Optimax Laser Eye Clinics - London

Updated 18 November 2021

Optimax Laser Eye Clinics - London is operated by Optimax Clinics Limited. The service was established in 1991. It is an independent private service in the London borough of Camden. The service provides refractive (laser) eye surgery for patients over the age of 18. The service receives patients from mostly London and the surrounding area.

The service provides refractive eye surgery only (LASIK; laser-assisted in-situ keratomileusis, LASEK; laser-assisted sub-epithelial keratectomy, or TESA; transepithelial surface ablation). If patients required further care or surgery using anaesthesia or sedation, for example, lens replacement surgery, patients were referred for private surgery to another site managed by the same provider. If patients have lens surgery in another branch, the London location provided pre-, and post-operative care. In 2020 the service performed 1591 refractive eye surgery procedures.

All patients are self-referring and paying for their refractive (laser) eye surgery themselves. Surgery days are variable and are booked according to demand. There are no overnight facilities with opening times from 8am to 6pm Monday to Saturday, with occasional opening on Sunday, as required by demand of the patients.

The clinic operates from the first two floors of a three-storey building. The ground floor has a reception area, main waiting room, topography room, laser room and two consultation rooms. On the first floor, there is a staff changing room, reception waiting area, managers' office, storeroom, laser preparation and treatment room, recovery room, and doctors’ consultation room.

The service has not been subject to any external review or investigation by the CQC at any time during the 12 months before the inspection. There had been one never event in the preceding 12 months. Never events are serious, largely preventable patient safety incidents, which should not occur if the available preventative measures have been put into place by healthcare providers. At the time of the inspection, the incident was still being investigated by the provider.

The registered manager has been in the post since August 2021.

Our previous inspection of the service took place in December 2017. In 2017, we did not have a legal duty to rate refractive eye surgery services when they were provided as a single speciality service.

The team that inspected the service comprised a CQC inspector and a specialist advisor with expertise in clinical governance and service management. The inspection team was overseen by Nicola Wise, Head of Hospital Inspection.

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.

You can find information about how we carry out our inspections on our website: https://www.cqc.org.uk/what-we-do/how-we-do-our-job/what-we-do-inspection.

Updated 18 November 2021

We rated the service as requires improvement overall.

We found:

Equipment checks were not always carried out to ensure they were ready to use.

The service did not have enough staff with the right qualifications, skills, training and experience to keep patients safe from avoidable harm and to provide the right care and treatment.

The service did not have an appropriate system for monitoring doctors and optometrists’ mandatory training.

The role of Laser Protection Supervisor was not clearly identified and defined by the service.

The service did not make sure all staff were competent for their roles. Managers appraised staff’s work performance; however, they did not hold regular supervision meetings with them to provide support and development.

Staff were unaware of the provider's vision and mission and how they could turn it into action.

Staff did not always feel supported and valued by the provider. They had a limited impact on how the service was organised and on plans for the future.

The service had a plan to cope with major unexpected events but not for how some of the routine work would continue when staff were off sick.

The service did not have a local risk register that would help to identify and mitigate generic risks.

It was not always clear how identified shortcomings were used to facilitate service improvements.

However:

Staff treated patients with compassion and kindness, respected their privacy and dignity, and took account of their individual needs. The service used patients’ feedback to guide the service delivery.

Staff supported patients to make informed decisions about their care and treatment. They followed national guidance to gain patients' consent.

Staff understood how to protect patients from abuse. Staff had training on how to recognise and report abuse and they knew how to apply it.

The service controlled infection risk well. The service used systems to identify and prevent surgical site infections. Staff used equipment and control measures to protect patients, themselves and others from infection. They kept equipment and the premises visibly clean.

Staff completed and updated risk assessments for each patient and removed or minimised risks.

Staff recognised and reported incidents and near misses.

The service provided care and treatment based on national guidance and evidence-based practice.

Key services were available to support timely patient care.

Staff always had access to up-to-date, accurate and comprehensive information on patients’ care and treatment.

It was easy for people to give feedback and raise care concerns received. The service treated concerns and complaints seriously, investigated them and shared lessons learned with all staff.

Leaders were visible and approachable in the service for patients and staff.

Staff were focused on the needs of patients receiving care.

The service collected reliable data and analysed it. Staff could find the data they needed, in easily accessible formats, to understand performance, make decisions and improvements.