‘We embraced Lord Darzi’s vision long before it was drafted’

Carole Gilling-Smith, CEO and Medical Director of the Agora Clinic, outlines ‘our blueprint for exceptional NHS care’.

There are two topics that never fail to spark passionate debate among the British public: the weather and the NHS. While I can’t claim to be a meteorologist, I do have a wealth of experience in the latter. After many years of working within the NHS, 18 years ago I left; disillusioned by top-down leadership, a toxic culture, lack of management structure and wasteful use of resources. I could see even then that the NHS was in trouble, which inspired me to found the Agora Clinic in Brighton where I pledged to deliver fertility care differently, taking a far more patient-centric and innovative approach than anyone had done before.

I believe that you can provide exceptional fertility care to both NHS and private patients by creating an environment that not only prioritises the patient’s wellbeing but also embodies all the pillars of best practice embodied in the recent Darzi report investigating the state of the NHS.

The patient-centric approach

The importance of person-centric care is central to the Darzi report and has always been at the heart of our mission at the Agora. We understand that every patient’s fertility journey is unique and strive to tailor our services to meet their specific needs. By fostering a compassionate environment and offering educational support, we empower patients to take an active role in their fertility journey, ensuring they feel informed and cared for throughout.

Optimal resource utilisation

Darzi emphasises the critical challenge of optimising resources in the NHS. From the outset, we implemented a comprehensive quality management system (ISO 9001) with KPIs for every aspect of care, regular audits and continuous quality improvement activities. This system allows us to evaluate our processes, ensuring high-quality care while minimising costs and waiting times for both NHS and private patients, and meets a goal that has become increasingly vital in today’s healthcare landscape.

Integrated care for seamless services

The report also underscores the need for integrated care. At the Agora, we have forged strong partnerships with the Sussex Integrated Care Board (ICB) and other NHS partners and suppliers, ensuring seamless service delivery. This collaboration enables us to make the most of limited NHS resources to deliver high quality fertility care. By integrating with the broader healthcare system, we’ve eliminated financial barriers, making fertility treatment in Sussex equitable and accessible.

Leadership and culture: the backbone of success

Strong leadership is essential for any organisation to thrive, and healthcare is no exception. At the Agora, we have cultivated a leadership structure that embraces a clear vision, strong values that are lived by every member of staff and, in so doing, created a supportive and inclusive culture. Our leadership team strives to foster an environment where every employee feels valued and empowered, something that is so often lacking in NHS hospitals, and this in turn leads to high levels of engagement, excellent staff retention and the highest quality of care.

A commitment to staff wellbeing

Staff wellbeing, emphasised in the Darzi report, has always been a top priority for me. Having experienced long hours and limited recognition working for the NHS, I knew we needed a robust well-being strategy. We employed experts to develop a programme that meets world-class standards, appointing champions across all seven domains of well-being. This initiative promotes mental health and boosts job satisfaction which attracts talent and reduces turnover, allowing us to maintain that very special continuity of care our patients love.

No waiting lists

Many are surprised to learn that we have no waiting lists! In an era of long delays for treatment within the NHS, we proudly offer a fast-track fertility service. As soon as we receive an NHS referral for IVF, our team reviews it within days, scheduling the first appointment to facilitate a first IVF treatment cycle within a month. Both NHS and private patients receive the same high-quality care and emotional support, alleviating anxiety and ensuring timely, accessible fertility care is available to all who need it.

Listening to the patient’s voice

A key theme in the Darzi report is the importance of listening to patients and this is something I have personally always prioritised at the Agora, encouraging patient feedback and using it constructively to enhance the customer experience. Our quality management approach ensures that we continually adapt to meet our patients’ needs, fostering a culture of improvement based on their insights.

Leveraging technology for excellence

Embracing technology is another critical theme from the Darzi report. The Agora has long been an early adopter, operating since 2016 as a paperless clinic by using an electronic medical record system, offering our patients a bespoke app that allows patients to see their appointments, tap into educational content about their journey and communicate easily with our staff, enhancing their overall experience. Additionally, we are increasingly integrating AI into our laboratory and clinical processes, ensuring precision and efficiency.

And we go a step further: giving back through ESG initiatives

At the Agora, we believe that our responsibilities extend beyond providing excellent medical care, which is why we have gone a step further than suggested by Darzi through our Environmental, Social, and Governance (ESG) strategy. It emphasises giving back to the local and wider community. For instance, we have been the lead sponsor for the Rockinghorse Charity Ball for the past two years and actively support many other local, national and international initiatives that enhance the lives of children and those trying to conceive.

We are also dedicated to sustainability, having removed fossil fuels from our premises and opted for heat pumps and electric systems to manage temperature and air quality. This commitment not only reduces our environmental footprint but aligns with our mission to create a better future for the children we help bring into the world.

A vision for the future

I take pride in the fact that the principles outlined in the Darzi report align perfectly with the strategic direction we’ve always taken at the Agora. Our focus on patient-centric care, integrated services, strong leadership and staff well-being has created a thriving environment for both patients and staff. We are setting a gold standard for how NHS healthcare can, and should, be delivered in the 21st century while being responsible stewards of our community and environment.

While I welcome Rachel Reeves’ pledge of £25 billion to support the NHS, I worry it may be like using a teacup to bail out the Titanic! The NHS needs a fundamental rebuild, grounded in strong leadership and a clear vision. Values must be lived and shared to foster a positive culture. Streamlining middle management can allow for more investment in leadership development and prioritising staff wellbeing.

If the Health Secretary is ever curious about how this can be achieved, he should come and visit the Agora Clinic!

For further information please visit

www.agoraclinic.co.uk