HCA Healthcare UK The Christie Private Care

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• 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

This means we looked for evidence that people’s care, treatment, and support achieved good outcomes and promoted a good quality of life, based on best available evidence. This was the first assessment of the effective key question for the outpatient department. This key question has been rated good.

The service adopted a holistic approach to assessing patients’ needs and provided care that followed best practice and national guidelines. Regular audits and benchmarking underscored a commitment to evidence-based practice. Multidisciplinary team (MDT) meetings effectively prioritised patient outcomes, emphasising psychological and emotional needs. The service provided care that followed best practice and national guidance and had processes in place to identify and manage risks.

We have not awarded this service a score for Effective.

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

We scored the service as 4. The evidence showed an exceptional standard. The service always made sure people’s care and treatment was effective by thoroughly assessing and reviewing their health, care, wellbeing and communication needs with them.

Initial consultations and documentation were comprehensive, covering medical, psychological, emotional, and social needs providing personalised care planning.

All patients were assigned a key contact at the start of their treatment with the CNS coordinating the pathway. Staff considered protected characteristics such as disability, neurodivergence, and cultural needs. People were provided with a contact number if they had queries or concerns after appointments and patients we spoke with said they felt able to ask questions or raise concerns with staff.

Clear referral and booking criteria were in place, and triage systems helped allocate the right consultant and intervention pathway. Patients also had the opportunity to choose their consultant when booking.

During the assessment, we reviewed 4 care plans in OPD. Care plans were personalised and holistic. We saw evidence that staff updated care plans on a regular basis. We saw evidence that a sample of clinical records had been audited by the service in 2025, which confirmed a high standard and appropriate action points. Staff demonstrated an exceptional commitment to assessing and meeting patients’ needs. Risk assessments were completed and care plans were put in place to ensure patients received the right level of care. Assessments were holistic and covered physical health, wellbeing, and communication needs. Assessments reliably identified patients with dementia, learning disabilities or autism.

We saw evidence patients were involved in the assessment of their needs, and support was provided where appropriate to maximise their involvement. CNS staff told us about the comprehensive approach to assessing the needs of the patients and were passionate about providing the best and most up to date evidence-based practice in line with national guidance to ensure best outcomes.

Staff told us about an example where a patient with early onset dementia was highlighted to the CNS in OPD. The CNS arranged a best interest meeting with the multidisciplinary team (MDT). Following discussion with the next of kin, the decision was made to proceed with surgery. Reasonable adjustments were implemented to support the patient’s needs: as mornings were not optimal, afternoon appointments and admission were arranged. The expected length of stay was discussed with the family and 1:1 nursing support was provided throughout the patient’s journey.

We scored the service as 3. The evidence showed a good standard. The service planned and delivered people’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.

Staff took part in clinical audit, benchmarking and quality improvement initiatives. We saw evidence that clinical pathways aligned with National Institute for Health and Care Excellence (NICE) guidance.

The service worked proactively with recognised professional bodies including United Kingdom Oncology Nursing Society (UKONS), European Society For Medical Oncology (ESMO) and American Society of Clinical Oncology (ASCO). Leaders told us this collaboration supported continuous awareness of emerging trends, national developments, best practice standards and known gaps across cancer care. They reported that this engagement informed local decision making and kept the service aligned with national standards.

The service had corporate policies in place and shared clinical policies and procedures with the partner NHS trust. This meant that care pathways were in place and followed nationally recognised recommendations such as the NICE guidance. The policies we reviewed were easy for staff to access, up to date and referenced national guidance.

The nursing team told us they had access to a range of specialists required to meet the needs of patients attending the service. As well as doctors and nurses within OPD, patients had access to physiotherapy, psychology and wellbeing team, pharmacists, dieticians, and complementary therapists. We saw evidence that referrals to these services was timely and appointments were booked within 24 to 72 hours. Patients we spoke with said their nutrition and hydration needs were met. Patients told us there was a wide range of food choices which met specialist nutrition and hydration needs.

The service regularly monitored corporate policies and procedures at monthly head of department meetings. Leaders reported that all policies were up to date, and our review of policies confirmed that every policy we checked was within its review timeframe.

The consultants and nurses at the clinic were aware of any research and trials that were taking place in the partner NHS trust and at other centres; patients could be transferred to these trials if this was most appropriate for their treatment. All consultant oncologists at the service also practised at the partner NHS trust where clinical trials were conducted. This meant patients had their cases discussed at NHS disease group specific MDTs and could be referred to the clinical trials team for assessment if they were deemed suitable.

Staff were experienced and qualified and had the right skills and knowledge to meet patient needs. During care and treatment planning, staff routinely referred to the psychological and emotional needs of patients, their relatives and carers. A programme of enhanced training demonstrated the importance placed on this by the team.

CNS recognised the importance of offering services in line with the NHS 10-Year Health Plan (“Fit for the Future”) published in July 2025 with the aim of improved outcomes and enhanced support during and after treatment and involving patients and the public.

We scored the service as 3. The evidence showed a good standard. The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff communicated effectively within multidisciplinary teams, supported by shared care planning and clinical supervision, through a variety of methods including meetings, emails and documentation. We saw evidence of consultants and nurses working with other teams such as dieticians and wellbeing services to plan and deliver treatment pathways.

Staff reported excellent working relationships with colleagues and across external partnerships with NHS trusts, Integrated Care Boards (ICB), and the wider HCA Healthcare network which enabled coordinated input where needed.

Information-sharing protocols were in place to support safe transitions and continuity of care.

The service had worked in partnership with the hospital trust to access a bespoke service for private patients. Rather than the requirement to travel to the OPD, patients had the option to book blood tests at a time and location most convenient to them through the “Blood Closer to Home” service. Patients told us that the introduction of a flexible blood testing service closer to their home had improved their experience and they had not needed to repeat information or move providers.

We scored the service as 3. The evidence showed a good standard. The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduce their future needs for care and support.

Staff supported people to reflect on their own health goals and recovery journeys as part of treatment planning.

People accessing the service were offered health advice specific to their needs including dietician and physiotherapy.

The service provided ‘The Wellbeing Space’ which had recently celebrated its 10 year anniversary. This provided education and psychological support in small group settings for patients, families and carers. It was free and seen as part of the patients care, evolving and changing following patient feedback.

The group sessions comprised of topic-based discussions with sessions led by an expert speaker. We saw patient feedback that said, ‘the knowledge of the speakers was amazing, the sessions have helped me beyond words….’

One patient told us ‘it really was great to have the support of The Wellbeing Space after treatment, myself and others from the group have just completed a trek for a cancer charity. I found The Wellbeing Space fantastic.’

Another patient told us they received good advice from their consultant and CNS in relation to managing their symptoms with exercise and diet and had been able to return to the gym with confidence and additional knowledge. Health promotion leaflets such as smoking cessation were available in OPD waiting areas.

We scored the service as 3. The evidence showed a good standard. The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes met both clinical expectations and the expectations of people themselves.

Staff regularly reviewed patient progress and adapted support accordingly. Nurses completed follow up calls with patients and this was audited monthly showing good compliance. Feedback and themes from outcome monitoring were discussed in governance meetings to support service development.

Patients we spoke with said their nutrition and hydration needs were met. Patients told us there was a wide range of food choices which met specialist nutrition and hydration needs.

The service conducted a monthly ‘promises audit,’ this was a facility-wide observational audit conducted across all clinical departments. The audit standards are aligned with the fundamentals of care, incorporate the service’s core values and corporate policies. Results from the audit were reviewed and presented each month during the facility heads of department (HODs) and governance meetings, where opportunities for improvement in care and outcomes were discussed and actions for any exceptions were agreed.

We saw evidence that OPD had achieved 100% in the most recent promises audit. Audits included: hand hygiene compliance; medical devices audit and IPC principles and practices. The matron was responsible for coordinating and overseeing the production of the audit plan and monitoring to completion. We saw evidence that any actions following these audits, such as equipment requests, were escalated appropriately.

The service demonstrated compliance with established quality standards through accreditation from recognised national bodies. The service had achieved accreditation from Macmillan Quality Environment Mark (MQEM) since 2018. The most recent reassessment took place in April 2025, where the service again achieved the required standards. MQEM recognises cancer care environments which provide high quality, welcoming, and supportive spaces for people living with cancer.

We scored the service as 3. The evidence showed a good standard. The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

People gave informed consent prior to treatment; we saw this was documented in patient records.

We reviewed training records that demonstrated that 100% of staff within the OPD had received training on the Mental Capacity Act (MCA) 2005. Staff we spoke with had a good understanding of mental capacity and how to apply the principles of the MCA.

Staff understood how to assess whether a patient had the capacity to make decisions about their care and when this was appropriate. Where patients did not understand information given or asked about care and treatment, or they demonstrated reduced capacity to consent, staff carried out a capacity assessment. They also referred patients to psychologists when needed. Where relevant, best interests’ decisions were clearly recorded within patient care records and staff gave examples of meetings they had been involved in.

Staff explained the scope and limits of confidentiality at the start of any appointment.

We found evidence that capacity assessments and ‘allow a natural death’ (AaND) forms had been completed for patients who required them, and appropriate consent forms were used for those subject to DoLs.

The service completed quarterly AaND audits for assurance that treatment was aligned with the AaND plan and that patients and family were involved in decision making. Data from December 2024 to September 2025 showed that the service had scored 100%.

The service completed monthly audits that reviewed consent and do not attempt cardiopulmonary resuscitation (DNACPR) compliance. The service provided audit data from November 2024 to October 2025 that showed consistently high compliance with average scores of 100% for these metrics. The monthly audits also measured how compliant staff were with the MCA (2005) and DoLs. The service also scored 100% during the same time period.