Optimax Laser Eye Clinics - Milton Keynes

Optimax Laser Eye Clinics – Milton Keynes is operated by Optimax Clinics Limited. The clinic opened in July 2009. Facilities include one treatment room where laser eye surgery is performed, a topography room, two consultation rooms, a counselling room, a preparation room, a recovery room and two reception areas. The clinic is set over two floors, with disabled access.

The service provides refractive eye surgery to patients aged over 18.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 3 October 2017, along with an unannounced visit to the hospital on 12 October 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:

• Despite the lack of an incident reporting policy, there was a strong culture of reporting incidents.

• The environment was visibly clean.

• All staff had completed their mandatory training.

• The theatre environment met guidance set by the Royal College of Ophthalmologists.

• Patient retreatment rates were within acceptable limits.

• Pain relief was available to patients to take home following surgery.

• The surgeon who performed the laser surgery held the Certificate in Laser Refractive Surgery.

• There were appropriate consent processes.

• Staff provided compassionate care to patients.

• All patient feedback we received was very positive.

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

• There was no incident reporting policy.

• We found some pieces of equipment which were past their expiry or servicing date.

• The service did not use the World Health Organisation’s ‘Five Steps to Safer Surgery’ checklist. The patient verification checklist used was not robust or embedded in practice.

• There was no specialist spillage kit available to clean any spillages of cytotoxic medicines.

• Non-clinical staff had access to medicines.

• Not all staff who worked with cytotoxic drugs had demonstrated competence in this area.

• Patient outcomes were not benchmarked against other services.

• All information leaflets were only available in English.

• Interpretation services, whilst available, had to be paid for by the patient.

• There was no vision or strategy for the service.

• The clinic manager had limited autonomy to make improvements to the service.

• Not all risks identified on inspection were on the service’s risk register.

• Emotional support was provided to patients, where needed.

• Patients had continuity of care throughout their procedure and aftercare.

• The facilities and premises were appropriate for the services that were being delivered.

• Appointments were available on weekends, if necessary.

• Complaints were managed in line with the service’s policy.

• There was a clear leadership structure.

• All required staff had appropriate indemnity insurance.

Following this inspection, we told the provider that it must take some actions to comply with the regulations and that it should make other improvements, even though a regulation had not been breached, to help the service improve. We also issued the provider with two requirement notices. Details are at the end of the report.

Heidi Smoult

Deputy Chief Inspector of Hospitals (Central)