Archived: The CyberKnife Centre London

Updated 27 April 2017

The CyberKnife Centre London is operated by Robotic Radiosurgery LLP. Robotic Radiosurgery LLP is a registered provider under the HCA International Ltd . HCA International Ltd is a major shareholder of the company and is the ultimate parent company and guarantor for Robotic Radiosurgery LLP. The CyberKnife Centre is located on the lower ground floor of The Harley Street Clinic, which is also part of the HCA International group.

This service treats privately-funded patients using stereotactic radiotherapy or radiosurgery treatments for a wide range of benign and malignant conditions and provides treatment for private patients from all over the UK and from across the world.

The CyberKnife Centre at The Harley Street Clinic was the first in the UK to offer this treatment and it opened in February 2009 as a joint venture collaboration with a group of 15 founder member consultants.

The service is registered with CQC to provide the regulated activities of the treatment of disease, disorder or injury (TDDI) and, at the time of our inspection, had treated over 900 patients since opening.

The provider’s nominated individual for this service is Mr Michael Neeb. The registered manager for the service is Ms Aida Yousefi (CEO).

We carried out the announced inspection of this service on 15 and 16 December 2016.

Updated 27 April 2017

The CyberKnife Centre London is operated by Robotic Radiosurgery LLP. Robotic Radiosurgery LLP is an independent health care service and is part of HCA Healthcare UK. The CyberKnife Centre is located within The Harley Street Clinic, also part of HCA, but it is registered separately with CQC.

The CyberKnife Centre London provides stereotactic radiotherapy or radiosurgery treatments for privately funded patients with a wide range of benign and malignant conditions. Stereotactic radiosurgery (SRS) is a non-surgical radiation therapy used to treat functional abnormalities and small tumours of the brain. It can deliver precisely targeted radiation in fewer high-dose treatments than traditional therapy, which can help preserve healthy tissue.

We inspected this service using our comprehensive inspection methodology. We carried out the announced inspection of this service on 15 and 16 December 2016. We inspected this service under the medical care core service.

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.

We rated this service as outstanding overall because:

• We found that staff were actively engaged in activities to monitor and improve quality and outcomes and that opportunities to participate in benchmarking, peer review, accreditation and research were proactively pursued.

• We saw many examples of innovative practice and staff could tell us about the research being undertaken by the centre and how outcomes were being embedded within clinical practice to benefit patients.

• We found excellent multidisciplinary team working. Staff, teams and services worked collaboratively to find innovative and efficient ways to deliver more joined-up care to patients.

• Feedback from people who use the service and those who are close to them was consistently positive about the way staff treated people. People told us that staff went the extra mile and the care they received exceeded their expectations.

• There was a strong, visible, person-centred culture and patients were active partners in their care. Patients’ individual preferences and needs were always reflected in how care was delivered.

• We found approachable and motivational leadership that promoted staff development and career progression, teamwork and high-quality patient-centred care.

• Governance structures were well organised and well embedded and worked effectively to ensure there were clear lines of communication between key groups.

• The service had a clear vision and strategy. Staff were aware of the corporate vision. The vision and strategy of the service was embedded into practice by staff.

• Staff told us they were well supported, and felt valued, by management and felt proud of the organisation as a place to work and spoke highly of the positive and open culture.We found there were high levels of staff engagement and that staff at all levels were actively encouraged to raise concerns.

However, we found areas of practice that required improvement:

• The risk register did not reflect all risks identified by recent incidents and near misses; managers told us that all risks identified by incidents and near misses should be recorded as risks on the centre’s risk register.

• Patient experience survey response rates were variable and were on average 17% for the 12 months prior to our inspection. Only 16 of 92 patients provided with the survey had returned it. We were told action was being taken to try to improve this.

• It was unclear how the results of the patient experience survey were used. We were not provided with any examples of where patient feedback had been used to improve services.

Following this inspection, we told the provider that it should make other improvements, even though a regulation had not been breached, to help the service improve. Details are at the end of the report.

Professor Sir Mike Richards

Chief Inspector of Hospitals

Updated 27 April 2017

We rated medical services at The CyberKnife Centre as outstanding overall. The service was rated as outstanding in the effective and well-led domains. We rated safe, caring and responsive domains as good.