CES Medical – Tunbridge Wells

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

We looked for evidence that patients and communities were always at the centre of how care was planned and delivered. We checked that the health and care needs of patients and communities were understood, and they were actively involved in planning care that met these needs. We also looked for evidence that patients could access care in ways that met their personal circumstances and protected equality characteristics.

This is the first assessment for this service. This key question has been rated good. This meant patients’ needs were met through good organisation and delivery.

We have not awarded this service a score for Responsive.

Find out about when we will not publish a key question score and what we look at when we assess Responsive.

The service made sure patients were at the centre of their care and treatment choices, and they decided, in partnership with patients, how to respond to any relevant changes in patients’ needs.

The service had systems to support patients with a variety of additional needs. The clinic was fully accessible. It had a large unisex disabled toilet with a pull cord for visitors to call for help, a hearing loop and signage was clear to those with sight loss.

Managers made sure staff, patients, families and carers could get help from interpreters or signers when needed.

During the assessment, we found that the service was aware of the needs of patients who were non‑verbal or who had complex communication needs. Staff had received communication‑support training at induction to help them understand how to meet a range of communication needs.

Staff told us they could use alternative communication methods, such as written communication and nonverbal communication, to support patients’ understanding. Patients were able to use their own communication tools, such as communication boards or digital devices, where required. With patient consent, staff said they would work with carers, advocates, and family members to support communication, particularly where patients relied on familiar individuals to interpret their needs and preferences. The service could also arrange professional interpreting services or specialist communication support when appropriate.

Staff identified communication needs at the earliest opportunity and clearly recorded them in the patient record system so that all staff could make appropriate adjustments. Training and guidance supported staff to recognise and respond to different communication needs in a respectful and person‑centred way. These measures promoted inclusion, dignity, and effective communication and ensured that patients with complex communication needs accessed care safely and equitably.

As per Royal College of Ophthalmology guidelines the service told private or self-pay patients about all the planned and possible costs, including the costs of future surgery and dealing with possible complications. Patients responsible for paying the costs of their care or treatment (either in full or partially), received a statement specifying the terms and conditions in respect of the services to be provided, including the amount and method of fees payment. Where possible, the service always provided this in writing prior to the commencement of the services.

The service understood the diverse health and care needs of patients and their local communities, so care was joined-up, flexible and supported choice and continuity.

The service planned and provided care in ways which met the needs of local people, and the communities served. They worked with others in the wider system and local organisations to plan care where relevant. During the assessment, we saw the clinic understood the diverse health and care needs of its patients and the local community and delivered care that was joined‑up, flexible, and supportive of choice and continuity. The service worked effectively with general practitioners, optometrists, and secondary care providers to ensure clear referral and shared‑care pathways, which supported coordinated and timely care. Staff offered flexible appointment arrangements and community‑based clinics to improve access and reduce unnecessary hospital attendance. Care records showed continuity for patients with long‑term ophthalmic conditions, with efforts made to see the same clinician where possible and clear communication when this was not achievable. The service made reasonable adjustments to meet individual needs, responded to changes in patients’ circumstances, and involved patients in decisions about their care, which promoted choice, continuity, and a person‑centred approach.

Managers ensured the service contacted patients who did not attend appointments to make alternative arrangements; however, the clinic had very low numbers of non-attendance.

The service usually supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

All leaflets were in electronic format to ensure patients only received the most recent version. The provider printed and posted leaflets to those who requested this.

A range of information was available to patients, including leaflets on various surgical procedures, investigations and advice for maximising their health. We asked if information was available in alternative languages and were shown how required leaflets could be printed as needed. Information was also available on the service’s website and there was a member of staff with responsibility for keeping all information updated.

The service made it easy for patients to share feedback, raise concerns, and be involved in decisions about their care, treatment and support. Patients were informed about their treatment plans and staff involved them in decisions to ensure care reflected their needs and preferences.

Patients were given opportunities to provide feedback through a range of accessible methods. Information about how to raise concerns or make a complaint was displayed in the waiting area. Leaders told us that patients, their families and carers were encouraged to share their experiences and could be confident that any concerns would be taken seriously and addressed compassionately.

The service had a complaints policy and reported no complaints in the previous 12 months. The provider, CES Medical Ltd, had systems to investigate complaints thoroughly and respond in a timely way. We reviewed a sample of formal complaints and found these had been fully investigated and managed in line with the provider’s policy. The service handled complaints in an open and transparent way, with no negative impact on patients raising concerns. Patients could escalate unresolved complaints to an independent body, including the Parliamentary and Health Service Ombudsman for NHS-funded care.

Staff treated patients as individuals and ensured care, treatment and support were tailored to meet their needs. We reviewed five care records and found clinicians completed personalised assessments and developed care plans based on individual needs, medical history and identified risks. Records showed clear documentation of discussions with patients about treatment options, including risks and benefits.

Staff made reasonable adjustments where required. For example, they allowed additional time for appointments, involved family members or carers where appropriate, and arranged interpreters. Follow-up care and treatment decisions were based on individual patient needs rather than a standardised pathway.

The service used feedback from the NHS Friends and Family Test (FFT), which had an average response rate of 11% over the last four months, to drive improvements. For example, following patient feedback, the service installed a mirror in the bathroom and increased the number and comfort of chairs in the waiting area. Subsequent feedback showed these changes had improved patient experience, with one patient describing the seating as “100%”.

The service made sure that patients could access the care, support and treatment they needed when they needed it.

We found the service ensured patients could access the care, support, and treatment they needed at the right time. The clinic operated clear referral and triage processes, which enabled staff to prioritise patients based on clinical need and respond promptly to changes in symptoms. Appointment systems allowed flexibility for urgent reviews, follow‑up care, and ongoing management of long‑term eye conditions. Staff provided timely advice, clear safety‑netting information, and onward referrals where required, ensuring patients knew how to seek further help if their condition changed. These arrangements supported timely access to care and helped prevent unnecessary delays in assessment or treatment.

People could access the service when they needed to and received the right care promptly. Waiting times from referral to treatment and arrangements to admit, treat and discharge patients were in line with national standards,

Managers monitored waiting times and made sure patients could access services when needed and receive treatment within agreed timeframes and national targets.

The service also worked in partnership with a community provider that operates a mobile eye care unit, helping to improve access to ophthalmology services for people within the local community.

Staff and leaders listened to information about patients who were most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

The service monitored patient access and outcomes to identify potential health inequalities. This information was used to inform service planning and delivery. The service had systems and processes for gathering feedback which enabled collection of information about equity of patients’ experiences and outcomes. Staff and leaders listened to information about patients who were more likely to experience inequality in access, experience, or outcomes and adjusted care in response. The service identified these patients through referral information, clinical assessments, and ongoing conversations, including people with sensory impairment, learning disabilities, neurodiversity, language barriers, mobility issues, or social disadvantages. Staff used this information to prioritise appointments, adjust communication methods, and offer additional support tailored to individual circumstances.

Leaders supported staff to respond flexibly and proactively, including making reasonable adjustments, involving carers or advocates with consent, arranging interpreters, and adapting follow‑up arrangements to reduce barriers to care. Care records showed that clinicians considered both clinical and social factors when planning treatment, and staff responded promptly when patients’ needs changed. This approach helped reduce inequalities and ensured patients most at risk of poorer experiences or outcomes received personalised, equitable care.

People who did not speak English as their first language could access the service. Staff had access to interpreting services by telephone.

Patients were supported to plan for important life changes, so they could have enough time to make informed decisions about their future.

Patients were supported to make informed choices about their care and plan their future care, with the support and involvement of their family or carer if they wished. We saw staff supported patients to plan for important life changes and gave them time to make informed decisions about their future care. Clinicians discussed the long‑term implications of eye conditions, treatment options, and possible progression in a clear and timely way, particularly where conditions could affect independence, driving, employment, or daily activities. Staff explained expected outcomes and reviewed options over more than one appointment where appropriate, which allowed patients time to reflect and ask questions.

The service also supported forward planning by involving carers or family members with patient consent and by signposting patients to additional support services when required. Clinicians tailored follow‑up arrangements to reflect individual circumstances and ensured patients understood how to access advice if their situation changed. This approach helped patients feel prepared, supported, and able to make informed decisions about their care and future wellbeing.