Royal Eye Infirmary

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 people and communities were always at the centre of how care was planned and delivered. We checked that the health and care needs of people and communities were understood, and they were actively involved in planning care that met these needs. We also looked for evidence that people 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 people’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 people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

The services at the Royal Eye Infirmary were awarded an internal trust certificate for making reasonable adjustments. The award was issued in 2024 to recognise they met the trust’s gold standard mark for making reasonable adjustments and improving the standards of care for patients with a learning disability.

The service had specialist trained staff who were available to support people during their appointments. There were staff experienced in supporting people living with Parkinson’s, learning disabilities and Autism. Staff could access further advice and support from teams at the trust’s main hospital.

The provider’s website had information about the Royal Eye Infirmary. This included easy read information for people to read before attending an appointment.

The booking process identified people using non-emergency patient transport. There was a system to identify people using transport, to ensure that they were booked on early clinics so not to miss transport collection times.

Staff received training in learning disabilities and autism and some staff groups completed special educational needs and disability training.

The evidence showed some shortfalls. There were some shortfalls in how the service responded to the care needs of people. Care was not always joined-up, flexible or supportive of choice and continuity.

The service ran clinics Monday to Friday between 8 am and 6pm, and some clinics at weekends.

People did not always find it easy to contact the service regarding their care and treatment. Feedback collected by system partners showed that some people were frustrated that calls made to the Royal Eye Infirmary were often unanswered. During our assessment of the service people told us, they had experienced difficulties with the booking process. A person had experienced cancellation of appointments without prior notice. Another person said there had ‘sometimes been mix up of appointments”. Another person said they had been given a course of treatment, but had not received any follow up appointments, so they had to chase these. Feedback collected as part of the National Patient-Led Assessments of the Care Environment (PLACE) assessment of the Royal Eye Infirmary showed a patient was frustrated attempting to contact the service. Leaders told us they were reviewing the booking process to improve people’s experience.

The Royal Eye Infirmary had an optic dispensary located on the ground floor. Staff said this was really useful as people could have support in real time from outpatient staff to ensure eyewear was suitable for more complex conditions.

The service met people’s needs for food and drink. The service had water dispensers in waiting areas and vending machines at the entrance to the outpatient’s area.

The evidence showed some shortfalls. The service did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Electronic and paper records were not always stored securely. During the assessment we saw paper records being stored in a lockable cabinet. However, this cabinet was not kept locked when not in use and was in a corridor accessible to people. Also, computers were not always locked when not in use. This meant information could be accessed by unauthorised people.

We saw staff did not always wear identification. Not all staff were wearing name badges that were designed to clearly identify staff. However, we did hear staff regularly introducing themselves to people using the service by saying “Hello my name is...”

Staff had conversations involving confidential information in private. However, we observed a member of staff discussing confidential information with a patient in the waiting area, which could be overheard by people waiting to be seen.

The service had up-to-date policies to manage the storage and destruction of records.

People using the service said they had received a text reminder of appointments. Feedback provided by system partners found there was a need to review and refresh all patient letters to ensure clarity and accessibility. Managers told us they were reviewing appointment letters to make them more informative with an aim to reduce instances of patients not attending appointments.

In the 12 months prior to our assessment the trust told us there were 15 data breaches of which 14 involved adults. These did not report harm, loss or damage. The service reviewed incidents of data breaches and shared learning bulletins with staff. People affected by a data breach received professional duty of candour letters.

The trust reviewed their website to make information accessible. People were able to contact the trust to request information in different formats like large print, audio recording or braille. The website was viewable in 32 languages. Webpages could be viewed in different contrasts to help people with certain eye conditions read information.

The trust’s website had information for people who wished to request medical records or make a subject access request.

The service complied with the Accessible Information Standard. The Accessible Information Standard (AIS) is a legal requirement in England that ensures people with disabilities, impairments, or sensory loss receive health and social care information in formats they can understand.

Staff received training in information governance and data security.

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

The service had policies and processes to receive and respond to feedback from people using the service.

The Royal Eye Infirmary received 35 complaints in the 12 months prior to our assessment. 33 of these complaints related to care and treatment in the outpatient’s service, including children and young people. Most complaints were regarding access and waiting, or safe quality care. Senior leaders told us they took complaints seriously. Records showed complaints were reviewed and actions to make improvements were implemented.

The service created a feedback board to collect people’s immediate feedback. People could write comment cards and attach them to a board. Staff told us they had recently created this and were looking to develop this to encourage more feedback.

The service had policies and procedures in receiving, reviewing and responding to complaints. Complaints were reviewed and actions put in place to improve quality and safety of care.

During our assessment, people told us they had not been informed how to make a complaint. However, they had not had the need to make a complaint. In patient waiting rooms there was information leaflets advertising the Patient Advice and Liaison Service. The trust’s website clearly displayed how to make a complaint.

Survey results of staff showed 47% believed the organisation would act on concerns raised by patients or service users. This was below the trust average.

The evidence showed some shortfalls. The service did not always make sure that people could access the care, support and treatment they needed when they needed it.

The service carried out 63,202 outpatient appointments in the 12 months prior to the assessment. The service identified the reason for cancellations and patients who did not attend appointments. There were action plans to make improvements in lost appointment times.

The service had 4,304 patients who did not attend booked appointments in the 12 months prior to the assessment. The service worked to reduce the number of people who did not attend appointments by reminding people of their appointment time and date.

The Royal Eye Infirmary had a hearing loop (sound system for use by people with hearing aids) at the main reception, but not in other waiting areas. During our assessment we saw a person with a hearing aid who was unsure if they had been called for an appointment as a member of staff said a name once and then walked back to the clinical area without identifying the person. Another person said "Everyone is very good; my biggest complaint is I am profoundly hard of hearing and when they call for appointments it is very difficult to hear if they are calling me. I am always on hyper alert to make sure I don't miss it… Makes you anxious."

The service carried out audits of the patient environment to make improvements to patient experience. Most actions identified in the October 2024 audit had been actioned, but handrails were identified as needing to be changed to contrast the wall and make it easier for people to locate them if needed. At the time of our assessment this had not been replaced.

The service had up-to-date policies and procedures to manage bookings, cancellation and patients who did not attend appointments.

The service was step-free to make it accessible for people using mobility aids. The service had braille on signs to guide people to the correct area. Signage was in yellow and black to make it easier to read for people with certain eye conditions. There were facilities for toileting, infant feeding and changing.

The service had processes to identify a person’s communication needs. They had a policy to support decisions on what interpretation support was needed in each circumstance for example, when a face-to-face interpreter was needed over telephone interpretation services.

The evidence showed a good standard. Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

The provider had undertaken equality impact assessments on policies used by the service. Equality impact assessments is a process to review policies to ensure vulnerable people or people with protected characteristics are not placed at a disadvantage.

Staff received training in equality diversity and Human Rights.

The evidence showed a good standard. People were supported to plan for their future, including at the end of their life.

People were supported to make decisions about their care and treatment. People using the service told us they were given the opportunity to discuss treatment options to help them plan for the future.

The service could access a person’s wish not to be resuscitated in their clinical records. Staff knew how to find this information.