Optegra Eye Hospital Uttoxeter

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

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

We looked for evidence that people and communities had the best possible outcomes because their needs were assessed. We checked that people’s care, support and treatment reflected these needs and any protected equality characteristics, ensuring people were at the centre of their care. We also looked for evidence that leaders instilled a culture of improvement, where understanding current outcomes and exploring best practice was part of their everyday work.

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 assessed patients’ needs using a range of assessment tools to ensure their needs were identified and understood. Assessments considered patients’ health, care, wellbeing, and communication needs, to enable them to receive care or treatment that had the best possible outcomes.

People’s communication needs were assessed and met.

The service had a standard operating procedure to ensure it met the national accessibility requirements. Any requirements a patient had were documented on both the patient administration and clinical administration system and in their electronic patient records.

Each patient was individually assessed at the pre-assessment clinic. Any patient identified with reduced mobility or communication concerns had their needs assessed and recorded on the patient record. Aplan was made to address any issues identified as necessary. The clinical areas were accessible and based on the ground floor of the building. Toilets were also accessible for patients with mobility needs.

Staff protected the rights of patients subject to the Mental Health Act and followed the Code of Practice. At staff huddles, staff routinely referred to the psychological and emotional needs of patients. Patients’ needs were assessed individually to ensure appropriate care and treatment was provided. All patients undergoing procedures had their needs assessed and their care planned prior to any treatment.

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. Staff did this in line with legislation and current evidence-based good practice and standards.

Changes to clinical practice, national guidance and policies were reviewed and developed centrally by the corporate provider, Optegra, and cascaded to each hospital or clinic site and shared with staff. Policies based on evidence-based good practice and clinical guidelines were developed nationally and cascaded to the hospitals for implementation. Changes in practice and guidance updates were routinely discussed as part of clinical governance and medical advisory committee meetings. Policies and procedures reflected current guidelines and were easily accessible electronically. We reviewed a sample of policies and guidelines and found all were within their review dates and reflected national guidelines.

Staff followed up-to-date policies to plan and deliver care according to best practice and national guidance. Care and treatment were delivered to patients in line with the provider’s corporate national guidelines, Royal College of Ophthalmologists (RCOphth) standards and National Institute for Health and Care Excellence (NICE) guidelines in relation to refractive eye surgery.

The operating theatre teams used an adaptive ‘five steps to safer surgery’ checklist, based on World Health Organisation guidance. Staff followed appropriate guidance such as NICE Interventional Procedures Guidance, guidelines on photorefractive eye surgery and NICE guideline for cataracts in adults. Staff also followed the national early warning score system to assess and respond to any change in a patient’s condition.

Optegra had redesigned its cataract pathway to improve patient experience and safety and optimise the time taken to complete the process. Dropless surgery was introduced which reduced reliance on post-operative drops, hydrophobic intraocular lenses supporting longterm outcomes, AI supported patients throughout their pathway through Optegra’s virtual assistant platform available to patients 24 hours a day and in multiple languages.

There were no prerequisite nutrition and hydration requirements for patients in relation to refractive eye procedures carried out at the clinic. Patients were only present on site for a short period of time so were offered light refreshments. However, if for any reason they were on site for a longer period, food could be ordered for them.

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

Staff held regular and effective multidisciplinary meetings. There was a daily communication between multidisciplinary teams within the surgical areas. Staff handover meetings took place during shift changes and safety huddles were carried out daily to ensure all staff had up-to-date information about risks and concerns.

One patient commented to us that you could tell everyone was talking and working together. Staff worked with other healthcare services when required. There were contractual arrangements with several external organisations to support processes. This included, for example, equipment maintenance, sterilisation of surgical instruments, pharmacy services and clinical waste disposal. Staff at the clinic also liaised (with patient consent) with GPs to confirm information when patient risks were identified as part of the initial pre-operative assessments. This included any risks around patient capacity or mental health.

There was an effective daily communication between multidisciplinary teams within the hospital. Nursing and healthcare staff told us they had a good relationship with the optometrists and ophthalmologists. Staff shared information about patients at effective handover meetings within the team, at the beginning of each surgery day, the team completed a team brief to discuss patient safety and individual staff roles and responsibilities. There was
regular communication between the day surgery team, diagnostics, administration team, domestics and the bookings teams so patient care could be coordinated and delivered effectively.

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 focused on identifying risks to people’s health and wellbeing early on and how to support and maintain this. The hospital offered relevant health promotion advice which related to the specific and specialist nature of the treatments provided. Staff offered verbal advice and information leaflets relating to the eye procedures. They discussed lifestyle choices relating to the patient’s vision needs as part of the initial consultation process. Information was also available on the provider’s website.

Patients were given verbal and written information to take home which provided information on how to manage symptoms following discharge from the hospital.

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. Staff ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Staff monitored the effectiveness of care and treatment. They used the findings to make improvements and achieved good outcomes for patients. The service participated in relevant national clinical audits. Outcomes for patients were positive, consistent and met expectations, such as national standards. Patient outcomes were measured and submitted to the National Ophthalmology Database. Optegra used this data to drive improvement and share learning through continuing professional development and national forums.

The hospital submitted data to the Private Healthcare Information Network (PHIN). This is an independent, government-mandated source of information about private healthcare which supports patients to make better-informed choices of care provider. PHIN data did not identify any concerns in relation to his service. The hospital also collated data for individual ophthalmologist surgeon’s outcomes. This data included data on number of treatments, the number of complications and patient outcomes measured against benchmark standards and we found no concerns. We looked at the outcomes data for current consultant ophthalmologist surgeons. There were 3 consultants that worked across many sites including Uttoxeter and all 3 had between 98.9% and 99.9% of success rates with no post-operatively complications.

The hospital was performing better than the benchmark for clinical outcomes The clinic
monitored and benchmarked outcomes through the National Ophthalmic Database (NOD) and
against the provider’s other clinics. In the latest data from 2024, the hospital completed 1,594
cases. Of these:

• 99.5% experienced no complications against a NOD benchmark of 98.8%.
• There were no recorded cases of posterior capsule (PC) rupture for the site, against a
  NOD benchmark of 0.79%.
• Corrected distance visual acuity (CDVA) 6/12 vision or better for the hospital was noted
  to be 96.3% against a NOD benchmark of 91%.
• CDVA of 6/6 or better for the hospital was noted to be 59% against a NOD benchmark of
  46.6%.

Managers used information from the audits to improve care and treatment. The ophthalmologists were presented with their outcome data as part of the annual appraisal process. Meeting minutes showed outcome data was also reviewed as part of routine hospital and corporate provider medical advisory committee meetings to monitor performance and identify improvements.

Optegra was an active member of the Independent Healthcare Providers Network (IHPN), which facilitated collaboration and the sharing of best practice across the independent sector.

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-centred care and treatment.

People understood their rights around consent to the care and treatment they were offered. People’s views and wishes were considered when their care was planned. To support patients with communication difficulties, the hospital had access to a specific tool, along with professional interpreters when needed, to ensure that communication was clear. Patients could fully express their wishes and ensured they understood the consent process.

Staff understood how and when to assess whether a patient had the mental capacity to make decisions about their care. Mental capacity assessments were carried out if required as part of pre-assessment processes. If there were concerns about a patient’s capacity to make decisions, best-interest meetings were held with people with legal authority or responsibility. Staff told us consultants undertook best interest decisions meeting with input from the patient’s relatives and other healthcare professionals (such as the patient’s GP). We saw evidence of this in one
patient record we looked at.

Staff gained consent from patients for their care and treatment in line with legislation and guidance. Patients underwent initial consultation with an optometrist or ophthalmologist. Risks and benefits were discussed with the patient to enable them to make an informed decision about their procedure and written consent was obtained. Consent was also obtained a second time on the day of surgery. We observed good examples of this process during our assessment at the clinic and during surgical procedure. Staff had clearly recorded consent in the patient records we viewed. Consent forms showed the risks and benefits were discussed with the patient prior to carrying out eye surgery procedures. Staff told us there was a minimum of 7 days ‘cooling off’ period for the patient from the initial signed consent to the day of surgery, in line with the Royal College of Ophthalmologists guidance. Private patients were provided with information about fees and charges as part of the initial consultation process and these were clearly explained to them prior to undergoing any treatment.