The Care Quality Commission
  • Hospital
  • Independent hospital

St Anthony's Hospital

Overall: Good read more about inspection ratings

London Road, Sutton, Surrey, SM3 9DW (020) 8337 6691

Provided and run by:
Spire Healthcare Limited

Important: The provider of this service changed - see old profile

All Inspections

During an assessment of Surgery

We carried out a short announced, responsive and comprehensive assessment of services for Surgery on 16 and 17 June 2026, due to risk and extended time since the last rating.

The hospital’s primary service was adult surgery. Surgical services provided elective surgeries which included general surgery, gynecology, cardiac surgery, urology, gastroenterology, dermatology, ophthalmology, cosmetic surgery, rheumatology, vascular surgery and neurosurgery. There were 3 wards where surgical patients were cared for. However, at the time of assessment 2 wards were open due to low acuity and used for the care of inpatient and day surgical patients. The location had 6 operating theatres, of which 5 were used for surgery and 1 interventional hybrid theatre used for cardiology and interventional radiology. The service also had 6 anaesthetic rooms, 5 preoperative clinic rooms and 9 recovery beds.

The service provided care to both private, insurance and NHS funded patients. From May 2025 to April 2026, the service had 7,420 surgical cases of which 67% were for insured patients, 18% were self-paying patients, and 15% were NHS patients.

The quality of care and treatment of children aged between 16 and 18 years of age undergoing surgical procedures was not reviewed as part of the assessment of surgery.

We rated the service as good. We found 2 breaches of the regulation to mandatory training and governance. Not all staff were up to date with their training modules. Governance systems were not always effective in ensuring leaders reported notifications of events and incidents to the commission in a timely manner without delays. This requires improvement to ensure staff deliver safe care to patients.

The service had a good learning culture and staff and patients could raise concerns. Managers investigated incidents thoroughly and lessons learned and improvements were identified and shared with staff. Patients were protected and kept safe because staff understood local safeguarding arrangements and safe systems of working.

There were enough staff with the right skills, qualifications and experience in departments, wards and in theatres to ensure high quality care and treatment. Managers made sure staff received training and had regular appraisals to maintain high-quality care.

Staff managed medicines safely. Staff identified and reacted to unexpected deterioration in a patient’s condition. Staff understood and managed risks from the environment. The facilities and equipment met the needs of patients, were clean and well-maintained and any risks were mitigated.

Patients, and where appropriate those close to them, were involved in assessments of their needs. Staff reviewed assessments taking account of patient’s physical emotional, communication and personal care needs. Care and treatment was based on latest evidence and good practice guidance. Patient outcomes met expectations, and harm free care was the norm. Patients’ pain was quickly identified and well managed.

Staff assessed patients nutritional and hydration needs, made sure patients had sufficient to eat and drink or alternatives as needed. Staff made sure patients understood their care and treatment to enable them to give informed consent.

Staff treated patients with kindness and compassion. Staff protected their privacy and dignity. They treated patients as individuals and supported their preferences. Staff responded to patients in a timely way. Patients had the opportunity to ask questions and were given access to specialist services, including from allied health professionals.

Patients, or their representatives, were involved in decisions about their care and treatment. The service provided information which patients could understand. Patients were invited to give feedback, knew who to speak with if they had concerns and were confident the service took their concerns seriously.

The service monitored and worked to improve access. The environment was adjusted to meet the needs of people with conditions which could create a barrier to access.

The service worked to reduce health and care inequalities through service planning, quality monitoring, staff training and feedback. Patients were involved in planning their care and understood options around choosing to withdraw or not receive care.

The service supported staff wellbeing.

Leaders and staff knew the service’s local vision, aims and objectives and understood how their service aligned with this. There was a culture based on speaking up, listening, learning and trust.

Leaders were visible, knowledgeable and supportive, helping staff develop in their roles. Staff felt supported to give feedback and were treated equally, free from bullying or harassment.

Staff understood their roles and responsibilities.

Leaders had sound oversight of the quality of service being delivered through effective governance and risk management systems.

Staff with protected characteristics felt supported.

There was a culture of continuous improvement with staff able to contribute ideas through a quality improvement programme.

However, there was unstable leadership in the past 18 months, which affected consistency in leadership oversight and strategic direction.

We have requested an action plan, this will be requested upon publication of the final report.

During an assessment of Critical care

We carried out a short-announced comprehensive inspection at St Anthony’s Hospital Critical Care unit
on the 16 and 17 June 2026 as the service was last inspected in 2019 and we received some
information of concern.
The Critical Care service is an 8 bedded unit and provides level 2 and level 3 care. The service admitted
patients under a set of criteria from surgery and does not provide cancer or end of life care services.
Patients were not discharged directly from the critical care unit but were transferred to wards.


During our assessment, we looked at Safe, Effective, Caring, Responsive and Well-Led key questions for
the critical care service. We found that the service provided a person-centred and holistic approach to
patients’ care and treatment, considering individual needs, emotional beliefs and dietary
requirements. The service is consultant led and is supported by a team of specialist critical care nurses,
critical care doctors, healthcare assistants, allied health professionals and non-clinical staffs. We spoke
to 15 members of staff, including nurses, consultants, anaesthetists, physiotherapist, pharmacists, and
healthcare assistants. We also spoke with 5 patients and reviewed 10 patients’ records.

Staff understood safeguarding procedures and there were systems in place to ensure that the patient/
staff ratio was in conformity with the requirements for level 2 and level 3 care to ensure that people’s
safety and needs were met. Staff respected the privacy of patients, knew how to identify and mitigate
risks and we observed dignity and compassion being at the centre of the care provided.
Although the service had an open-door policy for staff to report concerns, staff reported to us that
concerns raised were not always responded to, they did not always feel that they were listened to and
were not involved in key decisions making which affected the service.


Leaders and staff understood the overall vision of the unit and there were processes in place to ensure
the safety and good experience of people whilst in the critical care. The service monitored the quality
of care provided and took action to improve the quality of service and care where required.
Governance and policies ensured an oversight and assessment of quality and performance although
staff reported that they were not always actively involved in quality improvement. The provider had
enough staff to ensure patients’ safety and that individual needs, and preferences were met and they
could access services when required.


We rated the service as good. We found that the Critical Care Unit provided Safe, Effective, Caring,
Responsive and Well-led care services.
People's

During an assessment of Outpatients

Our short-notice announced inspection of St Anthony’s Outpatients Department (OPD) was conducted over two days between 16 and 17 June 2026. We carried out our assessment as the service had not been inspected since 2019, and because of information of concern that we had received.

During the assessment, we spoke with 33 members of staff, including leaders, consultants, nurses, healthcare assistants, allied health professionals and administrative staff. We spoke with 13 patients and relatives, reviewed 12 patient records, inspected clinical and non-clinical equipment and reviewed information submitted by the provider.

The outpatient department (OPD) was a consultant-led service supported by registered nurses, healthcare assistants, administrative staff and allied health professionals. The service provided outpatient consultations, treatments and pre-operative assessment services. Between June 2025 and May 2026, the hospital’s OPD saw over 48,000 outpatient attendances across a range of specialities. This comprised of over 31,000 who were insured, almost 10,000 self-funding, and over 7000 who were NHS funded. Over 45,000 of the patients were adults, with children and young people seen totalling just under 3000.

The 2 most frequently used OPD specialities were orthopaedic surgery and cardiology. This assessment focused on the OPD, including the Pre-Operative Assessment (POA) part of the OPD service. Physiotherapy and radiology services were not assessed.

Patients were protected from avoidable harm. Staff understood safeguarding responsibilities, recognised and escalated concerns appropriately, and followed safe systems of working. Medicines were managed safely with pharmacy support, and staff responded appropriately to clinical deterioration. The environment and equipment were generally clean, well maintained and fit for purpose, with systems in place to identify and mitigate risks.

There were processes to support safe and effective staffing. The department had a stable workforce, supported by appropriate staffing tools, training systems and appraisal processes. However, there had been a vacancy in the substantive Head of OPD role since September 2025, and some staff were not fully up to date with all mandatory training requirements. Whilst these gaps reduced assurance, we saw no evidence that patient care had been adversely affected.

People's needs were assessed holistically, taking account of their physical, emotional, communication and personal care needs. Care and treatment were delivered in line with current evidence-based guidance. Patient outcomes were monitored and were generally positive. Staff assessed and managed pain effectively. Patients were supported to understand their care and treatment and give informed consent.

Staff treated patients with kindness, compassion and respect. Patients and those close to them were involved in decisions about their care and treatment and were provided with information they could understand. Patients told us they felt listened to and had opportunities to ask questions about their treatment.

The service monitored access to care and took action to improve services where required. Adjustments were available to support people with additional needs and reduce barriers to accessing care. Staff considered equality, diversity and inclusion when planning and delivering services and worked to reduce health inequalities.

Leaders and staff understood the service vision and objectives and demonstrated a culture that encouraged openness, learning and continuous improvement.

Although there had been significant leadership changes in the past 18 months. Current leaders were visible and supportive, and staff told us they felt able to raise concerns and provide feedback. Governance and risk management systems provided oversight of quality and performance, and staff were actively involved in quality improvement activities designed to enhance patient care and experience.

Overall, we found the outpatient department provided safe, effective, caring, responsive and well-led care. Systems and processes supported the delivery of high-quality care, although some areas relating to mandatory training compliance and leadership continuity required ongoing attention.

During an assessment of the hospital overall

Date of assessment: 16 June to 17 June 2026. St Anthony’s Hospital provides medical care, services for children and young people, critical care, surgical, and outpatient services to both private and NHS-funded patients.

This assessment looked at critical care, surgical, and outpatient services, which we rated as good. The rating of St Anthony’s Hospital remains good.

Our assessment of the Outpatients department found a positive culture of safety, openness and learning. Staff understood their responsibilities to safeguard people from abuse and reported incidents appropriately. Leaders investigated incidents and shared learning to support improvement. The environment was clean, and infection prevention and control risks were well managed. Staff assessed patients promptly, involved them in decisions about their care and treatment, and delivered care in line with current evidence and best practice guidance. Patients were treated with compassion, kindness, dignity and respect. Recent leadership changes had been implemented, including the appointment of a new Head of Outpatient Services. Leaders were visible, approachable and supportive, demonstrated the skills and capabilities required for their roles, and worked collaboratively with partners to support the sustainability and ongoing development of the service.

Outpatient department leaders valued and empowered staff and encouraged opportunities for professional development. However, not all outpatient department staff were fully up to date with mandatory training requirements. Although some areas showed signs of wear and tear, the hospital was undertaking a refurbishment programme to improve the environment.

Our assessment of surgery services found a positive learning culture where staff and patients could raise concerns. Patients were protected from abuse and avoidable harm because staff understood local safeguarding arrangements and safe systems of working. There were enough staff with the appropriate skills, qualifications and experience across surgical services to provide safe and effective care and treatment. Staff reviewed assessments regularly, taking account of patients' physical, emotional, communication and personal care needs. Care and treatment were delivered in line with current evidence and good practice guidance. Staff identified and managed patients' pain effectively. The service monitored and worked to improve access to care. Leaders and staff understood the service's vision, aims and objectives and how these aligned with the wider organisational strategy. The culture was characterised by openness, speaking up, listening, learning and trust. However, leadership arrangements had been unstable during the past 18 months, which affected the consistency of leadership oversight and strategic direction. In addition, governance systems were not always effective in ensuring that statutory notifications relating to incidents and events were submitted to the Commission without delay. Not all staff were up to date with their required training modules. We found 2 breaches of the regulation within surgical services on mandatory training and governance.

During the assessment of the 8-bedded Critical care service, we found the service provided high-quality, person-centred care that was tailored to patients' individual needs, beliefs and preferences. Care was consultant-led and delivered by a multidisciplinary team.

Staff demonstrated a good understanding of safeguarding procedures and risk management, and staffing levels were sufficient to meet the requirements for level 2 and level 3 care. Patients were treated with dignity, compassion and respect, and feedback from patients was positive about the care they received.

Although there had been changes in the senior leaders. The leadership teams had clear oversight of quality and performance through established governance processes, and the service routinely monitored and acted on quality and safety information to drive improvements. Staff understood both the unit's and the hospital’s vision and were committed to delivering safe and effective care. However, some staff reported they did not always feel listened to or involved in decision-making.

6, 12 and 13 June 2017

During a routine inspection

St Anthony’s Hospital is operated by Spire Healthcare. The hospital has 92 beds in en-suite rooms. Facilities include six operating theatres (three with laminar flow), a cardiac catheter laboratory for cardiac procedures and an eight-bed level three critical care unit, and X-ray, outpatient and diagnostic facilities.

St Anthony’s provides surgery, including critical care, medical care, services for children and young people, and outpatients and diagnostic imaging. In this inspection we only inspected critical care and services for children and young people. These services had been suspended at the time of our inspection in September 2016 and had since re-opened. The children’s outpatient service opened in 2016 and sees about 150 children a month. The children’s ward, for day case surgery for children over three years old, opened in late February 2017.

The hospital carries out some surgery for adult NHS patients some of whom might be in critical care.

This inspection was a focused inspection looking only at critical care and services for children and young people (including children’s outpatients not inspected as part of outpatients in September 2016). We visited unannounced on 6 June 2017, and made two follow up visits by arrangement with the hospital on 12 and 13 June 2017 to observe children’s outpatients and a children’s surgery list which had not been able to inspect on 6 June 2017.

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.

Services we rate

We rated critical care as requires improvement for safe and good for responsive and well led. We rated children’s services as good for Safe, Responsive and Well-led. We did not consider there was sufficient evidence to rate Effective and Caring for either service because there were few outcome measures for either service and we saw only a small number of patients during our inspection.

Announced visit 13 and 14 September 2016. Unannounced visits 20 and 22 September 2016

During a routine inspection

This was the first comprehensive inspection of Spire St Anthony's Hospital, which was part of CQC's ongoing programme of inspection of independent acute hospitals. We carried out the inspection on 13 and 14 September 2016. Following this, two unannounced visits took place on 20 and 22 September 2016.

Spire St Anthony's hospital is an acute independent hospital that provides outpatient, day care and inpatient services. The hospital is owned and managed by Spire Healthcare Limited. A range of services such as physiotherapy and medical imaging are available on site. The hospital offers surgical procedures as well as rapid access to assessment and investigation. Services are available to people with private or corporate health insurance or to those paying for one off treatment. Fixed prices, agreed in advance are available. The hospital also offers services to NHS patients on behalf of the NHS through local contractual arrangements.

The inspection reviewed how the hospital provided outpatient services (including to children), medical care, surgical services and critical care, as these were the four core services provided by the hospital.

Just before the planned inspection, the hospital's senior management team took the decision to stop treating and admitting children under the age of 18, including as outpatients and to stop providing critical care at levels 2 and 3.The hospital had a long history and had been run as a charity for 100 years. Spire took it over in late 2014 and had to make significant changes to modernise premises and practices, which included building six new theatres. While acknowledging that many improvements had been made over the previous 20 months since Spire took over the hospital, there was considerable work still to do, so overall we rated the hospital as requires improvement.

We rated outpatients and diagnostic imaging as good and surgery as requires improvement. We were unable to rate medicine as there was not sufficient data provided about medical care and the medical ward itself was closed for refurbishment at the time of the inspection. We also could not rate critical care, as the service was not operating at the time of the inspection.

Are services safe?

By safe we mean people are protected from abuse and avoidable harm.

  • The hospital was not reporting all serious incidents promptly to national bodies. A never event had not been reported as such and the hospital's process for investigating serious incidents lacked rigor.
  • There was an appropriate system for reporting clinical and non-clinical incidents, but there was limited evidence of staff learning from incidents.
  • The hospital had slightly higher rates of falls, venous thrombo-embolism and pressure ulcers than its target.
  • Staff were aware of their responsibilities regarding safeguarding vulnerable adults and children and knew who to contact if they had any concerns.
  • Mandatory training was up to date in most areas.
  • The hospital had three resident medical officers (RMOs), who covered the wards, cardio-thoracic patients and critical care.
  • 331 consultants had practising privileges. 10.6% (36) consultants had not carried out any clinical activity in the past year.
  • The hospital used paper records for patient care, which were mostly adequately completed.
  • Medicines were managed and stored safely.

Are services effective?

By effective, we mean that people’s care, treatment and support achieves good outcomes, promotes a good quality of life and is based on the best available evidence.

  • National guidance was mostly followed.
  • Improvements were needed to ensure all surgical patients had a full pre-operative assessment and the WHO safety checks were routinely carried out.
  • We could not benchmark the hospital nationally for patient outcomes, although we saw some information to compare the hospital with other Spire hospitals across a range of indicators.
  • Staff development was taking place in theatre processes and in critical care.
  • There was limited internal multidisciplinary working.
  • Medical and surgical staff were required to have practising privileges to work at the hospital and these were appropriately checked and maintained by the Medical Advisory Committee as necessary. We saw evidence of consultant contracts being discontinued or being suspended, if they did not meet the practising privileges criteria. 
  • We found staff mostly had a general awareness of the Mental Capacity Act and Deprivation of Liberty Safeguards.
  • Patients were happy with the choice of meals and drinks.

Are services caring

By caring, we mean that staff involve and treat patients with compassion, dignity and respect.

  • Most patients we spoke with reported a positive experience of their care. They reported staff were kind and maintained their privacy and dignity.
  • Patients and their families reported being involved in their care, including being informed about potential costs in most departments.
  • Patients understood the care and treatment choices available to them and were given appropriate information and support regarding their care or treatment.
  • 92% of staff (hospital-wide), up to September 2016, had attended compassion in practice training which was mandatory at the hospital. The deadline for remaining staff was the end of December 2016. This was a high completion rate.
  • The hospital was rated very positively in patient feedback provided.
  • Staff offered support to patients and families who wanted or required it, and there was strong chaplaincy support.

Are services responsive?

By responsive we mean that services are organised so they meet people’s needs.

  • Patient flow through the hospital was generally smooth, although targets for discharge were not always in place at the time of admission.
  • The service was generally responsive to patient needs although there was limited support for those living with dementia.
  • The hospital met and exceeded targets for responding to patient needs such as referral to treatment times.
  • Complaints were mainly well-managed, but the number of complaints about payment was a concern. Self -paying patients needed to be given clearer information about costs, and the hospital's billing process was not always accurate.

Are services well-led?

By well-led, we mean that the leadership, management and governance of the organisation, assure the delivery of high-quality person-centred care, supports learning and innovation, and promotes an open and fair culture.

  • The hospital director had been in post for nearly two years. Some of the senior management team (SMT) had been in post a year or less. However, staff described that the management made a positive impact on the hospital and said the hospital director and other senior managers were visible to staff and patients.
  • There were plans for the development of services in most departments, although we did not see a defined vision for medical inpatient services.
  • Governance and performance monitoring was in place across most services, although some of this was very new and it was too early to judge its effectiveness.
  • The senior management team (SMT) were aware of what needed to improve and were working on this. They were aware of the risks, but a stronger process was needed to ensure risks were accurately rated and actions were in place to mitigate the risks.
  • The culture of the services was mostly positive and staff felt engaged in how the hospital was to improve.
  • The SMT decided the week before our inspection to suspend paediatric services and critical care services. These decisions had been taken quickly and evidence showed if the hospital had carried on these services, there could have been some safety risks.
  • Auditing of the services provided was improving, although information was not provided at sufficiently detailed level in some areas.

We saw outstanding practice including:

  • The design of the new theatres and the training programme for staff being developed.

However, there were also areas of where the provider needs to make improvements. The provider must:

  • Improve all its governance processes, so that patients receive safe and effective care. For example: ensure there are effective systems to monitor and review all patient deaths and other adverse events, including involving the medical advisory committee; ensure risks are tightly managed with clear mitigation; ensure compliance with practising privileges policies.
  • Implement a robust governance structure for paediatric services and ensure that hospital staff and consultants are all appropriately trained prior to re-starting all paediatric care.

The provider should:

  • Review and close incidents and complaints promptly to ensure learning to improve the service is identified at the earliest opportunity,
  • Assess all risks and record, monitor and review actions to control risks,
  • Ensure effective multidisciplinary working take place across all specialities.
  • Review the process of pre-operative assessment to ensure all patients requiring one have this sufficiently far ahead of the surgery procedure date for results to be available.
  • Continue to control surgery bookings so that procedures do not overrun and that doctors do not add patients late to the list.
  • Ensure staff receive feedback about incidents and complaints to help them learn and improve.
  • Ensure nurse documentation of patient observations is accurate.
  • Staff should review the appropriateness of a cross on the wall in patient rooms.
  • Staff should consider a means of capturing informal complaints raised by patients, and improve the timeliness of complaints handling.
  • The hospital should review its support elderly patients and those living with dementia to ensure staff have an understanding of how to assess and meet the needs of this group of patients.

Professor Sir Mike Richards

Chief Inspector of Hospitals