Accuvision Eye Care Clinic - Wetherby

Accuvision Eye Care Clinic Wetherby is operated by Accuvision Limited. It is a private clinic in Wetherby, North Yorkshire.

The service opened in 2009 and primarily provides refractive (laser) eye surgery, together with specialist diagnosis and treatment of eye conditions such as keratoconus, including corneal cross-linking. The service is provided to adults and does not treat children.

We inspected this service using our comprehensive inspection methodology. We carried out an announced inspection on 12 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.

The main service provided by this hospital was refractive (laser) eye surgery.

Services we do not rate

We regulate refractive eye surgery services 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:

• 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.
• There was an excellent track record of safety over the previous 12 months.
• Staff were competent to carry out their duties. All staff were up to date with their mandatory training and safeguarding training and all clinical and support staff were trained in basic life support. Additional training was provided to staff who used laser eye equipment, which ensured patient procedures were carried out safely.
• Medicines were managed and administered safely.
• There were good infection prevention and control procedures in place, all areas were visibly clean and well equipped. There were no incidents of a healthcare acquired infection in the previous 12 months.
• Clinical outcomes for patients consistently exceeded benchmarked standards. Reported outcomes were good for patients with a range of prescriptions.
• Staff used an adapted surgical 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.
• We saw a proactive, multidisciplinary approach to coordinating patients’ care, where patients were kept informed throughout their care and felt involved in decision-making. Care was delivered in a compassionate way and patients were treated with dignity and respect.
• There was a system in place for obtaining patient feedback. Patient feedback was valued and results were consistently positive. Patients we spoke with and comment cards reflected this.
• There was evidence of leadership and strategy for the service. Managers were visible and respected by staff.
• Staff we spoke with were extremely proud to work for the clinic and spoke highly of the leadership and the culture. Every member of staff felt like a valued contributor within the team.
• Policies, procedures and treatments were based on nationally recognised best practice guidance. Regular audits were carried out on a range of topics.

However, we also found the following issues that the service provider needs to improve:

• The practice of using goggles in laser theatre was not always followed as per the policy requirements.
• 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 not in line with Royal College recommendations for refractive surgery.
• There were no formal interpreting services available and patients were asked to bring a family member, carer, or friend to their consultation to translate; this is not in line with best practice guidelines.
• The complaints policy did not include arrangements for progressing a complaint with an independent adjudicator, such as the Independent Complaints Adjudication Service (ISCAS).

Following this inspection, we told the provider that it should make some improvements, even though a regulation had not been breached, to help the service improve. Details are at the end of the report.

Ellen Armistead

Deputy Chief Inspector of Hospitals