Optegra Maidstone

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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

This meant we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

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

We looked for evidence that people's needs were assessed, and that their care, support and treatment reflected those needs and any protected equality characteristics. We also reviewed how leaders promoted a culture of continuous improvement, using outcomes and best practice to inform everyday work.

The service delivered effective care through comprehensive assessments, personalised care planning and treatment delivered in line with national guidance and established clinical pathways. Staff were well trained, received regular supervision and appraisal, and had access to ongoing professional development to maintain clinical competence.

Multidisciplinary working was effective, with good communication between teams and external healthcare professionals to support safe, coordinated care. The service monitored outcomes through a programme of audits and participation in national benchmarking, with positive results including a 99.6% complication-free cataract surgery rate in 2025 and 99% patient satisfaction in March 2026. Systems ensured staff had access to current policies and best practice guidance, while consent processes were consistently applied.

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.

We scored the service as 3. 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 carried out a detailed pre‑assessment to ensure patients were safe and suitable for cataract surgery. They reviewed key clinical factors such as cardiovascular or respiratory conditions, diabetes, anticoagulation, allergies and any recent surgery. This helped them assess whether a patient could proceed safely or whether additional time or optimisation was needed.

Staff were able to articulate how they coordinate care transfers to external providers, including the information shared and the pathways followed, supporting continuity of care.

Staff also looked at wider needs, including hearing, mobility, implanted devices and the patient’s health on the day of surgery. This holistic approach supported consistent decision‑making and helped reduce avoidable risk.

Staff developed integrated care plans that met patient needs identified during assessment. We reviewed 3 care plans and saw that these met the needs of patients. Records showed staff completed appropriate clinical assessments, considered individual risks, and documented consent. The service clearly recorded patients’ communication needs and provided information in a way patients could understand. Care records demonstrated that staff involved patients in decisions about their care, explained treatment options and aftercare clearly, and reviewed needs at key stages of the pathway to ensure care and treatment remained effective.

Staff communicated with patients in ways that supported their understanding of care and treatment. They adapted communication methods to meet individual needs, particularly for patients with communication difficulties.

We scored the service as 3. 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. They did this in line with legislation and current evidence-based good practice and standards.

Staff could show us where they found the most up to date policies and standard operating policies (SOPs) were on an internal internet. They could name recently released policies and policies they used regularly in their roles. New policies were displayed on a staff board and staff confirmed they were discussed at team briefings for their awareness.

There had been a joint regional meeting where staff could network with their peers from other sites in the region. This ensured they were aligned in the way they worked, and it was an opportunity to learn about different approaches that could be used to improve the way services were delivered.

The service held regular continuing professional development (CPD) events for staff and external stakeholders (optometrists) in the community led by the lead consultant for the site. These allowed staff to keep up to date with developments in the ophthalmic field.

National and professional guidance was reviewed centrally and shared with staff through local governance meetings. The service was contracted to the ICB to provide cataract surgery to NHS patients. It followed the NHS cataract pathway. We saw that policies and protocols referred to relevant national and professional guidance.

Staff followed up-to-date policies to plan and deliver high quality care according to best practice and national guidance.

Policies were aligned to Royal College of Ophthalmologists (RCOphth) and National Institute for Health and Care Excellence (NICE) guidelines, as well as Getting It Right First Time (GIRFT), the NHS Standard Contract and the best‑practice expectations to deliver high‑quality, value‑for‑money cataract services set out by RCOphth, GIRFT and the NHS England National Eye Care Recovery and Transformation Programme (NECRTP).

We scored the service as 3. The evidence showed a good standard. The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff worked collaboratively across clinical, surgical, and non-clinical roles to plan and deliver safe, person-centred care. Staff spoke positively about the access to support from their colleagues to ensure patients received the right care.

We observed a huddle meeting, led by the surgeon. During the huddle, each patient’s medical history, lens choice, and biometry results were reviewed, with clear actions identified to confirm theatre readiness.

Staff were working cohesively towards providing safe and effective care for patients. For example, each patient was managed as an individual and the staff worked with the patient and their relative/ carer to ensure their patient experience was effective. This included allowing extra time for appointments, encouraging relatives or carers to enter clinical areas such as the ward to provide support and reassurance, providing a clinic room for privacy and arranging their appointment at a time that suited the patient.

We observed effective multidisciplinary working and communication between staff in theatre and outpatient areas. We saw good interactions among members of the team.

The teams had effective working relationships, including good handovers, with other relevant teams within the organisation (for example, optometrists). We observed the daily huddle meeting, staff were aware of needs of patients, for example, hard of hearing and this information followed through from huddle to handover.

We scored the service as 3. 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.

The service had relevant information promoting healthy lifestyles and support in patient waiting areas. Staff assessed each patient’s health when admitted. The service’s optometrist would always assess patients during their appointment and refer them accordingly if they identified a potential diagnosis that could not be managed at Optegra Maidstone. Patients could be referred back to their local optician, to the NHS particularly if in need of specialist care or local charities for day to day and financial support.

Post surgery all patients were provided with an electronic device to watch the service’s discharge aftercare video to support independence, recovery and give advice regarding preventing eye loss. The service had a blog with educational posts authored by the surgeons across Optegra to provide on a range of topics. Blog posts were displayed on information boards or could be printed for patients to take home with them as well as being available on Optegra’s website.

We noted that the provider gave patients clear, accessible advice to support safe recovery at home. We saw that patients were shown a video with instructions to watch before surgery, given a booklet with same information, and were able to access patient portal too AI assist “Iris” – follow up by telephone (a conversational virtual agent for patients at every step of their care journey. Iris accurately and immediately answers patient questions).

We scored the service as 3. The evidence showed a good standard. The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Staff monitored patient outcomes, including complications and infection rates after cataract surgery. This included tracking posterior capsular rupture (PCR), the most common intra‑operative complication, which involves a tear in the thin membrane that supports the lens and increases the risk of post‑operative problems.

The service participated in clinical audit, benchmarking, and quality improvement initiatives, including contributing data to the National Ophthalmology Database (NOD) to monitor patient outcomes.

Data showed that in 2025, Optegra Maidstone carried out 4537 surgeries, 99.6% resulted in zero complications. The site performed similar or better than the national average in all outcome data recorded. For example, the PCR rate was 0.18% compared to the NOD average of 0.79%. For 6/12 or better visual outcome the site achieved a score of 97.1% compared to the NOD average of 91.8% and 65% for 6/6 or better vision compared to 46.6%. This meant that the service monitored the effectiveness of care through audit and bench marking, using the findings to improve practice and achieve good patient outcomes.

The service took part in Optegra’s audit programme and was consistently compliant with the audits. In the period April 2025 to March 2026, a total of 517 clinical audits were completed across all our sites, with an average compliance rate of 98%. For example, Five Steps to Safer Surgery 98%, Decontamination and Clinical Waste Audit 97%, and Scrub Procedures Hygiene Audit 100%.

We scored the service as 3. The evidence showed a good standard. The service told people about their rights around consent and respected these when delivering person-centered care and treatment.

Staff communicated patients’ rights around consent, ensuring these were respected in line with NICE guidance on decision-making and mental capacity. Consent was embedded in the patient pathway, and we saw consent was further confirmed on the day of surgery to ensure decisions remained current.

Staff understood that consent also applied to other parts of the patient journey. They told us it was important to ask for verbal consent for basic care, and we observed this in practice. Staff we observed asking for verbal consent to administer eye drops and explaining the purpose of each eye drop. This ensured patients were fully informed about their care.

Staff were knowledgeable about consent and decision‑making requirements, including those set out in the Mental Capacity Act (MCA) 2005, and knew how to access advice when needed. Data showed that they had completed MCA training, with 100% compliance in November 2025.

Staff understood how and when to assess whether a patient had the capacity to make decisions about their care. Staff gained 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. Staff clearly recorded consent in the patients’ records. Clinical staff received and kept up to date with training in the Mental Capacity Act and Deprivation of Liberty Safeguards.

There was a dementia lead who supported the service with mental capacity advice and best interest meetings. For example, where appropriate, the dementia lead would support patients and their families during best interest discussions; however, these meetings were primarily led by the responsible surgeon. The dementia lead also provided guidance, support, and learning updates to staff to promote best practice in caring for people living with dementia.

Optegra ensured that patients whose first language was not English received the information they needed and could communicate appropriately with healthcare staff. An interpreter service was available and booked in advance of any appointments/admissions. The use of an interpreter was recorded in the patients’ healthcare record. The service also used language line which offered British Sign Language virtually or in person.

We were told that consent for refractive surgical interventions included a two-stage process in which consent forms were taken away from the consultation at which the procedure recommendation was made by the operating surgeon, and patients were given an open line of communication with their surgeon (email, telephone, or optional repeat consultation) for follow-up questions during a cooling off period. For refractive procedures minimum cooling off period of one week was mandated between the confirmation of consent between the patient and surgeon and date of surgery.

There was an up-to-date consent policy, and consent was embedded within the patient pathway. Staff ensured formal consent forms were signed on the day of admission and confirmed with patients that their decision had not changed before treatment, helping ensure consent remained current and informed.

Staff followed their internal process for seeking consent from patients in line with legislation and guidance, and this was clearly recorded. We observed staff asking patients’ verbal consent prior to examinations, observations and delivery of care. We reviewed 3 patient records and noted the consent forms were completed in full.

The service provided clear information and consent forms for cataract surgery, Yttrium Aluminium Garnet (YAG) laser capsulotomy and minor eyelid procedures, including risks, outcomes and procedural details.

Patients we spoke with said they were involved in decision-making about their care and treatment. They could describe the risks and benefits that they were told about prior to surgery.