Questions and answers
This section provides answers to the most frequently asked questions from professionals.
Clinical governance- What are Netcare’s clinical governance arrangements?
- How are untoward incidents dealt with?
- What does Netcare’s Medical Advisory Committee do?
- How do you manage, record and report complications?
- What clinical audits are undertaken?
- How does Netcare assess the surgeons it employs?
- What length of time do Netcare’s surgeons spend working on the units?
- What is Netcare’s approach to staff training?
- How are patients assessed once they’ve been referred?
- Are patients ever referred back because they are unsuitable for an operation, and what is the process?
Clinical governance
- What are Netcare’s clinical governance arrangements?
Netcare’s clinical governance arrangements reflect those within the NHS. All staff members are encouraged to report personally or anonymously suggestions for improving our clinical, organisational and logistic activity. Clinical governance bulletins provide the feedback and communication to all members of staff. Clinical governance matters are monitored by the Medical Director of Ophthalmology and reported to the Clinical Sub-Group of the Central Contract Management Unit at the Department of Health, and Netcare’s Medical Advisory Committee. - How are untoward incidents dealt with?
We have a robust incident reporting mechanism. Untoward incidents are reported as they occur to the senior management team, and action plans quickly formulated for addressing the incident. Again, these matters are monitored by the Medical Director of Ophthalmology and reported to the Clinical Sub-Group of the Central Contract Management Unit at the Department of Health, and Netcare’s Medical Advisory Committee. - What does Netcare’s Medical Advisory Committee do?
The Medical Advisory Committee comprises an anaesthetist and three ophthalmologists, none of whom are employed by Netcare, as well as Netcare’s UK Medical Director, Medical Director of Ophthalmology, and the Operations Managers. It is responsible for ensuring effective monitoring of clinical performance and outcomes. The committee reviews all clinical outcome data and incidents. - How do you manage, record and report complications?
Complication rates are low as indicated in our Clinical Outcomes report, which can be viewed by visiting the ‘Performance’ page of this site. Prior to commencing service delivery, Netcare establishes links with every ophthalmic emergency service in relevant PCT areas. We establish a patient care pathway to cover emergency situations. However, in the unlikely event of an emergency, patients are primarily encouraged to contact us on our 24 hour emergency helpline, which will be provided to them at the end of their surgery. We will arrange for the patient to be seen, ether at our unit or the most appropriate local ophthalmic unit. - What clinical audits are undertaken?
Netcare is committed to quality assurance, and believes that audit is a valuable element in continuous improvement. Regular inspections are undertaken by the Healthcare Commission and we contribute to the European Cataract Audit, covering surgical practice and outcomes. In-house audits of the key aspects of our administration and performance are continually undertaken, for example we audit the quality of our case notes every month. The Department of Health receives monthly data on a wide range of outcome measures.
- How does Netcare assess the surgeons it employs?
All OC123 surgeons must be on the GMC Specialist Register for ophthalmology. Doctors being considered for roles on our units are visited at their current place of work, interviewed and referenced, and then undergo an induction process. Surgeons must submit detailed audit results and videos of their surgery, and are supervised to ensure the required high level of expertise. Recruitment of overseas doctors follows the same rigorous recruitment process as that applied by the NHS. - What length of time do Netcare’s surgeons spend working on the units?
Surgeons usually work in blocks of 1 to 2 weeks, and we currently have nine surgeons on rotation. Many of our surgeons have been working with us since we commenced operations in 2003, and some have performed in excess of 3000 procedures with Netcare in the past three years. - What is Netcare’s approach to staff training?
Training is an important part of Netcare’s culture and development. All our staff undergo mandatory training days. In house training will be delivered by doctors and anaesthetists, and this is documented as part of their ongoing professional development. Outside courses are available which staff can attend.
- What happens if a patient has a problem before the four week appointment?
All patients are encouraged to phone our 24 hour helpline, and the number is given to them when in the unit and is also available on this website. If possible we will see the patient quickly within our mobile unit. Otherwise we will advise them to visit their local Eye Casualty facility with the information we give them. We ask all local NHS units to advise us if they see one of our patients post-operatively.
- How are patients assessed once they’ve been referred?
All patients receive a telephone call from the Patient Referral Centre to discuss the initial assessment, during which the date of the appointment will be confirmed and transport arrangements discussed. Every patient follows a patient care pathway at the outpatients unit to assess clinical suitability for day case cataract surgery under local anaesthesia. There is usually a 2-3 week interval between outpatient assessment and surgery. - Are patients ever referred back because they are unsuitable for an operation, and what is the process?
If there is a need to refer back, the patient will be informed of the reasons that surgery is not deemed suitable in his or her situation. The reasons can include current infection, uncontrolled diabetes, hypertension and unstable anticoagulation. A letter will be sent the Patient Referral Centre and the referrer as appropriate. In some cases the patient can be re-referred once the problem has been resolved.
- How does Netcare follow up with its patients after surgery, if there are no complications?
Follow-up consists of a telephone call around 24 hours after surgery, followed by a post-operative assessment in our outpatient unit around four weeks later. 95% of our patients require just one such visit; a few are followed up more often.
- How can GPs or local NHS staff make arrangements to visit the units?
Many GPs and staff at PCTs and Patient Referral Centres have expressed an interest in finding out more about our units and working practices. We are delighted to host visits, and have also held open days and seminars that local healthcare professionals are welcome to attend. GPs are invited to telephone the local PCT, or Netcare directly, in order to make arrangements.