Community Health and Eyecare Limited (CHEC - Worcester)

On this page

• 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

We looked for evidence that there was an inclusive and positive culture of continuous learning and improvement that was based on meeting the needs of people who used services and wider communities. We checked that leaders proactively supported staff and collaborated with partners to deliver care that was safe, integrated, person-centred and sustainable, and to reduce inequalities.

This is the first assessment for this service. This key question has been rated Good. This meant that the service was consistently managed well. Leaders and the culture they created assured the delivery of high-quality care.

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 had a shared vision, strategy and culture. The vision was to make healthcare services more readily available and accessible in local communities, by offering patients greater choice, flexibility and reduced waiting times. Their values included caring, passionate, togetherness, listening and focus. Staff understood these values and embodied these to deliver good patient care. Care was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

Staff were aware of the vision and strategy for the local clinic. They knew of the challenges and flexibility of the service. Senior managers were able to describe the challenges of providing the service but felt that the staff were aligned with the needs of the service and Staff were flexible in delivering a service wherever this may be. This was demonstrated by supporting sister sites during times when this clinic was quieter.

The service had experienced a significant turnover of managers over the previous 12 months. The long-term manager left in August 2024 and was replaced by interim managers who supported the team. A new manager was recruited in November 2024 but did not stay to the end of their probation. Managers from other parts of the company provided support to staff during the managers’ vacancy. However, a new manager was appointed in the summer who began to stabilise the workforce culture. However, a manager who knew the clinic was providing cover. This change in managers had influenced how staff felt about the team. The organisation undertook a staff survey called Great Place to Work. This demonstrated that staff felt more valued since the appointment of a substantive hospital manager. It also demonstrated that they were being developed through appraisals and that their objectives were more personalised. Staff felt the new manager and the interim manager had helped morale within the team.

There was a national lead for endoscopy who was well known to staff working at the site. They provided further training and support to staff. They had extensive experience in the area of endoscopy, having attended training at a nationally recognised centre.

The service fostered a positive culture where people felt they could speak up and their voice would be heard. There was companywide freedom to speak up guardian and a champion who worked in the education team. Freedom to speak up opportunities were advertised in the staff room. Staff were aware of this process but felt well supported by their clinic manager and would raise any issues with them without fear. They were confident they could contact the clinic manager at any time through a text message if they were not on site. Staff felt they were included in the development of the service.

The service valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them. Staff felt they would be able to apply to work flexibly should they need to. Within the team there were staff who worked across sites. Where transportation was an issue for these staff this was provided by the organisation. Staff working at the service were reflective of the population they served and as such the manager felt they understood the communities they worked within.

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

There was a clear framework of what must be discussed at a clinic, team or regional level and national level in meetings to ensure that essential information, such as learning from incidents and complaints, was shared and discussed. Flash alerts were created following incident investigation to share learning across the provider. However, staff reported that these were not always highlighted to them at huddles. Monthly team meetings had been reinstated now the new manager was in post.

Staff at clinic level could escalate concerns when required. They reported incidents although feedback from these had been limited. While information systems were generally electronic, the provider had applied limits to the amounts of data individuals could see. For example, the clinic manager and region operations manager could only see parts of the HR system that was relevant to them. Staff in the clinic area did not have access to this area of the IT systems. However, the clinic manager and senior managers had access to the areas which they needed to assess performance both individually and at a clinic level.

Staff were aware of the impact of their service on the planet and sought to use reusable equipment wherever possible. Where single use items were used these were packed individually and only opened when necessary. Staff also separated waste into recycling and other waste in both the procedure rooms and in the staff areas. The service used electric vehicles to transport staff and patients and in other areas as much as possible. Recycled paper was used in the clinic.

The service understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement. They engaged with the integrated care boards (ICBs) and NHS trusts for whom they held contracts. This included the review of performance and quality indicators. The new clinic manager was available to patients; their families and carers should they wish to raise any issues. Information was shared with the referrer to ensure seamless care. The clinic and senior managers were aware of performance and sought to address deficits and understand other markets within the healthcare system.

The clinic worked with several partnerships, such as the NHS and suppliers, some of which were managed centrally. Meetings were held with all partners to ensure that parties had the opportunity to raise any issues to improve services experienced by the patient. These partnerships included suppliers of equipment such as lens suppliers, pathology services and sterilisation services.

The service focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged staff to look for ways of improving the experience, outcomes and quality of life for people. They actively contributed to safe, effective practice and research. Staff were given the time and support to develop opportunities for improvements and innovation and this led to changes in care delivery. Patients were encouraged to offer suggestions for improvements. Suggestions could be made through the patient satisfaction survey using the tablet available within the clinic.

There was a notice board in the main waiting area which included a ‘you said we did’ element where staff wrote about what they had done with patients’ comments. There was also an area to note key performance indicators which then had a section highlighting “our promise”; this area was used to inform patients what the team were doing about the indicators.