ensuring patients fully understood what they were consenting to and the importance of obtaining consent before they delivered care or treatment. Staff clearly recorded consent in the patients’ records. Patients were given a14 day cooling off period following consultation prior to surgery.

The service mostly ensured patients were consent in line with their policy. The service audited the completion of consent forms quarterly and if compliance was below 95%, the audit was increased to monthly until an improvement in compliance. In January 2025 the compliance was 92% and the service therefore completed an audit in February 2025 where results showed an improvement of 98.5% compliance. In May 2025 compliance remained high at 99%. We looked at 10 sets of patient notes and saw consent was recorded in all these records. Staff had the appropriate skills and knowledge to seek verbal and written informed consent before providing care and treatment to their patients.

Patients’ capacity and ability to consent was considered, and they, or a person lawfully acting on their behalf, were involved in planning, managing and reviewing their care and treatment. All patients underwent a capacity assessment at pre-operative assessment with the nurse. There was a 2-stage test of capacity and where required, a dual consent form was completed if a patient lacked capacity. The details of the intended procedure or treatment was discussed with the patient together with their family or lasting power of attorney. The optometrist conducting the pre-assessment obtained a second opinion from a fellow optometrist or consultant to agree that the proposed procedure was in the best interest of the patient. Dual consent was documented on a separate consent form and signed by all persons involved. The consent policy clearly outlined this procedure.

Staff were aware of the legal requirements of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards. Data showed 91.3% of staff had completed MCA training. There was an up-to-date Mental Capacity Act policy.

We observed a consultation where consent took place. We found the staff were engaging with the patient, provided appropriate information and completed the consent alongside the patient while checking their understanding.

There was an up-to-date consent policy which staff followed when gaining consent from patients.