The Christie: Manchester’s renowned cancer hospital gets downgraded in its latest CQC inspection

The Christie is still rated as good following its latest CQC inspection, but the watchdog marked it down compared to its previous visit.
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Manchester’s renowned cancer hospital The Christie has been given a rating of good in its latest inspection by the health watchdog, but has been downgraded by the inspectors.

The Christie NHS Foundation Trust no longer has the best-possible rating of outstanding according to the Care Quality Commission (CQC) following its most recent visit to the site.

The CQC said it inspected the acute medical services being provided by the specialist cancer trust but also took the opportunity to look at how well led it was following concerns raised by whistleblowers about the culture and leadership there.

The Christie in its response highlighted the more positive comments the CQC had made and said it was pleased with the good rating, saying it had been a difficult few years for the NHS.

What did the CQC find when it inspected The Christie?

The CQC settled on an overall rating of good for The Christie, a downgrade from the previous inspection when it was judged outstanding.

The trust was also downgraded in two specific areas, with the trust now requiring improvement on being well led rather than being good and the trust also requiring improvement on offering a safe service. This aspect, too, was previously rated as good. The other areas the CQC looks at, which are being effective, caring and responsive, all remain rated as outstanding.

Acute medical services at The Christie’s main site have changed from outstanding to good, with safe dropping from good to requires improvement. The trust’s acute services remain good when it comes to being well-led, effective, caring and responsive.

The Christie is Europe’s largest single site cancer centre in Europe, treating more than 60,000 people each year. As well as serving the people of Greater Manchester and Cheshire it also has patients come to be treated from around the UK, without around a quarter of those receiving care there coming from further afield.

The Christie hospital, ManchesterThe Christie hospital, Manchester
The Christie hospital, Manchester

The CQC sad it found some staff struggled to raise concerns that they had and that although some work to improve the culture there had happened there is still more to be done. It found senior leaders were not always approachable or visible and there were some concerns around the priority given to equality, diversity and inclusion.

There were also examples of people being put at increased risk of harm by risk assessments not being done quickly enough, while things learned from complaints or incidents when things went wrong were not always shared with everyone who would benefit from it.

More positively, the inspectors found patients and their families and carers were looked after and treated well, and in some areas the CQC saw work which it said was of the top level. It found there were enough staff to keep people safe, records were completed and infections were well controlled. However, some training was not always completed in a timely manner, there were areas where medicines could be managed better and some policies needed to be reviewed as the time period for doing so had passed.

The CQC did say The Christie had an overall vision and a strategy and both leaders and staff actively engaged with people. The staff were committed to continuously learning and improving the services and were encouraged by bosses to participate in research.

What did the CQC say about The Christie?

Ann Ford, CQC’s director of operations in the north, said: “When we inspected The Christie NHS Foundation Trust, we found most leaders understood the priorities and issues the trust faced and were focused on providing the best care to people. Its vision was to be a leader in cancer care and provide the best experience and a high standard of care to people.

“However, staff didn’t always feel supported and valued, with some telling us they felt they couldn’t raise concerns or weren’t listened to when they did. Although the trust had made some changes to improve the culture, more work needs to be done to address the issues we identified.

“I want to thank the staff who came forward to give feedback, I know speaking up in these circumstances isn’t easy, but it’s important it happens because it helps us understand where organisations may need to turn their attentions to identify and address any issues.

“In medical care, we found staff treated people with compassion and kindness, respected their privacy and dignity and met people’s individual needs. They also provided emotional support to people, families and carers. They advised them on how to lead healthier lives, supported them to make decisions about their care, and made sure they had access to good information. However, they didn’t always carry out risk assessments in a timely manner which potentially put people at risk of harm.

“We did see some outstanding practice at the trust. There was a strong focus on research and innovation to improve outcomes for people with cancer and the trust and everyone involved should be proud of that important work.

“We have told the trust where it needs to make a number of improvements and we will return to check that these have been made and fully embedded.”

What has The Christie said about the report?

Roger Spencer, chief executive of The Christie NHS Foundation Trust, said: “We are pleased that the CQC has rated us good despite the difficulties the NHS has faced over the past few years. Demand for cancer services has continued to rise, resulting in us treating more patients than ever before.

“We are working hard to make the improvements that have been highlighted by the CQC, ensuring that all our staff feel supported and valued and I thank all of them for continuing to put patients at the centre of everything we do.”