Royal Eye Infirmary

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We looked for evidence that people and communities had the best possible outcomes because their needs were assessed. We checked that people’s care, support and treatment reflected these needs and any protected equality characteristics, ensuring people were at the centre of their care. We also looked for evidence that leaders instilled a culture of improvement, where understanding current outcomes and exploring best practice was part of their everyday work.

This is the first assessment for this service. This key question has been rated good. This meant patient’s outcomes were consistently good, and people’s feedback confirmed this.

We have not awarded this service a score for Effective.

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

The service usually made sure patient’s care and treatment was effective by assessing and reviewing their needs.

Staff shared key information to keep patients safe when handing over their care to others. Shift changes and handovers included all necessary key information to keep patients safe.

Pain relief medicines were timed for maximum effect. The service gathered patient’s views on pain management, 97% of respondents said pain was controlled after surgery. Also, 87% of respondents said pain did not keep them awake at night following surgery.

Plans for discharge considered people’s individual needs, circumstances, ongoing care arrangements and expected outcomes.

The service usually planned and delivered patient’s care and treatment with them, including what was important and mattered to them. Staff did this in line with legislation and current evidence-based good practice and standards.

Staff followed up-to-date policies to plan and deliver high quality care according to best practice and national guidance. All policies we looked at contained a creation and review date, and clear references to current national guidelines.

Policies and processes took account of changes to the Royal Colleges guidelines and National Institute of Care and Excellence (NICE) guidelines. There were systems and processes to monitor compliance.

We reviewed 5 care records for evidence of completion of care plans. We found risk assessments of patients and information was complete.

The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when patients moved between different services.

Doctors, nurses, and other healthcare professionals worked together as a team to benefit patients. They supported each other to provide good care. We observed staff working in collaborative ways to provide care. There was a positive culture within theatres.

Staff reported healthy working relationships across staff groups including between medical and nursing teams. We saw and heard examples of effective team working which was based on mutual respect and trust. The staff survey for 2024 showed they felt they were a team. This was better than the trust average.

We observed staff working well when handing over patients from theatres to post op recovery.

Information was shared between teams and services to ensure continuity of care. Huddles enabled teams to come together to discuss and plan care.

The service generally supported patients to manage their health and wellbeing to maximise their independence, choice and control. The service supported patients to live healthier lives and where possible, reduce their future needs for care and support.

Patients undergoing elective operations had access to information about their condition, their treatment and how best to prepare for surgery. Staff spoke with them about how best to optimise their outcomes after surgery and how to modify their choices to ensure better health.

The trust’s website contained various patient information guides to support patients with their condition and to live healthier lives.

During our assessment of the service, staff were identifying patients who were eligible for flu vaccination and provided the service by trained staff.

The trust promoted a tobacco-free environment. Patient discharge information included contact details of support and advice for patients who wished to stop smoking.

The evidence showed some shortfalls. The service did not meet people’s expected access to treatment. However, there were improvements over time.

The maximum number of weeks patients should wait to be seen by a doctor is set by the NHS Constitution to try and make sure people were seen in a timeframe that means their medical condition will not get worse while they were waiting. The longest time the Constitution says people should wait is 18 weeks for most non urgent referrals. Risks to people increase the longer they wait.

People were waiting longer than 18 weeks. The referral to treatment for theatres performance when we assessed the service showed there were no people waiting over 78 weeks to be seen. There were 40% of people waiting more than 18 weeks, which showed an improved picture since the services high of 49% during the 12 months prior to our assessment. Work was ongoing to reduce waiting times in line with the 18 week wait.

The service did not have any accreditations. The service said this had been paused whilst the cataract action plan was being developed.

Staff monitored the effectiveness of care and treatment through audit to compare performance with other similar services. The service participated in relevant national and provider led clinical audits, including National Ophthalmology Database Audit for cataract. Results for the audit which ran from April 2023 to March 2024 showed the service was within expected limits.

The service implemented a system to review patient reported outcomes a month prior to our assessment. The service had captured data for September 2025 which showed monitoring of a patient’s post operation pain management.

The service did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

The service had up-to-date policies and processes to support staff in gaining informed consent. Staff understood and could explain how to gain consent from adults and children to provide care and treatment. However, consent prior to surgery did not always give patients time to consider information. We observed this for 1 patient and 2 patients fed back to us how they were not afforded enough time to fully read the consent form, felt rushed to read, and staff did not consider whether individuals required support to do so considering their eye impairments. This meant that patient may not be fully aware of risks and benefits of a procedure.

The service monitored consent compliance with audits against World Health Organization (WHO) consent guidelines. Records showed the service achieved between 96.73% and 100% in the 12 months prior to our assessment.

Staff understood their responsibilities where a person lacked capacity.

The booking process was able to capture the support a patient needed during an appointment. For example, translators or advocates. The service used this to plan care.