CES Medical – Tunbridge Wells

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

We looked for evidence that patients and communities had the best possible outcomes because their needs were assessed. We checked that patient’s care, support and treatment reflected these needs and any protected equality characteristics, ensuring patient 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.

This is the first assessment since registering to provide a regulated activity. This meant patient’s outcomes were consistently good, and patient’s feedback confirmed this.

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.

The service ensured patients received effective care by assessing and reviewing their health, wellbeing, communication needs and involving them in decisions about their treatment.

We reviewed care records and found patients’ needs were assessed and recorded consistently. Staff completed appropriate clinical assessments, considered individual risks and recorded consent in line with guidance. Communication needs were clearly documented, and information was provided in ways patients could understand.

Records showed staff involved patients in decisions about their care. Procedures, including cataract surgery, were explained clearly along with the risks, benefits and aftercare requirements. Patients’ needs were reviewed at key stages, including assessment, pre-operative checks and follow-up appointments, to ensure care remained effective.

Patients undergoing cataract surgery attended a pre-assessment to confirm their suitability. This included reviewing clinical needs, relevant medical history and whether patients could safely undergo the procedure.

During the assessment, we also observed staff discussing individual needs and alternative treatment options with patients, including referring patients onward where appropriate.

Staff shared important information when transferring care. Following appointments and surgery, relevant clinical details and outcomes were communicated to GPs and referring clinicians to support continuity and ongoing care.

The service planned and delivered patients’ care and treatment in partnership with them, considering what was important to them. Care was delivered in line with legislation, current evidence-based practice and national standards.

Staff followed up-to-date policies to plan and deliver high-quality care. All policies we reviewed included clear creation and review dates and referenced current national guidance. There were effective systems to communicate updates, including team meetings, management newsletters and staff notice boards displaying current guidance.

Policies and processes reflected national professional guidance, including Royal College of Ophthalmologists (RCOphth) standards, National Institute for Health and Care Excellence (NICE) guidance and National Safety Standards for Invasive Procedures (NatSSIPs2) adapted for ophthalmology. We saw evidence the service adhered to these standards in practice.

We reviewed 5 care records and found care planning and risk assessments were completed consistently and to a good standard. Records demonstrated that care and treatment were planned in line with best practice and individual patient needs.

Cataract surgery was delivered as a day-case procedure with discharge on the same day. The service ensured patients were safely prepared for surgery through pre-operative assessment and provided clear aftercare instructions to support recovery and reduce risks. Patients were given a contact number to access advice if they had concerns following treatment.

The service supported continuity of care through effective communication systems. Staff shared key clinical information following outpatient appointments and surgical procedures with referring clinicians to ensure ongoing care remained safe and effective. Any concerns raised by patients or external services were reviewed through clinical governance processes.

The service had systems to ensure the safe management of ocular implants and devices. We saw evidence that lenses and associated devices were recorded and managed in line with national guidance, supporting traceability and patient safety.

The service worked well across teams and services to support patients. Doctors, nurses and other healthcare professionals worked together effectively to deliver coordinated care and achieve good outcomes.

Staff reported positive working relationships across professional groups, including between medical and nursing teams. We observed effective multidisciplinary working during the assessment, based on mutual respect and trust, which supported the delivery of safe and effective care.

Teams and services shared information appropriately to ensure continuity of care. Following each episode of care, clinicians sent discharge summaries or clinic letters to the referring clinician, ensuring relevant clinical information and outcomes were communicated clearly and in a timely way.

Patients were supported with clear information about their care. Patients received details of the treatment they had undergone via email and left the service with written instructions on eye drop administration and self-care. The service could also provide correspondence by post for patients who preferred not to receive information electronically. Patients were given information on how to contact the service if they had any concerns, supporting continuity and ongoing care.

The service supported patients to manage their health and wellbeing by promoting independence, choice and control. Staff provided advice and information to help patients understand their condition and make informed decisions about their care.

The provider promoted eye health and the prevention of avoidable sight loss through early assessment, timely treatment and patient education. This supported patients to maintain independence and reduced the risk of further deterioration.

Patients undergoing elective procedures were supported to prepare for treatment and recovery. Staff explained conditions, treatment options and aftercare, including how patients could optimise outcomes following surgery.

Information to support patients was readily available in a range of formats. This included written leaflets available on site and a comprehensive range of resources on the provider’s website. We saw examples of patient information covering conditions, treatments and procedures, including cataract surgery, laser therapies and intravitreal injections. This enabled patients to access information before and after treatment and supported them to make informed choices about their care.

The service checked how well care and treatment worked by reviewing patient outcomes and making improvements where needed. Although the provider was not currently required to submit data to national databases, leaders demonstrated a commitment to best practice and planned to begin national reporting from April 2027.

The service regularly reviewed outcomes through audits and compared results with national standards, including those set by the Royal College of Ophthalmologists. For cataract surgery, the service monitored complications such as posterior capsular rupture (PCR). The service’s rate was 0.41% (1 in 245 cases), which was better than the national benchmark of around 1%, demonstrating good surgical outcomes.

The service also monitored outcomes for other procedures. For YAG laser treatment, no complications were reported between January and April 2026. Vision was recorded before treatment in all cases. YAG laser treatment (Yttrium Aluminium Garnet laser capsulotomy) is a non-invasive procedure used to treat posterior capsule opacification, a common complication that can occur following cataract surgery.

Between 4 March and 18 May 2026, the service carried out 57 YAG capsulotomy procedures. Pre-procedure visual acuity was recorded in all cases (100%). Post-procedure visual acuity was recorded in the clinic for 8 cases (14%), all of which showed improvement, meeting expected standards. However, post-procedure data was not routinely captured for all patients, as many were discharged to community optometry services for follow-up care. Leaders recognised this limitation and had taken steps to improve outcome monitoring, including introducing a post-procedure survey.

Outcomes indicated that patients’ vision improved following treatment, supporting their ability to carry out everyday activities. Leaders reviewed outcomes regularly and used this information to improve services and ensure patients received safe and effective care.

The service ensured patients were supported to make informed decisions about their care and treatment and respected their rights around consent. Staff followed national guidance and local policies to obtain consent in line with legislation.

Staff supported patients to make informed decisions by providing clear explanations of their care and treatment options. During the assessment, we observed consultations where staff obtained verbal consent prior to examination and ensured patients understood the procedure.

Consent for surgery was obtained by the appropriate clinician and included a discussion of benefits, risks, potential complications and alternative treatment options. Patients signed consent forms in advance of their procedure, and consent was rechecked on the day of surgery to ensure it remained valid.

Staff followed the service’s consent policy and demonstrated good practice in records and observations. We reviewed 5 patient records and found consent was appropriately documented in all cases. This was further supported by observations in theatre, where staff confirmed consent prior to procedures.

The service completed consent audits and used the findings to monitor and improve practice.

Patients were supported to give informed consent through accessible communication methods. Interpreting services were available, including British Sign Language (BSL) and face-to-face interpreters where required, ensuring patients could fully understand and participate in decisions about their care.