SpaMedica Solihull

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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

The service was very well managed. There was an inclusive, positive learning and improvement culture which was well-established and was driving improvements in outcomes for patients who used services and wider communities. Learning was shared with and sought from partners. There were consistent examples of how an inclusive, supportive, and collaborative leadership approach has driven improvements in safety, sustainability, meeting patients’ needs for staff and patients who use services. Governance and management systems enabled leaders to identify information about risks, performance and outcomes. Leaders made continuous efforts to maintain and improve understanding of ways of working, including staff and patients’ experience, to proactively mitigate risk and improve care delivery.

This is the first assessment for this service. This key question has been rated as outstanding.

This service scored 93 (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 had a clear shared vision, strategy and culture. This was based on transparency, equity, diversity and inclusion, engagement, and a good understanding of the challenges and the needs of patients and their communities.

Senior management ensured there was a shared vision and strategy. Staff in all areas knew, understood and supported the service's vision and values. Regular updates from senior leaders ensured staff felt informed and included. Staff and leaders ensured the service's vision and values were developed in collaboration with patients who used the service, staff and external partners. Staff felt respected, supported, and valued. They were focused on the needs of patients receiving care and worked well together to ensure they achieved good outcomes for patients. Staff were positive and proud to work in the organisation.

The wider provider had three main objectives: patient safety, excellent care and patient satisfaction. They were centred around ensuring every patient had the best possible experience of their services, and the best possible outcome. The organisation's values of safety, integrity, kindness and transparency encouraged staff to achieve the objectives.

The service had created 3 pillars which were a new strategy brought in by the senior leadership team. These included areas for all staff at each hospital to focus on and take accountability for. These were:

• Securing cataract referrals,
• Managing costs, and
• Diversification.

This was discussed as a team and all staff wrote a pledge of how they were going to help deliver the outcomes for the 3 pillars. Pledges included "to not over order stationery", "to continue to promote and encourage correct use of waste streams to keep company costs low" and "to ensure reduced waste with medicines by stock rotating".

Staff and leaders demonstrated a positive, compassionate, listening culture that promoted trust and understanding between them and patients using the service and was focused on learning and improvement. Staff told us managers really listened to them and made changes where possible. Staff we spoke with were proud to work for this service and emphasised how good the service was and it was run well.

The model of working in partnership with the NHS met the growing demand for cataract surgery within an ageing population, and their focus was to bring care closer to home and aimed to be aligned with the NHS priority of delivering exceptional, specialist care in communities.

The service had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

Leaders had the experience, capacity, capability and integrity to ensure the organisational vision could be delivered, and risks were well managed. The hospital manager was well supported by an area manager and the North Region hospital director. The hospital manager was on a 12-week managers course - ‘eyemanage’ -, to enhance their managerial skills. There was also a hospital managers academy to upskill patients who wanted to move towards a hospital manager role.

Leaders at every level were visible and led by example, modelling inclusive behaviours. Staff told us leaders were approachable and supportive. Members of the senior leadership team were visible, and staff told us they listened to staff. Staff gave us examples of things they had highlighted to the senior leadership team which had subsequently changed for the better. Staff felt the leaders gave them a voice and staff were grateful for this.

The board provided a monthly ‘cascade’ video to the staff with updates. We saw one from June 2025 which was predominantly on the 3 pillars strategy and another in July 2025 which focused on how they were investing in the teams and what development opportunities were available.

The hospital manager was passionate about development and supporting staff’s career goals. All staff we spoke with told us career development was important to them. They felt supported by their leaders at all levels to progress and they felt the company valued progression. The company had recently been recognised as a “best workplace for development” for October 2024 to October 2025.

There were processes for providing all staff at every level with the development they needed, including high quality yearly appraisals and career development conversations. The service provided opportunities for career development. There were several different courses and qualifications staff could access. For example, there was in-house scrub nurse academy and age-related macular degeneration injector training.

Leaders were knowledgeable about issues and priorities for the quality of services and could access appropriate support and development in their role.

Leaders at all levels demonstrated high levels of capacity and capability needed to deliver sustainable care. There was a clear management structure with defined lines of responsibilities and accountability.

Leaders held regular staff meetings where staff told us they could voice their views and were listened to and valued.

Senior managers attended regional and national meetings with the senior leadership team where they received updates, discussed governance, performance and shared learning.

There were 2 managers on-call 24 hours a day, 7 days a week to support staff.

The service fostered a positive culture where patients felt they could speak up and their voice would be heard.

Staff and leaders acted with openness, honesty and transparency.

Staff and leaders actively promoted staff empowerment to drive improvement. They encouraged staff to raise concerns and promoted the value of doing so. All staff were confident their voices would be heard.

There was a culture of speaking up where staff actively raised concerns and those who did were supported, without fear of detriment. Staff we spoke with felt able to raise concerns without fear. Staff told us managers acted on concerns raised.

Staff could speak up to the Freedom to Speak Up Guardian, one of whom was the area manager for the company. When concerns were raised, leaders investigated sensitively and confidentially, and lessons were shared and acted on. Staff could raise concerns anonymously.

When something went wrong, patients received a sincere and timely apology and were told about any actions being taken to prevent the same happening again.

The service valued diversity in their workforce. Staff work towards an inclusive and fair culture by improving equality and equity for patients who work for them.

The service promoted equality and diversity in daily work. Managers were looking to target job adverts to enable more blind and partially sighted people to apply. Their provider website was accessible including a recite tool to hear the words and face to face job open days.

There was an equality and diversity policy. Equality and diversity and human rights training was part of staff's mandatory training programme; 100% of staff had completed this. All staff completed an annual employee survey and results from 2024 showed 100% of staff felt patients were treated fairly regardless of their sexual orientation, race or gender.

Leaders took action to continually review and improve the culture of the organisation in the context of equality, diversity and inclusion. There was an equality, diversity and inclusion lead as well as a working group who were looking at ensuring the company had a focus on this.

There was an inclusion and engagement hub which offered a range of insights, information, reminders and resources for raising awareness of and celebrating special events across the year. The hospital displayed the inclusion and engagement calendar and ensured they celebrated different religious festivals including Diwali, Eid al-Adha, Hanukkah, as well as Easter and Christmas. At the time of our assessment, the reception area was decorated for Pride month and the company were celebrating this with a quiz, LGBTQ+ network meet-up and a coffee and catch up event.

Leaders made reasonable adjustments to support disabled staff to carry out their roles well. The leaders had looked at what specific requirements staff might have and ensured they made adaptions to accommodate these.

Leaders ensured there were effective and proactive ways to engage with and involve staff. Staff felt empowered and were confident their concerns and ideas resulted in positive change to shape services and create a more equitable and inclusive organisation. For example, the staff had raised pay issues and the patient's director came and spoke to the staff and pay was reviewed.

Staff completed human factors training which helped staff understand different learning styles, behaviours, cultures, and values.

The service had clear responsibilities, roles, systems of accountability and governance. Staff used these to manage and deliver quality, sustainable care, treatment and support. Staff acted on the best information about risk, performance and outcomes, and share this securely with others when appropriate.

There were clear and effective governance, management and accountability arrangements. Staff understood their role and responsibilities. Managers could account for the actions, behaviours and performance of staff. There was a well-led and effective clinical governance structure with clear systems and processes. Each region had a governance lead who supported the hospital manager with compliance.

Information was reviewed monthly and quarterly from their risk and patient management systems to identify trends in patient outcomes and clinical quality that needed addressing.

There was an assurance framework which included sub-committees that reported to senior management on a regular basis supported by the regional clinical governance lead. There were bi-monthly regional meetings which ensured information was fed back to the senior management team.

Leaders took additional steps to ensure good governance and compliance. For example, staff carried out monthly CQC self-assessment to determine compliance. Clinical governance meetings reviewed the outcomes and shared the findings across all service to look for themes and informed staff where improvements were needed. Information was fed back to staff in monthly team meetings. Leaders told us if staff could not attend, they ran a second team meeting and distributed meeting minutes to ensure all staff were kept up-to-date.

The service had effective systems, such as audits and risk assessments, to monitor the quality and safety of the service. There was a comprehensive audit schedule of clinical and non-clinical audits.

Staff understood and actively contributed to the risk management strategy. Staff used patient outcomes and submitted data to the National Ophthalmology Database Audit to benchmark their performance against other service providers. Data we reviewed demonstrated performance targets for indicators were met.

The service had a risk register, but it did not show the actions taken to mitigate risks. It was not clear who owned the risks and whether these were regularly updated. They had been added in 2023, and no clear updates had been made since. The risk register was discussed in the monthly team meetings but there was no level of detail discussed.

Surgical staff performance was regularly monitored. The senior leadership team shared a quarterly dashboard with outcomes of surgical staff outputs; all of which were positive. Staff identified and addressed risks in an open and timely way. All surgeon reported outcomes, behaviours and clinical outcomes were rated against the red, amber and green (RAG) scale. This was presented at the quarterly meeting and also fed into the medical advisory committee and their rating could impact their ongoing practising privileges. There was a database of surgeon performance which gave immediate and real time information on performance to all hospital managers. A full report was generated annually and hospital managers received outcomes monthly.

There were suitable arrangements for the availability, integrity and confidentiality of data, records and data management systems. Information was used effectively to monitor and improve the quality of care.

Leaders implemented relevant or mandatory quality frameworks, recognised standards, best practices or equivalents to improve equity in experience and outcomes for patients using services and tackle known inequalities.

Staff were sent a weekly update email which included new policies and any tasks that needed to be actioned. These were also discussed at monthly team meetings.

The service were working towards being more sustainable and reducing their impact on the environment. All staff had made a pledge about how they were going to do this. For example, ensuring lights were turned off and managing stock levels appropriately. Information was displayed in staff areas about how and where to recycle items.

Sustainability was an agenda item in the clinical effectiveness group meeting. In February 2025 meeting minutes showed 2 members of staff advised they were part of a sustainability expert group and its aim was to decrease the carbon footprint, reduce emissions, and improve sustainability across the organisation for eye care and surgery. They had proposed 5 pillars to be shared for consideration.

The service clearly understood and carried out their duty to collaborate and work in partnership, and services worked seamlessly for patients. Staff always shared information and learning with partners and collaborated for improvement.

The service worked with several charities. The hospital had worked together with a charity for macular disease to raise money for it. The company would match any donation raised by the hospital. There was a local macular group, which hospital staff attended to offer discussion and support to the patients in the group. The service had also held a macular support group on site, involving patients and other patients with macular conditions, to help the wider community within Solihull feel supported and build relations with other patients with these conditions.

The team had also supported a project alongside a charity to end gender-based violence. They crocheted orange flowers to support a display where each flower represented the number of victims of domestic abuse reported each day.

The company had appointed 30 community champions across the organisation to focus on improving access for those in hard-to-reach communities.

The regional promotion team ran continuous professional development (CPD) events. For example, there was a day planned for September 2025 where all local optometrists and staff were invited and they ran CPD events throughout the day, often led by surgeons to ensure staff and the local community optometrists were kept up-to-date and worked in partnership with the service.

The service produced a newsletter for community optometrists. This included information about the service and how to access further support.

The service had a strong focus on continuous learning, innovation and improvement across the organisation and local system. Staff always encouraged creative ways of delivering equality of experience and outcomes for patients. Staff actively contributed to a safe, effective practice.

Leaders demonstrated a commitment to improvement. Performance was used to promote learning and learning was shared across the organisation. The senior leadership team and staff shared a wide range of innovation and research. We saw examples of innovative ways of working for the benefit of patients. For example, steroid injections during surgery releases anti-inflammatory medication for 4 to 6 weeks post-surgery and could be given as an alternative to discharge eye drops. This was introduced for certain groups of patients who might struggle to administer eye drops post-surgery.

There was shared learning across the organisation. For example, there had been an increase in calls to the patient helpline related to simple dry eye queries post-cataract surgery. They have since provided all cataract surgery patients with lubricating eye drops, free of charge. They also updated their information on managing eye symptoms on their patient information leaflets and website.

Staff were committed to learning and improving. Staff spoke about how managers supported them to attend courses that supported their development and contributed to improving services.

Leaders developed specialist training courses. These in-house clinical training programmes enabled continuous development of clinical teams providing training for nurses to train as scrub nurses and age-related macular degeneration (AMD) injectors. This increased skill sets for the registered nurses. This initiative aimed to increase resilience in clinical service teams and improve retention rates. All registered nurses had direct access and support from an advanced nurse practitioner.

The service offered an apprenticeship programmes to allow staff to gain external accredited qualifications to further their development. There were a few different apprenticeships offered, including customer service specialist, coaching and mentoring, team leader supervisor and business administration.

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. The theatre had 2 microscopes so both the consultant and trainee could see the procedure. SpaMedica Solihull was one of the main sites for surgical training and had supported 3 trainee surgeons since October 2024.

Staff spoke about how the managers were open to suggestions for improvement and facilitated improvements suggested by staff.

There was a commitment to professional development within the company and in the local community. The service arranged learning development days for optometrists at the service as well as community optometrists. In addition, the service supported to trainee surgeons and were committed to their development with the Surgeon Training and Education Programme for Surgeons (STEPS). SpaMedica Ltd had purchased dual microscopes and developed governance pathways so trainees could perform supervised operations at SpaMedica Solihull alongst other sites. A surgeon from Solihull had won the outstanding trainer award 2023-2024. They were nominated by their trainees and were recognised for their dedication to their students, exceptional attention to detail and ability to foster a supportive and encouraging learning environment.

The company had a remote-controlled slit lamp. This allowed an optometrist to carry out a real time examination from one location while the patient was in the other. This reduced travel time, local costs and made their service more efficient.

They had a box at reception for patients to leave their old glasses. These were then recycled with a charity and meant they did not go into landfill.

There were crochet patterns available in different waiting areas in the hospital for patients or staff to take home. Once items were completed, they were then sent off to a national charity.

The staff had received a letter from a boy at a local primary school saying they were struggling to afford reading books for the children. The team held a bake sale to raise money which was used to purchase 83 new books for the children.

The team were completing a team blood donation to the local blood bank as there had been an increased demand in the area for blood donations.

At Christmas, the teams had donated to the operation Christmas child appeal by creating shoeboxes with gifts for children in need across the world.