SpaMedica Portsmouth

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

This is the first assessment for this service. This key question has been rated good. This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

This service scored 86 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We scored the service as 3. The evidence showed a good standard. The service had a shared vision, strategy, and culture. This 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 knew and understood the provider’s vision and values and how they were applied in the work of their team. The provider’s senior leadership team had successfully communicated the provider’s vision and values to the frontline staff in this service. Regular updates from leaders ensured staff felt informed and included.

The service’s vision and values were developed in collaboration with patients who used the service, staff and external partners. Staff told us they felt respected, supported, and valued. They were focused on the needs of patients receiving care and worked well together to ensure they achieved good outcomes for patients. Staff were positive and proud to work for the service.

The wider provider had three main objectives: patient safety, excellent care and patient satisfaction. They were centred around ensuring every patient had the best possible experience of their services, and the best possible outcome. The organisation’s values of safety, integrity, kindness and transparency encouraged staff to achieve the objectives.

The service had created 3 pillars which were a new strategy brought in by the senior leadership team. These included areas for all staff at each hospital to focus on and take accountability for. These were:

• Securing cataract referrals,
• Managing costs
• Diversification

All staff had made a pledge about how they were going to do improve the quality of care at the service through pledges such as improving community knowledge of the service and increased links with educational providers in the local area.

Staff and leaders demonstrated a positive, compassionate, listening culture that promoted trust and understanding between them and patients using the service and was focused on learning and improvement. Staff told us managers really listened to them and made changes where possible. We heard how they had no reluctance in approaching leaders with ideas or for support. Staff we spoke with were proud to work for the service and emphasised how the service delivered good care to its patients.

The service worked in partnership with the NHS to meet growing demand for cataract surgery, with a focus to bring care closer to home and easily accessed in a reasonable time frame. This aimed to be aligned with the NHS priority of delivering exceptional, specialist care in communities with the support of independent providers.

We scored the service as 4. The evidence showed an exceptional standard. The service had exceptionally inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience, and credibility to lead effectively. They always did so with integrity, openness, and honesty.

Leaders had the experience, capacity, capability and integrity to ensure the organisational vision could be delivered, and risks were managed. An area manager and regional hospital director supported the registered manager and had the skills, knowledge and experience to perform their roles.

Leaders had a good understanding of the services they managed. They could explain clearly how the teams were working to provide high quality care. The registered managed was also the manager of another location who supported the service with emergency treatment. This ensured consistency of leadership, care and oversight.

Leadership development opportunities were available, including opportunities for staff not currently in a leadership role. Leaders were knowledgeable about issues and priorities for the quality of services and could access appropriate support and development in their role. There were processes for providing all staff at every level with the development they needed, including high quality yearly appraisals and career development conversations. The service provided opportunities for career development. There were several different courses and qualifications staff could access.

Leaders at every level were visible and led by example, modelling inclusive behaviours. Staff told us leaders were approachable and supportive. Members of the senior leadership team were visible, and staff told us they listened to staff. The board provided a monthly ‘cascade’ video to the staff with updates.

Leaders held regular staff meetings where staff told us they could safely voice their views and were listened to and valued.

Senior managers attended regional and national meetings with the senior leadership team where they received updates, discussed governance, performance and shared learning.

There were 2 leaders on-call 24 hours a day, 7 days a week to support staff.

We scored the service as 3. The evidence showed a good standard. The service fostered a positive culture where people felt they could speak up and their voice would be heard.

There was a culture of speaking up where staff felt able to actively raise concerns. Staff told us they thought they would be supported to raise concerns without fear of detriment; they had not however had to do this.

Staff could speak up to one of 3 the Freedom to Speak Up Guardians for the provider, there were posters displayed in staff areas which provided contact information for them. There was a whistle blowing and speaking up policy that could be accessed by staff and this had been reviewed in August 2024.

We scored the service as 4. The evidence showed an exceptional standard. The service strongly valued diversity in their workforce. They had an inclusive and fair culture which had improved equality and equity for people who work for them.

The provider had been recognised with a platinum award for its excellent efforts in supporting and developing its employees from Investors in People. Investors in People is an internationally recognised accreditation scheme. A platinum award is the highest possible rating and reflected the work the provider led in people management and employee wellbeing. This put the provider within the top 450 companies to work for, across all sectors worldwide.

The provider promoted equality and diversity in daily work. Equality and diversity and human rights training was part of staff’s mandatory training programme; 100% of staff had completed this. Leaders acted to continually review and improve the culture of the organisation in the context of equality, diversity and inclusion. The service had an equality d policy which was in date and reflected national guidance. There was a provider level survey of all staff to determine which had been used to develop the EDI Strategy. The strategy reported that they received positive feedback about EDI efforts from 80% of staff. This included staff from groups the strategy aimed to support including 74% of disabled staff and 78% of staff who were LGBTQ+. The policy had been shaped around staff feedback to ensure it addressed areas to create meaningful impact. The provider has also liaised with subject matter experts and organisations that can support and guide us to ensure we’re engaging and doing all they could to support marginalised groups.

The provider undertook equality monitoring of staff within the service to ensure it is diverse in its make-up and representative of the patient group. There was a provider level move to target job adverts to enable more blind and partially sighted people to apply to work for SpaMedica. The provider website was accessible including a recite tool to hear the words and face to face job open days.

All staff completed an annual employee survey and results from 2024 showed 94% of staff felt patients were treated fairly, regardless of their sexual orientation, race or gender.

Staff were able to apply to work flexibly where this suited the business needs, to account for personal circumstances such as caring responsibilities and health issues. There were equality and diversity champions within the provider network for areas such as LGBTQ+ & BAME. The service had recently celebrated Pride month and provided information on how staff could become allies.

We scored the service as 3. The evidence showed a good standard. 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 act on the best information about risk, performance, and outcomes, and share this securely with others when appropriate.

There were clear and effective governance, management and accountability arrangements. Staff understood their role and responsibilities. Managers could account for the actions, behaviours and performance of staff. There was a well-led and effective clinical governance structure with clear systems and processes. Each region had a governance lead who supported the hospital manager with compliance. Information was reviewed monthly and quarterly from their risk and patient management systems to identify trends in patient outcomes and clinical quality that needed addressing.

There was an assurance framework which included sub-committees that reported to senior management on a regular basis supported by the regional clinical governance lead. There were bi-monthly regional meetings which ensured information was fed back to the senior management team. Leaders showed us monthly quality reports which gave companywide updates on incident reporting, learning outcomes and quality improvement outcomes.

There was a comprehensive audit schedule of clinical and non-clinical audits that were undertaken by all staff relevant to their role. We provided feedback to leaders following our inspection that highlighted potential gaps in auditing process to identify a lack of completion with WHO checklists. Leaders told us they would be taking immediate actions to improve these.

Staff understood the arrangements for working with other teams, both within the provider and external, to meet the needs of the patients.

Staff understood and actively contributed to the risk management strategy. The service used patient outcomes and submitted data to the National Ophthalmology Database Audit to benchmark their performance against other service providers. Data we reviewed demonstrated performance targets for indicators were exceeded for the provider.

The service had a risk register, which showed actions taken to mitigate these. All risks for the service were rated as green, indicating they posed a low risk of harm were mitigations not effective.

Surgical staff performance was regularly monitored. All surgeon reported outcomes, behaviours and clinical outcomes were rated against the red, amber and green (RAG) scale. This was presented at the quarterly meeting and also fed into the medical advisory committee, and their rating could impact their ongoing practising privileges. There was a database of surgeon performance which gave immediate and real time information on performance to all hospital managers. A full report was generated annually and hospital managers received outcomes monthly.

There were suitable arrangements for the availability, integrity and confidentiality of data, records and data management systems. Information was used effectively to monitor and improve the quality of care.

Leaders implemented relevant or mandatory quality frameworks, recognised standards, best practices or equivalents to improve equity in experience and outcomes for patients using services and tackle known inequalities.

Staff were sent a weekly update email which included new policies and any tasks that needed to be actioned. These were also discussed at monthly team meetings.

The service had plans for emergencies such as loss of power, there were two circuits providing electricity to the hospital and these were colour coded. Essential equipment, such as surgical tools were connected to the circuit which had a backup generator in place.

We scored the service as 3. The evidence showed a good standard. The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They share information and learning with partners and collaborate for improvement.

The service worked with several charities. There was a provider level partnership with a charity to support raising funds as well as improving information for patients with Age-related Macular Degeneration and signposting Macular Society services. The service was also collecting items for a local food bank and fundraising for a cancer charity.

The service had a satellite outpatients centre to support patients who lived on the Isle of Wight. Staff from the service also worked at the satellite site. Patients from this county can be restricted in their access to services due to the county being located on an island. This clinic enables patients to attend pre and postoperative appointments without having to travel to the mainland. This meant patients would saving time and money on travel costs. The service also provided a free transport service for patients with pick-up and drop-off from mainland ferry terminals.

We scored the service as 4. The evidence showed an exceptional standard. The service had a strong focus on continuous learning, innovation and improvement across the organisation and local system. They always encouraged creative ways of delivering equality of experience, outcome, and quality of life for people. They actively contribute to safe, effective practice and research.

Leaders demonstrated a commitment to improvement. Performance was used to promote learning and learning was shared across the organisation. The senior leadership team and staff shared a wide range of innovation and research across all locations.

Staff were committed to learning and improving. Staff spoke about how managers supported them to attend courses that supported their development and contributed to improving services. The service offered an apprenticeship programmes to allow staff to gain external accredited qualifications to further their development.

There was shared learning across the organisation. For example, there had been an increase in calls to the patient helpline related to simple dry eye queries post-cataract surgery. They have since provided all cataract surgery patients with lubricating eye drops, free of charge. They also updated their information on managing eye symptoms on their patient information leaflets and website.

There was a commitment to professional development within the company and in the local community. The service arranged learning development days for optometrists at the service as well as community optometrists. In addition, the service supported to trainee surgeons and were committed to their development with the Surgeon Training and Education Programme for Surgeons (STEPS).

The provider supported the Health Quality Improvement Partnership (HQIP) through the NOD audit, this looked at common complications that occurred during cataract surgery. and were the first independent provider to do this in the UK. The NOD dataset produced publicly available information that showed that based on annual cataract surgery volumes, low complication rates and visual outcomes respectively demonstrated the provider provided a high quality of treatment.