Newmedica Ophthalmology Services, London is operated by New Medical Systems Limited. The support office is located in Elephant and Castle with the clinics being operated from 20 hubs around the country, based in mobile units, hospitals and other clinic settings, in accordance with contracts with individual NHS Trusts and Clinical Commissioning Groups (CCGs). At the time of our inspection, there were 20 ‘hubs’ (for the purpose of this report, the sites where the provider carries out the activities for which it is registered with the CQC will be referred to as ‘hubs’) operating under the umbrella of the London location.

The services provide outpatients and surgery. We inspected both outpatients and surgery. We inspected this service using our comprehensive inspection methodology. We carried out announced inspections on 9 October 2017 at the Newmedica Glaucoma Monitoring Services at Kingston University Hospital, Kingston, Western Eye Hospital, Marylebone and the Two Rivers Medical Centre, Ipswich. On 10 October 2017 we carried out an announced inspection of the Newmedica Warwickshire Macular Service and cataract surgery provision hosted at the George Elliot Hospital, Warwickshire. On 12 October 2017 we carried out an announced inspection of the Newmedica central support office, Elephant and Castle. We carried out an unannounced inspection at the Newmedica Glaucoma service at Preston University Hospital, Preston on 25 October 2017. In total, we inspected six hubs and the support office.

At the support office we spoke with senior staff members and administrative staff. At the hubs we spoke to consultant ophthalmologists, optometrists, clinic assistants, administrative staff and people who use the service.

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 the service was outpatient services. Where our findings on outpatient services – for example, management arrangements – also apply to other services, we do not repeat the information but cross-refer to the outpatient core service. We rated this service as good overall.

• The service had robust processes in place to ensure consistent, safe and effective care and treatment across all of the hubs under this location.

• All staff had an awareness of the safeguarding policy and reporting procedure and felt confident in identifying a potential safeguarding incident and the steps they would need to take.

• Newmedica was a learning organisation. Incidents, complaints and concerns were treated as learning opportunities, and learning was cascaded throughout the service.

• The service had policies, procedures, and guidelines, which were based on current legislation, evidence-based care and treatment and nationally considered best practice. These were regularly reviewed at the medical advisory committee (MAC) meetings.

• Hubs were regularly and effectively benchmarked to drive improvement across the service.

• The service submitted patient outcomes to the clinical commissioning groups (CCGs) and NHS Trusts as part of their contract.

• Staff demonstrated a clear commitment to providing the best standard of care. They were caring and compassionate.

• The service made innovative use of telemedicine to ensure that patients received the best possible care, and to monitor outcomes and performance. Through this process, all clinical decisions were made or reviewed by a consultant.

• There was a strong, visible leadership team, who were committed to continuous improvement within the organisation.

• The governance team had clear oversight of the organisation nationally.

• There were effective channels of communication in place between staff working in the hubs and the senior leadership team, in both directions.

• There was a corporate and local risk registers in place, which the service regularly reviewed. All risks had an owner and mitigating actions recorded, and were audited for progress.

• Staff were proud to work for the service and embodied its vision and strategy. Staff, including those working remotely, described a feeling of belonging within the organisation.

Professor Sir Mike Richards

Chief Inspector of Hospitals