The Gamma Knife Centre at The National Hospital for Neurology and Neurosurgery

Updated 22 June 2021

The Gamma Knife Centre at the National Hospital for Neurology and Neurosurgery is operated by QSRC Limited. They are an independent health care provider and work in partnership with the NHS trust they are based within, referred here on as the ‘host NHS trust’.

The service provides care to both independently funded patients and NHS patients. They deliver stereotactic radiosurgery (SRS) to treat lesions in the brain. SRS is a very targeted way of delivery radiotherapy to precisely treat lesions. They treat malignant lesions, metastases, benign conditions and vascular conditions. The majority of patients are treated as outpatients, the service had an agreement with the host trust that they cared for the few patients who needed to be admitted to the ward for inpatient care.

The service was contracted by NHS England as one of two specialist SRS providers in England to provide gamma knife treatment to all diagnoses. Due to the specialist nature of the care delivered, NHS England has a four-tier system for complexity of patients, this provider was contracted to deliver care to all four tiers of patients.

The service provided care for patients from London and the South of England. They received referrals from external centres for specialist consideration.

At the time of inspection the service had two registered managers, this was because they did not work full time and this solution provided full time cover.

Due to the nature of the care delivered they had continued to treat patients throughout the COVID-19 pandemic, although numbers were reduced. In the past year the service had treated 334 patients.

The service was previously inspected in 2016 and was rated requires improvement overall and inadequate in well led. We followed up on these concerns with this inspection. On this inspection we found these had been addressed with significant improvements made which are reported in more detail in the following report.

Updated 22 June 2021

Our rating of this location improved. We rated it as good because

• The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service controlled infection risk and managed medicines well. Staff assessed risks to patients and kept good care records.
• Staff provided good care and treatment, gave patients enough to eat and drink, and gave them pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, supported them to make decisions about their care, and had access to good information.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
• 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. People could access the service when they needed it and did not have to wait too long for treatment.
• Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients to plan and manage services and all staff were committed to improving services continually.

Updated 22 June 2021

Medical care was the only care this service delivers. The service treated lesions or abnormalities in the brain, both benign and malignant using highly precise radiation and a technique called stereotactic radiosurgery (SRS). Although the technique is called radiosurgery it is not considered surgery it is only the radiation that enters the brain; most patients do not require general anaesthesia for this treatment. The service was one of two in England to be contracted by NHS England to treat all four tiers of SRS, this means they took referrals for patients from the whole of the South of England for some, more complex, treatments.

We rated this service as good because it was safe, effective, caring, responsive and well led.