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Inspection Summary


Overall summary & rating

Good

Updated 12 April 2017

The London Eye Hospital is a private hospital that provides a range of eye treatments and surgical procedures to adults who are self- funding. They specialise in providing cataract treatment and lens implants. Their location at 29a Wimpole Street, which this report refers to, is their surgical site where all surgical procedures take place.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led? We rate services’ performance against each key question as outstanding, good, requires improvement or inadequate.

Throughout the inspection, we took account of what people told us and how the provider understood and complied with regulations.

The main service provided by this hospital was surgery. Where our findings on surgery – for example, management arrangements – also apply to other services, we do not repeat the information but cross-refer to the surgery core service section.

We rated the surgical services as good overall. However, we found that the hospital required improvement in well-led domain. It was unclear how the medical advisory committee (MAC) functioned and how consultants might play an active role within it.

We rated this hospital as good overall because:

  • Staff spoke with compassion about patients. Doctors were kind and respectful towards the patient and took time to ensure they answered questions and concerns in full.

  • Local management of the surgery site was robust and well-led.

  • Staff told us they were confident to raise any issues with senior management. They told us the London Eye Hospital was a good place to work.

  • Procedures were scheduled to accommodate patient’s travel times or specific needs related to other illnesses. There was a 24 hour telephone support line available to patients.

  • There was a clearly defined patient pathway. Consultants were available to patients post-operatively.

  • There was a clearly defined complaints process.

  • Care was delivered in line with relevant national guidelines.

  • Staff had up to date training in the use of machines used at the hospital. We saw completed competencies for all staff directly employed by the provider.

  • There was evidence of good internal multidisciplinary working.

  • Staff understood their responsibility with regards to ensuring there was patient consent to all procedures.

However:

  • There was a nine months waiting list for a particular ophthalmic procedure.

  • The hospital did not have a written long term strategy.

  • Clinical governance meeting minutes did not have an attendance list and there was no update on actions from the precious meeting.

  • The risk register lacked consistency and detail. The incident log was not always updated to indicate how the incident was resolved.

  • There was no data available to assess clinical outcomes in line with the Royal College of Ophthalmologists Cataract Surgery Guidelines September 2010.

  • There was no provision for doctors to meet with each other on formal basis to share common themes.

  • Two consultants’ intermediate life support training was overdue at the time of our inspection. There was no record kept of consultant’s competencies or any mandatory training done by them.

Following this inspection, we told the provider that it must take some actions to comply with the regulations and that it should make other improvements, even though a regulation had not been breached, to help it move to a higher rating. Details are at the end of the report.

Professor Sir Mike Richards

Chief Inspector of Hospitals

Inspection areas

Safe

Good

Updated 12 April 2017

We rated safe as good because:

  • There was evidence of good learning from incidents.
  • Infection prevention and control was well managed within the surgical services.
  • Patients’ MRSA status was confirmed before undergoing a procedure.
  • Single use equipment was utilised.
  • Medicines were well managed and robustly audited.
  • All equipment including laser machines were regularly serviced.
  • Mandatory training for employees was up to date.
  • The World Health Organisation (WHO) surgical safety checklist was regularly completed and audited.

However:

  • The provider submitted data which showed that two consultants’ intermediate life support training was overdue at the time of our inspection. The provider was unable to confirm whether any consultant had advanced life support.

  • There was no record kept of consultant’s competencies or any mandatory training done by them.

  • The incident log was not always updated to indicate how the incident was resolved.

Effective

Not sufficient evidence to rate

Updated 12 April 2017

We did not have sufficient evidence to be able to assess effectiveness of the service. The provider did not fully assess clinical outcomes and benchmark against other specialist eye care and treatment providers.

We noted:

  • Staff had up to date training in the use of machines used at the hospital.

  • We saw completed competencies for all staff directly employed by the provider.

  • There was evidence of good internal multidisciplinary working.

  • Staff understood their responsibility with regards to ensuring there was patient consent to all procedures.

However:

  • There was no data available to assess clinical outcomes in line with the Royal College of Ophthalmologists Cataract Surgery Guidelines September 2010.

  • There was no provision for doctors to meet with each other on formal basis to share common themes.

Caring

Not sufficient evidence to rate

Updated 12 April 2017

We did not directly obtain views of sufficient number of patients to inform this judgement. This was due to the limited number of procedures performed at the location at the time of the inspection.

We noted:

  • 78% of patients thought that staff were either very good or outstanding.

  • Staff spoke with compassion about patients.

  • We observed a patient consultation where the doctor was kind and respectful towards the patient and took time to ensure they answered questions and concerns in full.

Responsive

Good

Updated 12 April 2017

We rated responsive as good because:

  • Procedures were scheduled to accommodate patient’s travel times or specific needs related to other illnesses.

  • There was a 24 hour telephone support line available to patients.

  • There was a clearly defined patient pathway.

  • Consultants were available to patients post-operatively.

  • There was a clearly defined complaints process.

However:

  • There was a nine months waiting list for a particular ophthalmic procedure.

Well-led

Requires improvement

Updated 12 April 2017

We rated well-led as requires improvement because:

  • The hospital did not have a written long term strategy.

  • Clinical governance meeting minutes did not have an attendance list and there was no update on actions from the precious meeting.

  • The risk register lacked consistency and detail.

  • It was unclear how the medical advisory committee (MAC) functioned and how consultants other than the medical director might play an active role within it.

However:

  • Local management of the surgery site was robust and well-led.

  • Staff told us they were confident to raise any issues with senior management.

  • Staff told us the London Eye Hospital was a good place to work.

Checks on specific services

Surgery

Updated 8 February 2018

Surgery was the main activity of the hospital. Where our findings on surgery also apply to other services, we do not repeat the information but cross-refer to the surgery section. Staff saw patients for the lens implant surgery. Patients were seen post operatively at another location.

Clinicians sought patients' consent and discussed risks with the patients at various stages of the consultation process. We also found that the hospital had a complaints procedure in place.

We observed that staff maintained patient’s privacy and dignity during consultations and post-operative checks.

However, not all staff had been trained in safeguarding .These staff were subsequently trained following our inspection. We also found that although the service saw individual patients post operatively to assess the success of lens implant surgery the service did not routinely monitor patient outcomes to give an overall measure of the effectiveness of the service. Furthermore, there was no evidence of the seven-day ‘cooling off’ period being discussed patients or being monitored in patient records.

The hospital did not have a registered manager in place at the time of our inspection.

We did not rate this service because the inspection focused on specific areas of the service and not the service as a whole.