The Priory Hospital

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We reviewed assessing needs, delivering evidence-based care and treatment, how staff, teams and services work together, supporting people to live healthier lives, monitoring and improving outcomes and consent to care and treatment as part of the effective key question.

At our last assessment we rated this key question as requires improvement. At this assessment the rating has changed to good. This meant patient’s outcomes were consistently good, and patient’s feedback confirmed this.

Staff followed up-to-date policies to plan and deliver high quality care according to best practice and national guidance. Staff completed comprehensive health assessments in a timely manner. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service made sure patient’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Staff completed a comprehensive health assessment of the patient in a timely manner. They gave patients information and advice about their care and treatment which included their physical, psychological and emotional wellbeing. Staff protected the rights of patients subject to the Mental Health Act and followed the Code of Practice.

Staff made sure patients nutritional needs were assessed and met in line with current guidance. Patients' nutritional and hydration status were assessed by oncology nurses as part of the treatment modified toxicity grading in the care pathway. We reviewed 19 patient records and found all patients had their nutritional needs assessed and where concerns were identified, staff referred patients to the dietitians for further specialist care.

Records were up to date and showed comprehensive assessments undertaken leading to effective ongoing care. Patients undergoing an endoscopy procedure that required bowel preparation or sedation were given appropriate fasting advice as part of the pre-assessment. Patients due to attend for a colonoscopy were given detailed advice on how to prepare for the procedure.

Patients were involved in their planned care and treatment, as well as the next steps of their treatment. Staff made sure patients did not fast for too long before diagnostic procedures such as gastroscopy. Patients were provided with information before fasting for colonoscopy procedures that detailed dietary requirements and how long patients should do this for. Staff took into account patients’ individual needs where food or drinks were necessary following the procedure.

The service planned and delivered patient’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

There were processes in place for staff to follow in order to assess and meet the needs of patients. The service used clinical tools which were relevant to the patients’ needs, for example, WHO checklists, mobility and falls risk assessments. Patients undergoing endoscopy procedures were monitored appropriately for signs of clinical deterioration. For example, heart rate, oxygen saturation and blood pressure. Staff checked the patients’ observations frequently and documented them on a chart.

Care, treatment and support were delivered in line with legislation, standards and evidence-based guidance. The service used policies, care and treatment pathways, clinical protocols and standard operating procedures. The endoscopy unit was re-accredited by Joint Advisory Group for Gastrointestinal Endoscopy in June 2025. This meant the team had demonstrated consistent care, quality and safety in line with national standards.

Staff followed up-to-date policies to plan and deliver high quality care according to best practice and national guidance. Policies were up-to-date and stored on an online system which all staff had access to.

During our last inspection in May 2019, we told the provider they must review their documentation to ensure it was reflective of current best practice, guidance and legislative requirements. Senior staff now issue NICE guidance to all clinical departments on a monthly basis and this was reviewed by the relevant head of department or clinical lead.

The endoscopy unit had a local standard operating procedure with next review date in June 2027. To achieve a high-quality patient-centred service, staff held quarterly endoscopy user group meetings. This helped to maintain positive communication between endoscopy staff and consultants.

The service worked well across teams and services to support patients. They made sure patients only needed to tell their story once by sharing their assessment of needs when patients moved between different services.

Staff held regular and effective multidisciplinary meetings (MDT). There was a daily huddle for all heads of departments and the senior management team to share any risks with their service. The teams worked together to prepare patients for what to expect post chemotherapy, endoscopy procedure and when they returned home.

Patients with complex needs received prompt screening by a MDT, including physiotherapy, occupational therapy, nursing, pharmacy and medical staff. Staff carried out a clear and timely MDT assessment and put treatment or management plans in place.

The teams had effective working relationships, including good handovers, with other relevant teams within the organisation. The pharmacy and oncology team of nurses, dietitians and physiotherapists had daily huddles to ensure a seamless handover of patients.

When patients received care and treatment from members of the MDT it was co-ordinated and effective. All relevant staff, teams and services were involved in assessing, planning and delivering patient care and treatment and staff worked collaboratively to understand and meet patient needs.

The service supported patients to manage their health and wellbeing to maximise their independence, choice and control. The service supported patients to live healthier lives and where possible, reduce their future needs for care and support.

Staff assessed each patient’s overall health and provided support and advice to help patients lead healthier lives. This included screening for alcohol dependence, nutrition, mobility requirements requiring physiotherapy input, and obstructive sleep apnoea.

Staff supported patients to live healthier lives. For example, at the time of our inspection, the Priory hospital offered free 30-minute physiotherapy consultations as a trial for patients experiencing musculoskeletal concerns. Patients were encouraged not to let pain hold them back and to book their free consultation to receive expert assessment and advice on treatment options. It was a great opportunity to discuss conditions with a specialist and explore potential solutions tailored to individual needs.

A small hydration station was available for staff and patients to use in the endoscopy department. Patients who were able to eat and drink were offered a drink and biscuits before leaving the endoscopy unit.

We saw posters and information in both endoscopy and oncology areas that related to mental health services, post procedure information, support groups, healthier food choices, and smoking cessation. The service also supplied additional information that supported patients to live healthier lives.

The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Patients who used the service experienced positive outcomes. These met agreed expectations as set out in legislation, standards and evidence-based clinical guidance. The service participated in national audits that were available for private providers such as Patient Reported Outcome Measures and generally performed well. The service also submitted data to the Private Healthcare Information Network.

The Priory hospital, along with other hospitals within Circle Health Group (CHG) that provided systemic anti-cancer therapy (SACT) services, did not currently participate in national clinical audits for cancer services coordinated by the Healthcare Quality Improvement Partnership (HQIP). The clinical audit lead and the national lead for cancer services had proactively engaged with HQIP to explore potential participation in various national cancer audits. They identified key challenges, but the CHG remained committed to the continuous improvement of cancer services and by embarking on internal audits aligned to national clinical standards. They also participated in peer review and accreditation schemes and held ongoing engagement with NHS England and HQIP for future opportunities for inclusion.

During our last inspection, we told the provider they should review their data collection to ensure it supported patients outcomes in the future. During this inspection, senior staff told us they had conducted a review and actions were in place to ensure this data was captured.

Staff carried out contemporaneous patient record audits in Highbury ward and endoscopy unit. The annual documentation audit in January 2025 was 91% and 92% for the United Kingdon Oncology Notes (UKONS) triage documentation audit in May 2025. Following the UKONS audit, it was identified that triage nurses were not completing the required forms correctly. In response, staff completed the UKONS triage e-learning and study days to ensure all staff received appropriate training for UKONS. Additionally, they implemented the Level 1 acute oncology e-learning for ward clerks to support the oncology team in their role as call handlers and to promote a consistent and accurate documentation across the service.

Care plan audit of cancer documentation at 91% and UKONS triage documentation was at 95%. With an expected compliance of 95%. The audit recommendation was for staff to check there was evidence of the completed 48 hours post oral SACT telephone call documented to see how the patient was coping with prescribed therapy. An action had been put in place to improve compliance. Fluid balance chart audit was at 96%.

Staff carried out peripheral venous and central venous catheter audits within oncology and endoscopy units and achieved 100% from January to July 2025. These were conducted based on clinical practice and documentation of peripheral and central venous catheters. Staff discussed the results of the audit during the unit meetings and any escalations fed into the hospital clinical governance committee. These were also discussed at corporate clinical governance committee as required.

A clinical audit schedule was available on the endoscopy unit which showed World Health Organisation audit at 100% in June 2025, resuscitation audit at 100% in May and August 2025 and mattress audit at 100% in August 2025.

Staff monitored endoscopy comfort scores for patients having a gastroscopy, flexible sigmoidoscopy and colonoscopy procedures. From March to September 2025, a total of 72.6% of patients were comfortable as reported by the endoscopist assessment, and a total of 75% of patients were comfortable from the nurses assessment. Results showed 0.7% of patients experienced severe pain from endoscopist assessment and 0.4% of patients were in severe pain based on the assessment undertaken by nurses.

Staff used recognised tools to improve the detection and response to clinical deterioration in patients as a key element of patient safety and improving patient outcomes. Staff monitored patients’ pain during procedures and were supported to communicate their pain and discomfort. In endoscopy, patients were offered an anaesthetic throat spray prior to their procedure to ensure patients’ comfort during the procedures.

Pain management audit for June 2025 revealed 79% for pain recorded every 15 minutes. We saw action had been taken to repeat the audit which was scheduled in October 2025.

Staff carried out national early warning scores audits on the oncology ward. The recent compliance was at 92%.

The service told patients about their rights around consent and respected these when delivering person-centred care and treatment.

Staff understood the importance of ensuring patients fully understood what they were consenting to and the importance of obtaining consent before they delivered care and treatment. All staff were aware of gaining consent from patients prior to completing any treatment or procedure. For example, staff gave patients information about side effects of chemotherapy prior to commencing the therapy. This enabled patients to make an informed decision prior to their treatment.

Staff gained consent from patients for their care and treatment in line with legislation and guidance. Staff made sure patients consented to treatment based on all the information available. Patients were given information about their proposed treatment both verbally and written, to enable them to make an informed decision about their procedure. Each patient file contained a consent form which showed staff had discussed the risks and benefits of treatment with patients prior to any procedures being undertaken. Staff carried out consent audits which included consent forms for patients receiving chemotherapy and endoscopy procedures. Compliance for this was at 89%.

There were effective practices to ensure patients understood the care and treatment being provided. This helped patients to make informed decisions about their care. The service had introduced a digital consenting platform which provided consultants with a wide autonomy of procedures which they were able to consent from. Digital consent had been rolled out to key areas in the hospital with the aim to be more sustainable, reduce the use of paper and unnecessary waste and improve patient experience.

Staff understood the relevant consent and decision-making requirements of legislation and guidance, including the Mental Health Act, Mental Capacity Act (MCA) 2005 and the Children Acts 1989 and 2004 and they knew who to contact for advice. During our last inspection in May 2019, we told the provider they must ensure assessments were comprehensive on admission and include all patient needs, including health, personal care, emotional, social, cultural, religious and spiritual. This had improved during this inspection as where a concern was identified, a MCA tool was completed for patients being screened during pre-assessment. Clinical leads had undertaken bite sized teaching and there were visual aids in every department around Deprivation of Liberty Safeguards (DoLS) and safeguarding.

We also told the provider they must ensure staff acted in accordance with the requirements of the MCA 2005 and associated legislation. The provider has now incorporated MCA and DoLS training into the hospital’s mandatory safeguarding training. Teaching of MCA, DoLs and safeguarding was incorporated into the hospital induction programme and delivered by the safeguarding leads.

Patients’ capacity and ability to consent was considered. Staff have introduced an alert system for patients who lack capacity. We were given an example of a patient who lacked mental capacity and a best interest decision making multidisciplinary team meeting was held.