HCA Healthcare UK The Christie Private Care

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• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

This means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question outstanding. At this assessment the rating remained the same. This meant services were tailored to meet the needs of individuals and delivered to ensure flexibility, choice and continuity of care.

We assessed 7 quality statements.

People were always at the centre of decisions about their treatment, with staff working in close partnership to respond to changing needs. The service had an exceptional understanding of the diverse needs of patients, ensuring care was joined‑up, flexible and continuously supported choice and continuity. Staff and leaders were innovative in how they identified and addressed inequalities, using this insight to deliver highly tailored care and support. People also received outstanding support to plan for important life changes, which enabled them to make informed decisions about their future, including at the end of life.

We have not awarded this service a score for Responsive.

Find out about when we will not publish a key question score and what we look at when we assess Responsive.

We scored the service as 4. The evidence showed an exceptional standard. The service was exceptional at making sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Pre‑operative assessments included past medical and social history, medications and performance status. Staff escalated any requirements that were outside of standard treatment plans through the alert system and shared these in MDT meetings.

Preadmission assessments identified patients living with dementia or a learning disability. Staff told us that from pre-op to emergency admission, teams escalated any dementia-related admissions and created individualised care plans. Staff from all specialities, including dietitians, physiotherapists, doctors, nurses, catering and housekeeping, attended daily MDT meetings to discuss patient needs and preferences, including tailored food choices. We saw evidence of this in the MDT meetings we observed.

Patients care plans fully reflected their physical, mental, emotional and social needs, including those related to protected characteristics under the Equality Act. Staff completed structured care plans on the electronic patient record system shared with the parter NHS trust. Care plans were completed on admission, including assessments of communication preferences, changes in mental state or behaviour, functional ability, psychological symptoms, safeguarding concerns, and lifestyle factors such as smoking and alcohol use. We saw evidence of this in the patient records we reviewed and they had been reviewed regularly.

Staff told us additional requirements were recognised early and that appropriate reasonable adjustments were put in place for patients with autism, learning disabilities or dementia.

We saw multiple instances of this through our assessment. For example, staff had provided tailored support for a patient with dementia and arranged a DoLS authorisation and allocated 1:1 nursing care to ensure the patient’s safety. They reviewed the patient’s “Who Am I” document to understand their preferences, communication needs and triggers, and planned care accordingly. Staff had adapted their approach by sitting at the doorway when continuous presence in the room caused distress. They also considered their likes, dislikes and usual routines to reduce anxiety.

Patients and those close to them were regularly involved in planning and making shared decisions about their care and treatment. For example, we saw evidence that staff supported patients through best‑interest meetings with their next of kin and arranged admission times that best suited patients and carers. We saw another example when a patient’s lasting power of attorney had been supported to visit daily and staffing had been planned so that consistent carers were allocated throughout their admission. Staff welcomed family or carers to be involved in care or stay overnight if required.

Staff told us they regularly invited new patients into the departments before starting treatment for an orientation visit to help them relax and become familiar with the environment and staff.

We observed positive interactions between staff and patients. We saw staff understood their needs and provided appropriate care and treatment.

Staff received mandatory training in equality and diversity and training data showed that compliance averaged 99% for all staff groups across the medical service.

Staff had access to a corporate policy on supporting adults and children with learning disabilities and autism and received mandatory training in learning disability and autism. Training data showed compliance averaged 99% for all staff groups across the medical service. In addition to the mandated e learning, 22% of staff members had attended a face-to-face study day with an external provider. Leaders told us that this higher level of training was not a requirement but had supported staff further in their role to identify and make reasonable adjustments to meet the needs patients.

Staff told us they completed corporate dementia training and used resources such as a dementia box, which included activities such as fidget toys, painting crafts, and a dementia orientation clock with lights/pictures to signify day/night for inpatient rooms.

Managers told us that although there had been no recent admissions of patients with a learning disability, staff would request that the patient’s hospital passport was shared so they could plan care that reflected the person’s likes, dislikes, communication and support needs.

Accessible toilets were available in all departments and were equipped with nurse call buzzers and emergency pull cords.

Patients had access to ‘language line’ that provided immediate interpretation in more than 200 languages, including British Sign Language. Face‑to‑face interpreters could be arranged when required. Patient information leaflets were also available in Braille and in multiple languages on request.

The psychology and wellbeing service was available to both patients and their families including children over the age of 18. Although the service did not have a dedicated mental health team, the service had a corporate mental health pathway referral and transfer policy, to support patients with complex mental health needs. When patients had known mental health needs prior to admission, staff liaised with their existing mental health team and GP.

We scored the service as 4. The evidence showed an exceptional standard. The service had an exceptional understanding of the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

The availability and provision of services was enhanced because patients received the private care they had chosen, while also benefiting from integrated access to additional specialist support delivered by the partner NHS trust. Patients could be directed promptly to specialist diagnostics, therapies and multidisciplinary input when required, without interruption to their treatment pathway.

The service shared information technology systems with the partner NHS trust which meant patients could interchange between both services and all records were accessible by staff from both services. Staff across all specialities could also access the information they needed to deliver safe and coordinated care. For example, Physiotherapists had access to all scans, imaging, nursing and medical notes.

This supported timely decision‑making, avoided duplication and promoted a coordinated and continuous journey for patients across both providers. The effective partnership working consistently delivered care that exceeded what is typically expected from a single service.

Staff kept accurate and complete records to facilitate communication and coordination which promoted continuity of care. We reviewed 6 patient records and found they were complete and contemporaneous.

Additional services were delivered through service level agreements with the partner NHS trust, including critical care, complementary therapies, speech and language therapy, information technology, palliative care and echocardiography.

Planning and delivery of services was aligned to meet the evolving needs of the population that the department served. Staff told us this involved analysing demographic data, health trends, and patient feedback. The service had also examined the prevalence of specific conditions and healthcare needs unique to its population. In doing this the senior leadership team had recruited specialists in fields where they felt there was a lesser provision to provide good care and treatment.

For example, specialist palliative and supportive care had been expanded through a service level agreement with an external provider. This meant the service had 3 additional consultants and 2 additional clinical nurse specialists (CNS) that specialised in supportive oncology. Consultants provided a 24-hour on call service for advice and ward rounds as required alongside regular outpatient clinics. A CNS was present on-site Monday-Friday 9am-5pm. Patients were referred to the service by the resident doctor team with the approval of the treating consultant for support with symptom management and advance care planning.

All patients received dedicated, disease‑specific support from a CNS throughout their cancer pathway who coordinated care between consultants, MDTs and community services. Support included advance care planning, financial guidance and signposting to external support services. CNSs also supported patients and families with planning significant events, travel and practical arrangements.

Patients’ advance care planning discussions were documented electronically which meant all staff involved in their care could access up‑to‑date information. For inpatients, any changes to patient wishes were shared at daily MDT meetings to maintain continuity and coordination of care.

The service primarily operated as a private healthcare provider. This allowed pathways and resource planning to be structured around the needs and expectations of private patients. We reviewed service activity and patient type between November 2024 and November 2025. During this period, there were 819 inpatient admissions and 1,198 day cases. Private patients accounted for 99.7% of activity, with 0.3% NHS patients.

Between November 2024 and October 2025, the average length of stay across both oncology inpatient wards was 2.05 days and 3.7 for the haematology transplant unit.

Leaders told us that although delays in discharge were not a routine occurrence, there were some occasions when patients remained in hospital beyond the point of being medically fit for discharge. Common reasons were patients awaiting a hospice placement, finalising care arrangements in the community and time required for family members to prepare to support the patient at home.

The discharge coordinator worked closely with patients, the MDT and external agencies, including social services, to ensure a well‑coordinated transition from hospital. Information was shared with the patient’s GP to support continuity of care.

We scored the service as 3. The evidence showed a good standard. The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Patients told us they received clear information from staff about their treatment and the arrangements for their discharge. One patient told us that that their first appointment had been ‘exceptional’. They described feeling anxious and unsure about their treatment and prognosis due to the complex information provided by their referring hospital. They said their consultant knew their case completely, had discussed it with the MDT beforehand, and that they left the appointment with clear information, faith and hope for the first time in weeks. Another patient we spoke with was waiting to be transferred to another hospital facility and said that staff had updated them numerous times throughout the day to discuss the plans and any changes that had been made to their plan of discharge.

We reviewed patient feedback data from surveys conducted between November 2024 and November 2025. We looked at questions about providing information in a way patients could understand and providing information about treatment and side effects. Radiotherapy services and inpatient services (634 responses) and the average overall score for reporting ‘excellent’ was 97%. Scores of 72% ‘excellent’ and 84% ‘very good’ were related to providing sufficient information about the costs of procedures. For providing information about the side effects of medication, data showed that 89% of patients reported ‘excellent’ and 98% reported ‘very good’.

Although there was a low number of formal complaints a common theme involved communication and one complaint acknowledged staff had not introduced themselves or explained their roles prior to a procedure.

We observed numerous information posters for patients displayed across the departments such as how to access the interpretation service which was displayed in a variety of different languages. The service itself could translate over 240 languages. There were posters about how to request a chaperone, the chaplain service and multifaith prayer room. Information on wards displayed performance information about infection rates, pressure sores and falls. We observed information folders in patient rooms that shared information about the services and facilities available. Food menus and times were provided in different languages.

The Accessible Information Standard (AIS) is a legal requirement introduced in 2016 to ensure that adults and children who have a disability, impairment or sensory loss receive information in a way that they can access and understand, and any communication support that they need is identified, recorded and provided. The service had processes in place to ensure that patients received information that met their communication needs and was compliant with the AIS standards.

For example, during the first contact with the service patients are asked about their communication requirements such as large print, easy read, interpreters, visual or hearing impairment. Staff could flag patient communication needs on the electronic patient record system and when patients were transferred to another provider, staff shared their communication needs as part of the referral process.

For patients that had hearing difficulties and used hearing aids, the service had a hearing loop service.

Leaders told us that information materials for patients such as leaflets, pre-assessment information, and discharge instructions were reviewed regularly to check they were aligned with the latest clinical guidance and service pathways. Staff received training on how to provide information using plain language, avoiding jargon, and adapting their communication to suit patients needs. For example, all staff had completed learning disability and autism training which included resources and information on how to better support patients. Leaders told us that this training was part of the wider learning disability framework.

We scored the service as 3. The evidence showed a good standard. The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Patients we spoke with knew how to give feedback about their experiences of care.

The service offered all patients the opportunity to complete patient satisfaction surveys following their admission. Surveys were completed on a regular basis and could be accessed on paper, online, or via email/text after appointments. The survey’s measured satisfaction, safety, communication, and environment.

Monthly patient feedback reports were reviewed by managers for oversight of immediate learning and actions that could be taken.

We observed posters on how to access the survey displayed on information boards across the departments along with recent patient survey scores.

The service also offered personalised handwritten feedback cards. The feedback cards were designed collaboratively with the patient user group and we observed these cards throughout the departments. Patients could scan a QR code to access the survey and staff said this meant they could gain more timely feedback on the care and overall experience.

One patient told us that it felt like the team were ‘constantly looking for improvements and actively ask for feedback’.

Patients could be part of a patient user group and attend meetings. One patient told us that they had “seen first-hand how the senior leadership team interact with patients, soliciting feedback and more importantly acting upon it”.

We saw numerous examples of when the service had made changes following patient feedback. These included a new service for patients to access a personalised collect and drop off laundry service. This initiative was in response to patients who stay for long periods of time, patients who do not live close by and some patients who do not have regular visitors or a close support system.

Inpatient rooms now had luggage racks after a patient had fed back they had struggled to unpack their personal belongings on admission to the ward without putting the suitcase/bag on the clean bed.

Radiotherapy staff had listened to feedback from a patient who shared that inconsistent breath-hold phrases could create uncertainty during treatment. The team made changes to standardise their breath-hold instructions for all radiographers and implemented training to ensure every staff member used the same phrases and timing cues.

Staff told us that they gained patient feedback through informal general discussions with patients and fed back any improvements to managers. The nurse in charge completed patient rounding to help identify and address any problems in real time.

Managers described how they responded quickly to informal concerns, often resolving issues before they escalated, while still providing patients with clear information on how to make a formal complaint if they chose. This included replacing the existing call bell system with a new model designed to safely reduce noise levels, which had previously affected both patient experience and staff working conditions

Leaders told us that feedback was regularly reviewed and that improvements were displayed on posters in patient areas. We observed this practice during our assessment.

The service had a complaints policy that set out the required procedures, including offering patients a face‑to‑face meeting to discuss their concerns if they wished. The policy stated that complaints should be acknowledged within 3 days and a full response provided within 20 working days, or within 20 days of a face‑to‑face meeting. We reviewed 3 complaint response from the previous 12 months which showed these targets were not always met. However, holding letters were sent on day 20 apologising for the delay. The response letters recognised the patient’s experience, used compassionate, non‑defensive language and thanked them for raising the concern. Learning and actions were also shared with the patients in the final response letters.

The complaints policy included the process to follow for unresolved complaints and signposted to external organisations such as the Independent Sector Complaints Adjudication Service (ISCAS) for private funded patients and the Parliamentary and Health Service Ombudsman (for NHS patients).

We asked the service to provide complaints data, broken down by number of complaints received, complaint type and complaint response rate target compliance for the previous 12 months. Data showed there had been 6 formal complaints relating to medical care. Of these, 2 were upheld, 1 was not upheld, 2 were partially upheld and 1 remained under review. Themes included communication, catering, clinical treatment and pharmacy. The service did not provide data on the complaint response rate target(s).

Information about complaints were shared with staff. We observed posters in staff areas that highlighted a recent formal complaint with learning and actions.

We scored the service as 3. The evidence showed a good standard. The service made sure that people could access the care, support and treatment they needed when they needed it.

Services were designed to make them accessible and timely for patients who were most likely to have difficulty accessing care. The pre‑assessment process supported this. For example, all patients, including those identified as high risk, underwent early screening so that chronic conditions such as hypertension and diabetes could be optimised and timely referrals made to specialist teams including cardiology, haematology and endocrinology. Staff told us that pre‑operative appointments were arranged around patients’ work commitments, and required tests and consultations were coordinated into one visit to reduce travel and associated costs.

Additional time was allocated for patients with high levels of anxiety or mental health needs, allowing them the opportunity to ask questions and process information. Staff offered visits to the wards to reduce pre‑procedure anxieties. Cultural and religious needs, including Sabbath observance and specific dietary requirements, were also accommodated.

Patients told us they received treatment in a prompt and timely manner and did not experience long waits when they arrived for their treatment. Staff told us they planned patients care, treatment and discharges in advance so they did not experience delays in their treatment. We saw evidence of this throughout our assessment when we reviewed patients records and observed MDT meetings.

The service did not carry out formal waiting‑time audits for inpatient admissions. Leaders told us that waiting times were consistently short, as patients were able to choose appointment times that suited them and admissions were supported by coordinated pathways and clinical teams who closely monitored and managed patient flow.

Patients could access services when they need to, including out of normal hours and in an emergency. There was a 24-hour helpline for patients to call following treatment and be given advice by appropriately trained clinicians including their clinical nurse specialist, their consultant or a resident doctor. Patients could return to the hospital to be reviewed and resident doctors were available 24-hours a day to patients if they needed a medical review.

During the 12 months prior to our assessment, the service had recorded 5 cancelled procedures 3 of which were related to non‑clinical reasons. These were all categorised as low or no harm and rebooked in a timely manner, including next‑day appointments.

The service did not have patients who experienced delays exceeding 14 or 21 days while awaiting placement in a care home, nursing home or hospice.

Physical premises, resources and equipment were accessible including accessible toilets and bathrooms. Hearing loops were available for patients with hearing impairments, patients could access interpretation services including British Sign Language and information materials were available in braille and multiple languages upon request.

We scored the service as 4. The evidence showed an exceptional standard. Staff and leaders were innovative in how they listened to information about people who are most likely to experience inequality in experience or outcomes. Staff and leaders actively used this information to provide exceptionally tailored care, support and treatment in response to this.

All staff were committed to ensuring equitable access, outcomes, and experiences for all patients, including those with learning disabilities, autism, dementia, and mental health needs. This was supported in several ways including, hospital patient passports and ‘this is me’ documents used to capture essential information about patients needs. Staff used this information to make reasonable adjustments such as adapting how they provided 1:1 care and extended appointment times.

The service promoted a culture in which patients felt empowered to give their views. For example, the service had a patient user group made up of current patients, former patients, staff and managers. The group met every few months to discuss patient experience and identify opportunities to improve the quality of care and support provided. This meant patients could contribute directly to service development and improvements that reflected their views and experiences.

Staff demonstrated an exceptional commitment to promoting equality and removing any barriers to patients accessing care and support. For example, we reviewed a patient case study where a patient receiving long‑term treatment experienced significant changes in their personal circumstances and had complex communication needs which affected their ability to engage with their care. Staff responded proactively by adapting treatment schedules to suit the patient’s situation, adjusting communication methods, and working closely with the patient and their family to ensure they could continue to access the service without disadvantage.

Staff arranged additional practical support and guidance to help the patient manage safely at home. The personalised and coordinated approach had promoted equity in outcomes for the patient and enabled the patient to remain fully involved in decision‑making and maintain their treatment plan despite the challenges.

The service shared another example of how staff had taken actions to improve equity in experience for patients based on religious needs. During an inpatient admission, staff had recognised that gaps in their knowledge about the patient’s religious practices and cultural requirements had the potential to create unintentional inequalities in care. Staff working in partnership with the patient and their family had adapted ward and catering practices to ensure the patient could observe their religious and cultural requirements without barriers. The catering team also created a calendar to support planning for future observances, helping staff to anticipate and meet similar needs. Staff engaged with local community representatives who provided additional education, guidance and resources to support the delivery of inclusive care. Further training sessions were arranged to enhance staff confidence in caring for patients with diverse religious, cultural or spiritual needs.

From this experience, the service had developed links with a Jewish community support organisation that offered person‑centred support for people affected by cancer. This included emotional, physical, social and practical assistance. Staff told us that this partnership had enhanced access to culturally sensitive support for patients.

Staff used a range of tools with patients who might struggle to share their experiences. These included easy‑read surveys, translated materials, picture‑based tools, communication boards and interpreters. Staff proactively approached patients who may not typically volunteer feedback, including patients with cognitive impairment, those who were non‑verbal or those receiving end‑of‑life care. Carers, independent advocates and community groups were involved to ensure the views of patients who could not easily express themselves were represented.

Leaders told us that information from safeguarding referrals, complaints involving vulnerable patients and repeat attendance patterns was reviewed to identify inequities. Patient experience, incidents and clinical outcomes were monitored against demographic characteristics such as disability, ethnicity, age and deprivation to monitor inequalities across different patient groups.

Senior nurses undertook targeted walkarounds to speak with patients at higher risk of inequalities, ensuring concerns were identified and addressed promptly. The service also worked with community organisations, including local faith groups, learning disability forums and voluntary sector partners, to understand barriers patients faced before accessing care.

We scored the service as 4. The evidence showed an exceptional standard. People were given exceptional support to plan for important life changes, so they could make informed decisions about their future, including at the end of their life.

The service demonstrated an exceptionally proactive and person‑centred approach to planning for the future. The service operated an open visiting policy, which enabled ongoing communication between clinical staff, patients and their families regarding future care. The resident doctor team liaised with next of kin to arrange attendance at ward rounds so important information regarding future care could be shared with them. For example, scan results or changes to treatment plans.

Planning for the future was done at the earliest opportunity and reinforced at discharge. GPs were updated with detailed discharge letters that included information regarding ongoing care, such as whether the patient should be considered for the Gold Standards Framework. This framework is an evidence‑based approach used across health and social care to improve the quality of care for people in the last years of life, including those with cancer. It supports clinicians to identify patients earlier, plan proactively, and coordinate care in line with the patient’s needs and preferences.

Holistic needs were routinely addressed. Staff told us that support with planning spiritual needs was available through on‑site and local faith leaders who met with inpatients when requested. The service had a clinical psychologist who provided support to patients and families during significant life changes.

Resident doctors worked closely with the psychology team when patients required additional emotional support, such as anxiety around scans or the delivery of difficult news. The psychologist used a range of coping strategies and worked with the wider multidisciplinary team to support family communication and wider emotional needs.

The service used the term ‘Allow a Natural Death’ (AaND) for Do Not Attempt Cardiopulmonary Resuscitation (DNACP) orders. Staff told us that this language supported more constructive and compassionate discussions with palliative patients, helping to focus on achieving a dignified and peaceful death. The discussions prior to completing AaND forms usually took place with the consultant, a resident doctor, patient and family with clinical nurse specialist support.

Staff told us that for patients whose cancer was palliative, staff actively monitored patterns such as increased admission frequency and worked collaboratively with the consultant and clinical nurse specialists to support timely discussions and decisions about future care.

Advance care planning was routinely reviewed and updated as patients’ circumstances changed. This included planning future needs, preferred place of care, preferred place of death (PPD), and who patients wished to be involved in decision‑making. Plans also included symptom priorities, personal goals, cultural or spiritual needs, and any concerns about the future. Staff told us discussions were encouraged between patients, families and clinicians to ensure shared understanding of the care plan and to enable active involvement in decisions.

Staff worked closely with external partners, such as local hospices to support patients in making informed choices regarding PPD. These discussions were also part of the resident doctor‑led and consultant‑led ward rounds. We observed an MDT meeting and saw evidence that discussions about advance care planning was shared.

The service monitored outcomes in relation to ‘preferred place of death’ (PPD) through an annual audit of end of life care. We looked at data from the most recent audit (November 2025). This showed that of 12 patients selected at random, 100% had PPD confirmed and documented and 75% of patients had achieved their PPD. The audit documented that there was good clinical justification for those who did not achieve their PPD and this had been discussed with the patients and/or their family.

Inpatients requiring additional support were referred to the specialist complex discharge team (CDT), who provided comprehensive coordination for those who chose home as their preferred place of death. This included arranging continuing healthcare funding, liaising with GPs and community nursing teams, organising anticipatory and supportive medication, booking transport, and maintaining regular communication with families.

The service followed a holistic approach to palliative care including following the 4 Ls approach; live, loved, listened to, leaving. This supported staff and families to promote quality of life, choice, relationships and spirituality for patients nearing the end of life.

The service used recognition of dying forms for patients that remained as an inpatient for their end-of-life care. The forms included the management of interventions at end-of-life and discussions with the patients around anticipatory medications. Staff told us this process allowed patients to have informed choice about their end-of-life care at the service.