This was the first comprehensive inspection of Cancer Centre London LLP, which we carried out on 24-26 May 2016. The inspection reviewed how the centre provided medical care and treatment, in this case chemotherapy and radiotherapy, to patients attending on an outpatient basis.
The Cancer Centre London LLP offered complex investigations such as computerised tomography (CT scanning) and if patients required additional investigations for treatment planning such as magnetic resonance imaging (MRI), this was available at the provider’s nearby location, Parkside Hospital. CQC had inspected Parkside hospital, to which oncology patients could be admitted for inpatient treatment, at the same time as the CCL inspection. Patients also had the choice to undertake some of their treatment planning investigations at any other private provider if they preferred, or if they needed a type of scan not available at Parkside Hospital.
Overall, we have rated
Cancer Centre London LLP
as good. We found the centre was good in four of the key questions we always ask of every service relating to safe, effective, caring and well led. We found the service to be outstanding in its responsiveness to patients.
Are services safe at this cancer centre?
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We saw a culture of safety among staff and effective systems and protocols to protect staff and patients from avoidable harm because staff understood the potential risks of cancer treatments.
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Anti cancer drugs were prepared in a germ free environment and were prescribed and administered safely.
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The radiotherapy department and chemotherapy service was certified to the ISO9001 Quality Standard and held cancer standards CHKS accreditation, which required clear policies, protocols and work instructions to ensure safety.
- Staff reported incidents which were investigated, feedback was given and learning applied to prevent the re-occurrence. If something went wrong, staff were open and transparent with patients and families.
- Staff we spoke with had a good understanding of safeguarding.
- There was always a registered medical officer (RMO) on duty when the centre was open and there were enough trained nurses and radiotherapy staff to ensure patients were safe from avoidable harm.
Are services effective at this cancer centre?
- The centre provided effective care because patients' care and treatment was individually planned in line with good practice, national guidelines and legislation. Any changes to guidelines or policies were signed off by the medical advisory committee (MAC) which met quarterly.
- The MAC regularly reviewed doctors' practising privileges.
- There was some participation in national audits, and staff audited many aspects of the centre's work.We saw action taken in response to audit results.
Are services caring at this cancer centre?
- We saw staff demonstrate kindness and compassion in dealing with patients and their families. Patients praised staff for their care and attention. They said they had confidence in staff treating them and were involved in making decisions about their care.
- A high proportion of patients would recommend the centre to their friends and families.
- There was access to emotional support for patients who needed it.
Are services responsive at this cancer centre?
- The service was extremely responsive to its patients and their families.
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Waiting times for radiotherapy treatments were minimal.
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Appointments were made to fit around patients' preferences and other commitments, for example if they were working or had carer responsibilities.
- Patients waited under an hour for their chemotherapy treatment after their medical consultation.
- Patients had individualised treatment plans, and there was a wide range of information as well as local support available to them.
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There had only been three complaints, all minor, about the service in the last year. If a patient or relative had a concern, staff aimed to resolve it at once.
Are services well led at this cancer centre?
- Staff were clear about the importance of providing safe, high quality care to patients and were proud of the personalised care they offered.
- There was an effective clinical governance structure, risks were identified and acknowledged and action plans were put into place to address them.
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Care was evidence based and action plans were regularly reviewed.
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The MAC and the registered manager monitored performance and reviewed practising privileges regularly.
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Although a small centre, they had developed some innovative treatment techniques.
We saw some areas of outstanding practice including:
- Heart sparing radiotherapy which had won the LaingBuisson award for innovation in technology in 2015.
- A radiotherapy technique for controlling Dupuytren’s disease had excellent results.
- The service was outstanding in its responsiveness to the needs of its patients.
However, there were also areas of where the provider needs to make improvements.
The provider should:
- The provider should consider improving temperature control in the chemotherapy suite and its clinic room, and review the suitability of the second chemotherapy clinical room for treatment.
Professor Sir Mike Richards
Chief Inspector of Hospitals