SpaMedica Carlisle

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.

Patients, or their representatives were involved in decisions about their care and treatment. The service provided information which patients could understand. Patients were invited to give feedback, knew who to speak with if they had concerns and were confident the service took their concerns seriously. The service monitored and worked to improve access. The environment was adjusted to meet the needs of people with conditions which could create a barrier to access. The service worked to reduce health and care inequalities through service planning, quality monitoring, staff training and feedback. Patients were involved in planning their care and understood options around choosing to withdraw or not receive care. The service supported staff wellbeing.

This is the first assessment for this service. This key question was rated good. This meant patient’s 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 evidence showed a good standard. 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 patient’s needs.

The service had systems to support patients with complex healthcare needs, sensory loss, mental health, learning disabilities and dementia.

Staff provided personalised emotional wellbeing support. An example given, was about a patient who experienced significant personal stress and anxiety. Staff took time to discuss the emotional impact of sight difficulties, personal stressors affecting confidence, the achievement of completing previous surgery, the importance of self-kindness under stress and appropriate recovery planning. The patient later shared that these conversations helped them recognise how far they had come, and how staff had given reassurance and confidence to proceed with treatment.

Staff followed up patients identified as potentially vulnerable or anxious, in a proactive way, in addition to routine clinical contact. Staff initiated wellbeing conversations focused on emotional resilience, confidence building and recovery planning.

Patient’s recovery plans were tailored to individual needs and circumstances, and not as standardised advice alone. For example, staff discussed work commitments, home circumstances, caring responsibilities, emotional readiness and previous recovery experiences.

As per Royal College guidelines, private or self-pay patients were told about all the planned and possible costs, including the costs of future surgery and dealing with possible complications. When a patient was responsible for paying the costs of their care or treatment (either in full or partially), they were provided with written terms and conditions in respect of the services to be provided, including as to the amount and method of payment of fees.

The evidence showed a good standard. 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 care system and local organisations to plan care where relevant. For example, managers met with other organisations, such as opticians, to discuss specific needs in their area.

The service had systems to help care for patients in need of additional support or specialist intervention. For example, where patients were unable to comply with instillation of eye drops at home, a single dose alternative medicine was given during surgery, although this was a more costly option.

Managers ensured that patients who did not attend appointments were contacted to make alternative arrangements.

The evidence showed a good standard. The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Communication and language requirements were identified at the point of referral and throughout the patient's journey.

All interpreter requirements were recorded and accessible to the central booking hub, to ensure communication needs were identified and actioned promptly. The service accessed professional interpreting services by telephone and face-to-face. If a face-to-face interpreter was not available, staff accessed a video interpreting service via a tablet device, which meant patients received timely communication support in their preferred language.

A range of information was available to patients, including leaflets on various procedures, investigations and advice for maximising their health.

Patient information booklets in different languages were available both on-site and digitally, and provided patients with access to important information in their preferred language.

The provider’s equality, diversity and inclusion strategy demonstrated how the service continued to ensure compliance with the Accessible Information Standard. This included review of systems across the patient pathway including website and easy-read access, recording of relevant support needs in systems, and use of patient data to improve care, and embed the NHS England Ask, Listen, Do framework.

The evidence showed a good standard. The service made it easy for patients to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved patients in decisions about their care and told them what had changed as a result.

The service and staff made it easy for people to share feedback, ideas or raise complaints about their care, treatment and support. For example, through an electronic survey sent following discharge, anonymous feedback cards in the waiting areas and through review platforms on the provider’s website.

The service received 4 formal complaints for the period June 2025 to June 2026. All were investigated thoroughly, and patients received a response in good time, in accordance with policy.

Learning from complaints and feedback were seen as an opportunity for improvement and was shared across the organisation so that service improvements were consistent at all locations. For example, review and improvement of 24-hour emergency line messaging, to ensure it was clear, reassuring, and prioritised the emergency support message earlier in the call, while still ensuring the line was not used as a default route for general enquiries.

Managers also told us about service changes at local level. For example, a patient had to travel to another location for specialist treatment, which impacted on them in terms of travel time, additional stress and inconvenient follow up visits. In response, local service provision was reviewed, specialist training delivered so that patients could access this service locally.

Private patients could take any unresolved complaints to a second stage regional review and a final third stage for corporate review. NHS patients were signposted to the Parliamentary Health Service Ombudsman (PHSO).

The evidence showed a good standard. The service made sure that patients could access the care, support and treatment they needed when they needed it.

People could access the service when they needed to and received the right care promptly.

The minimum waiting time for routine NHS cataract surgery set by the local Integrated Care Board, was 15 weeks. The latest NHS data showed average waiting time for first appointment at the service was 3 weeks, and 15 weeks for treatment. The waiting times from referral to treatment and arrangements to admit, treat and discharge patients were therefore in line with the national standard (NHS patients via the NHS e-Referral Service (e-RS) and the 18-week NHS target.

Patient feedback for the period July 2025-26, scored 99.94% satisfaction with waiting times for each appointment.

Patients could choose to access treatment sooner through the private Freedom Vision pathway if they did not wish to wait. However, the discussion with patients centred on patient choice and informed consent rather than commercial considerations, which demonstrated an understanding of the importance of supporting patients to make informed decisions regarding their care.

The service provided free car travel, with no mileage restrictions, for patients who were unable to arrange their own transport to and from appointments.

Managers worked to keep the number of cancellations to a minimum. When patients had their appointments or operations cancelled at the last minute, managers made sure they were rearranged as soon as possible and within national targets and guidance.

The evidence showed a good standard. 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 demonstrated a commitment to ensuring patients could access services and information in ways that met their individual needs. For example, through its Equality, Diversity and Inclusion Strategy and associated patient-access initiatives.

Support arrangements included staff training in equality and diversity, dementia awareness, learning disabilities and autism, sensory impairments and deaf awareness, alongside policies and services, which covered patient access, interpreter services, safeguarding, mental capacity, dementia, assistance/guide dogs and non-exclusion.

Patient feedback for the period July 2025-26, scored 99.94% satisfaction with the outcome of treatment and 98.98% of patients reported they would recommend the service.

People who did not speak English as their first language could access the service and had access to interpreter services.

We observed the discharge process for a postoperative patient. The discharge nurse prepared the patient's documentation and take-home medicines before undertaking a positive patient identification check.

The discharge consultation was unhurried and comprehensive. The nurse carefully explained post-operative care, discussed expected recovery, outlined symptoms which required urgent medical review and ensured the patient knew how to access emergency advice if required. Written information and contact details were provided before discharge.

The interaction was kind, compassionate and professional throughout. The nurse encouraged questions, listened carefully to the patient's concerns and ensured they were comfortable with the discharge plan before leaving the clinic.

The discharge process appeared structured, safe and patient centred.

The evidence showed a good standard. Patients were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including life-changing deterioration or complete loss of vision.

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.

For example, staff could refer patients to the provider’s sight support team or signpost to an appropriate national charitable organisation, for access to ongoing support and advice for managing the impact of their condition.

Discharge summaries were given to the patient to take home and for their optician or GP referrer and follow up appointments were made before discharge.