The Care Quality Commission (CQC) has rated four sites in London run by Leaders in Oncology Care (LOC), outstanding overall, following inspections in October.
LOC, which is part of HCA Healthcare UK, was established by four cancer specialists to offer a private service providing best practice care and treatment for people with cancer. It was initially set up as a single clinic but evolved to offer a range of services to meet the specialist needs of cancer patients. It now provides treatment to patients from seven locations in London and one in Manchester.
In October, CQC inspected three LOC sites in London for the first time since they registered with CQC:
Following the inspection, all three sites were rated outstanding overall, and outstanding for being effective and caring. They were also rated good for being safe, responsive and well-led. Cancer care services were also rated outstanding overall at all three sites.
Inspectors also visited LOC at Chelsea in October. This site was previously inspected in June 2019 when it was rated outstanding overall. The service was closed temporarily during the COVID-19 pandemic, but at the time of the inspection, it was open for two days a week. Following the recent inspection, LOC at Chelsea has retained its rating of outstanding overall and outstanding for being caring. The rating for effective has improved from good to outstanding, responsive has moved from outstanding to good, and safe remains as good. Cancer care services were also rated outstanding overall.
LOC at 95 Harley Street, LOC at PMC and LOC at Chelsea all share the same staff, governance and leadership teams. LOC at London Bridge Hospital is a separate outpatient service. It has no overnight beds, and some treatments for cancer patients, such as surgery and radiotherapy, are provided by the wider team at London Bridge Hospital.
Nicola Wise, CQC’s head of hospital inspection, said:
“I am delighted to say that we have awarded CQC’s highest rating of outstanding to Leaders in Oncology Care at all three of the sites we inspected for the first time recently; 95 Harley Street, London Bridge Hospital and Platinum Medical Centre. LOC at Chelsea has also done incredibly well to retain its outstanding rating awarded in 2019.
“Across all four LOC sites we inspected, we saw that staff went out of their way to treat patients with compassion and kindness. They respected patients’ privacy and dignity and provided personalised care, helping them to understand their conditions. They took account of people’s individual needs, including cultural, social and religious, as well as both their physical and mental health.
“Patients and their families were provided with emotional support through a variety of services, which is so important when facing a cancer diagnosis and going through treatment. Not only that, they were also offered a wide selection of complementary relaxation therapies such as massage, aromatherapy and reiki.
“We also saw many examples of outstanding practice. There were videos featuring patients and clinicians to explain the different types of treatment that people were likely to experience. Breast cancer patients were invited to contribute to the development of new patient leaflets, to ensure they contained information they felt would be important for future patients to understand.
“The service operated a hotline service 24 hours a day, seven days a week, for people undergoing chemotherapy treatment, so they could call and speak to someone, day or night, for advice if they were concerned about side effects. If someone needed urgent treatment, staff advised them to attend their local emergency department, then called ahead to let the team there know when to expect the patient, and what the issues were.
“Leaders and staff across these LOC sites are thoroughly deserving of their outstanding rating, they should be proud of themselves, and held up as an example of best practice in the care and treatment of patients with cancer. I would encourage other providers offering treatment to cancer patients to read the detailed reports and take learning from them back into their own services.”
Across all sites, inspectors found the following during this inspection:
- Leaders ran services well using reliable information systems and actively supported staff to develop their skills. They were forward thinking with a focus on continuous improvement and engaged staff in developing the service. Staff felt respected, supported and valued. They were focused on the individual needs of patients receiving care. Staff were clear about their roles and accountabilities and all felt able to suggest improvements. The service engaged well with patients to manage services and actively sought their views and ideas about how their experience could be enhanced. All staff were committed to improving services.
- 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. Key services were contactable seven days a week.
- The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback. Almost all feedback recorded in the year leading up to the inspection was unanimously positive. Patients told inspectors they were made to feel at home as they were so well looked after. One said: “Everybody, from doctors to the cleaners, makes an effort to smile, and makes me feel seen. Even with face masks on.”
- People could access the service when they needed it and did not have to wait for treatment. LOC is run by an independent provider, so is under no obligation to monitor waiting times for patients, but it did so in order to improve the service.
- The service had enough staff to care for patients and keep them safe. Staff had training in key skills, managed safety well, understood how to protect patients from abuse and worked with external agencies to do so. Staff provided excellent care and treatment, gave patients enough to eat and drink, and gave them pain relief when they needed it.
- The service managed safety incidents well and learned lessons from them and fostered an open environment where incident reporting was encouraged.
- Staff managed medicines well and were consistently supported by the pharmacy team to do so. The service also controlled infection risk well. Staff thoroughly assessed risks to patients, acted on them and kept good care records.
There were also examples of outstanding practice:
- The pharmacy team were included in the patient pathway to review all patient medicines and offer direct advice to patients. An electronic system for prescribing chemotherapy ensured that treatment was appropriately prescribed. Any irregularities were investigated by senior team members.
- The service emphasised the importance of patients emotional and social needs. They set up patient groups and support networks and signposted patients to them accordingly. People using the service were also provided with access to various support groups co-hosted by Macmillan.
- The service had taken an innovative approach in helping staff to identify and respond to domestic violence, with a clear process in place to ensure those at risk were signposted to specialist services for immediate support.
- In the last year, the service had been awarded the Macmillan Quality Environment Mark (MQEM) Cancer Support award, with a top score of five (excellent). This means that Macmillan had assessed the environment to check that it met the high standards needed to care for people with cancer.
However, inspectors did point out some areas for improvement including:
- At the time of inspection, there were seven nursing vacancies across the LOC at 95 Harley Street, LOC at PMC and LOC at Chelsea sites, although the service had enough nursing and support staff to keep patients safe as staffing was shared between the three sister sites. The service demonstrated it was actively recruiting into these vacancies with a number of initiatives, and senior staff provided clinical cover where required.
Read the report pubished on the CQC website:
LOC at Platinum Medical Centre (PMC)
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