Accuvision Eye Care Clinic London is operated by Accuvision Limited. Facilities include one laser treatment room, outpatient and diagnostic facilities.
The service provides laser vision correction procedures and outpatient diagnostics for adults. Patients are self-referring and self-funded with visual acuity problems (failing eyesight).
We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 4 December 2017.
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? Where we have a legal duty to do so 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 the Mental Capacity Act 2005.
Services we do not rate
We regulate refractive eye surgery but we do not currently have a legal duty to rate them when they are provided as a single specialty service. We highlight good practice and issues that service providers need to improve and take regulatory action as necessary.
We found the following areas of good practice:
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Systems and processes were in place to keep staff and patients safe. The service had systems in place for the reporting, monitoring and learning from incidents. Staff knew how to report incidents.
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There were good infection prevention and control procedures in place, all areas were visibly clean and well equipped.
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Staff used an adapted ‘five steps to safer surgery’ World Health Organisation (WHO) checklist to minimise errors in treatment, by carrying out a number of safety checks before, during, and after each procedure. Patients received a thorough assessment prior to treatment and were given an emergency contact number following their discharge.
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Staff were competent to carry out their duties.Additional training was provided to staff who used laser eye equipment, which ensured patient procedures were carried out safely.
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Policies, procedures and treatments were based on nationally recognised best practice guidance. Regular audits were carried out on a range of topics. Patient outcomes were measured and benchmarked and showed excellent results.
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Care was delivered in a compassionate way and patients were treated with dignity and respect. Patients were kept informed throughout their care and encouraged to ask questions. Staff recognised when patients may need additional support.
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There was a system in place for obtaining patient feedback. Patient feedback results were positive and patients we spoke with and comment cards reflected this.
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Clinic appointments were available at the patients’ convenience.
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Managers were visible and respected by staff. Staff felt valued. There was a culture of honesty and openness.
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Policies were in place for key governance topics such as information governance, incident management, risk assessment or management of complaints. Royal College of Ophthalmology standards were incorporated throughout policies and procedures.
However, we also found the following issues that the service provider needs to improve:
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The service did not perform adapted WHO safer surgery checklist audits
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Although patients were given sufficient time to reflect on their decision to go ahead with the procedure, written consent was obtained on the day of surgery, which was against recommendations of the Royal College of Ophthalmologists.
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Translation or interpreter services were not available through the service.
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The service did not perform formal staff surveys.
Following this inspection, we told the provider that it should make improvements, even though a regulation had not been breached, to help the service improve. Details are at the end of the report.
Amanda Stanford
Deputy Chief Inspector of Hospitals (London)