Archived: Optegra Leeds

Optegra Leeds is a private clinic operated by Optegra UK Limited. Facilities include an operating theatre, assessment and consultation rooms and a patient waiting area. The service is accessible from Leeds train station and car parking is available.

The service provides refractive (laser) eye surgery only. The service is provided to adults. All patients are privately funded, referring and paying for their refractive (laser) eye surgery themselves.

We inspected this refractive (laser) eye surgery service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 10 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.

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

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:

• There were low levels of incidents and complaints.
• Patients were consistently positive about their experience and the outcomes from their surgery.
• Effective governance and risk management processes were in place.
• Suitable numbers of competent, trained staff were available.
• Staff worked well as a team and were engaged with the local vision to expand the service.
• Staff were up to date with mandatory training and most staff had received an annual appraisal.
• Patients told us they felt involved in decisions about their care because staff took time to listen and explain.
• Medicines were managed and administered in a safe and appropriate manner.
• A surgical checklist was effectively used to ensure safe treatment for patients.
• Laser safety was well managed and records were appropriately maintained.
• Surgical outcomes were benchmarked internationally, to contribute to continuing improvement.

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

• Although we saw evidence incidents were addressed and actions taken to minimise patient safety risks, we found not all low or no-harm incidents were recorded as per Optegra policy. This meant some incidents or themes could be missed.
• Although an observational audit and training were in place to support nursing staff in infection prevention and control, this did not include optometrists.
• The optometrist-led pathway meant patients were not being seen by the surgeon carrying out treatment until the day of the procedure, which is best practice. However patients were seen by the consultant prior to undergoing surgery on the treatment day.
• Arrangements for managing emergencies did not include a service level agreement with the local NHS hospital or a written policy for managing ophthalmic emergencies, which are best practice. However, the service had not had any emergencies in the last 12 months.
• Patient information was not routinely available in easy read format, to assist people with impaired sight.

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