During your visit: your treatment
All of our patients are different so we aim to provide treatment tailored to each individual. The type of treatment you receive will vary depending on your needs.
How do I find my way around?
Wall maps, leaflets, signage and wayfinding kiosks are located in key areas around the Chelsea and Sutton hospitals to help you find your way around. We have tried to keep signage to a minimum and to keep it as simple as possible.
We use a system of ‘colour zoning’. You will find the colour zone of the ward or department you want on one of the wall maps, which are at all the main entrances. Follow the signs to the appropriate colour zone, where you will find more detailed signage for the department you need.
To make sure we’re providing you with treatment and care in a way that’s right for you, it’s important that we know who you are during your stay in hospital.
When you come to the hospital, we will give you a unique Royal Marsden number. This number will appear on hospital documentation. Along with these numbers, we may identify you in two other ways:
- Staff may ask you to confirm your name and date of birth. This will happen before various procedures such as blood tests and x‑rays and before we give you any medication
- If you are admitted to a ward or a day care area, we will give you a white or red name band. Please keep this on at all times during your stay at the hospital.
You will meet many different staff while you are at the hospital. So you can be sure of who they are, all our staff wear identity badges with their name and photograph. If you are not sure of the name of the person you are speaking to, please ask.
Students and their training
As a postgraduate teaching hospital, we train students and qualified doctors, nurses and therapists in the specialist treatment and care of cancer patients. This means that staff in training (who may be involved in your current or future care) may be present during your consultation with your Consultant or other healthcare professionals.
You have the right to choose whether or not you want this to happen. If you don’t want staff in training to be present, please tell your doctor or nurse. Your request will be respected and understood and won’t affect the treatment and care you receive at the hospital.
What happens during my appointment or stay?
The nature of your appointment or consultation will depend on whether you are coming to the hospital as an outpatient, a day care patient or staying as an inpatient.
Tests and investigations
Tests and investigations help us accurately diagnose and plan treatment for our patients and, depending on your personal treatment plan, may be requested whilst you are an outpatient, day patient or inpatient.
Tests are carried out in various departments in the hospital. We will let you know which department to attend.
Your doctor or nurse will explain to you the reason for the test, what is involved, including any special preparation, how long it will take and any potential complications. Your chosen consultant will also let you know when you can expect to receive your test results. If you don’t receive them then, please contact your consultant.
Before we proceed, we will always obtain your consent to go ahead with the test.
How will my treatment be planned?
Your treatment will be planned by a team made up of different healthcare professionals with different areas of expertise. We call this a multidisciplinary team.
As a private patient you are able to choose your consultant, who is responsible for your care. In line with best practice, your consultant will discuss your treatment options with professionals from other disciplines to ensure that you receive the very best care and advice available, and that all treatment options are fully considered.
Depending on your needs and the type of cancer you have, the multidisciplinary team of professionals who specialise in your type of cancer might include:
- A surgeon
- A medical oncologist (a specialist doctor who treats cancer with drugs, including chemotherapy)
- A clinical oncologist or radiotherapist (a specialist doctor who treats cancer with radiotherapy)
- A radiologist who specialises in the use of x‑rays and other imaging to diagnose and monitor disease
- A key worker, such as a specialist nurse, who acts as a point of contact for you and your family throughout your treatment and offers information and support
- Other healthcare specialists (for example, pharmacists, dieticians, social workers, physiotherapists) might also be part of your team and be involved in your care.
The multidisciplinary team meets regularly to discuss the best treatment options for each patient in their care. They will take into account the results of tests and your general health.
Your doctor will discuss the different treatment options available to you, taking into account the recommendations of the multidisciplinary team and your own preferences. You may find it helpful to take a family member or friend with you to your appointment when your treatment is being discussed.
What are the typical treatment types?
Some types of cancer can be treated with surgery. If surgery is part of your treatment you will be admitted to hospital. Depending on the surgery you need, this may be for day care or for a longer inpatient stay.
Before your surgery we might ask you to attend a pre‑assessment clinic so that we can make sure you are well enough for anaesthetic and surgery and advise you on how to prepare. For more information about surgery, please visit royalmarsden.nhs.uk/information.
Chemotherapy is treatment with anti‑cancer drugs, given to destroy or control cancer cells. A single drug may be given or several different drugs may be given together. The nature of the treatment will depend on the type of cancer you have and how advanced it is.
If you need chemotherapy, you will receive it either in one of the Private Patient Medical Daycare Units or you may need inpatient care. For more information about chemotherapy, please visit royalmarsden.nhs.uk/information.
Radiotherapy uses carefully measured doses of radiation to treat cancer. The type of radiotherapy most people have uses beams of high‑energy rays, usually x‑rays. The radiotherapy machine delivers specific amounts of the radiation to the area of the body that it is aimed at.
Radiotherapy is generally given as an outpatient treatment.
Your doctor will explain why radiotherapy is recommended for you and what your treatment will involve. For more information about radiotherapy, please visit royalmarsden.nhs.uk/information
Questions to ask
Before you can make a decision about treatment, it’s important that you fully understand what each treatment involves. This is particularly important because we will always ask for your consent before we treat you. During your appointment, you will have a chance to ask your consultant anything you would like to know about your treatment. It is a good idea to think about what questions you might want to ask before your appointment.
How do I give my consent to treatment?
Our doctors, nurses or therapists will ask you to agree to any form of examination, treatment or care.
They must explain the risks and benefits of the treatment or examination, any available alternative procedures and the risks and benefits if you choose to do nothing for the time being. We may also give you some written information about the procedure that has been planned.
It is important that you understand the information you have been given – please ask questions if you don’t understand or if you want more information. If the person asking for your consent isn’t able to answer your questions, ask them to find out or arrange for someone else to talk to you about your concerns. Remember, you are always free to say no, or to ask for more information.
We may also ask your consent for:
- Storing tissue samples
- Research and trials
- Cell donation (for more information see the Human Tissue Authority Codes of Practice 1 and 6 at www.hta.gov.uk).
Types of consent
There are different ways in which you can give your consent, but you are the only person who can give consent. No one else can do this for you.
Your consent could be simply offering up your arm when a nurse asks to take your blood pressure. By offering your arm, you are giving implied consent without actually saying anything in words. Sometimes you will give your spoken consent. In certain circumstances, you will also be asked to sign a consent form which you will then be given a copy of.
When consenting to any type of treatment you will usually be asked to sign a consent form – a written record that you have agreed to the planned treatment. The main benefits and risks associated with the treatment will be written on the form. We will give you a copy of this document.
It is important to remember that once you have made a decision about treatment, you can change your mind at any time, even after you have signed a consent form.
What do I need to know about medicines?
If you are staying in hospital as an inpatient, please bring any medicines you are currently taking with you when you come to the hospital. If your own medicines are suitable and your hospital doctor wants you to continue taking them, you may use them while you are in hospital.
Cancer related pain
At the integrated pain clinic patient’s cancer‑related pain can be assessed and treated throughout their journey. The pain team will be able to adjust pain killing drugs and doses and manage side effects according to individual patient needs.
The pain team is experienced at treating all types of pain associated with cancer, including the following:
- Pain after chemotherapy, radiotherapy or surgery
- Nerve‑related pain
- Pain associated with advanced disease
- Intractable pain
By working with oncologists, surgeons, palliative care and GPs, as well as physiotherapists and psychologists, the integrated pain clinic at The Royal Marsden offers a comprehensive approach to the treatment of cancer‑related pain.
Continuing your prescriptions after your stay
When you leave hospital, the pharmacy will supply you with any medicines you need to continue your cancer treatment. Your GP/family doctor should continue to supply you with medicines for any other conditions. Please be sure to contact your GP in advance to avoid running out. Please note that any ongoing chemotherapy and medicines related to your cancer treatment will be provided by the pharmacy at The Royal Marsden.
Disposal of unused medicines
Please return any unused medicines that are no longer needed to the pharmacy at your next visit so they can be disposed of safely.
The pharmacy provides and supervises the use of all medicines prescribed in the hospital. It also reviews each prescription regularly to ensure medicines are being used in the best way for patients.
If you have any questions about the service, please ask the dedicated private care pharmacist.
Pharmacy opening hours
Monday to Friday: 9am to 6.30pm
Saturday: 9am to 1pm
If you have any questions about medicines, please phone the medicines helpline on 020 8770 3821.The service is available from 9am to 1pm and 2pm to 5pm Monday to Friday. You can leave a message outside of these hours. You can email the service at email@example.com
What do I need to know about the hospital environment?
Conduct and behaviour
The Royal Marsden prides itself in being socially and culturally inclusive and sensitive to the needs of the patients and carers it serves.
We welcome your support in helping us to provide effective services in a safe and supportive environment that is free of prejudice, harassment and violence, meeting the needs of all who pass through our doors. Please remember that this includes our staff – they are here to help you and we ask that you treat them with respect.
We are a smoke‑free hospital. Smoking is not allowed on our premises, in our vehicles, at entrances or anywhere else in our grounds.
Mobile phone signals can interfere with some types of medical equipment. For that reason there are clearly signposted areas where we ask patients not to use mobile phones. Please observe these instructions. Our staff use a cordless internal phone system that does not affect medical equipment. When you do use your mobile phone, please be considerate to others around you.
If you see an area or an item that has recently been damaged or broken, please tell a nurse or the member of staff in charge. Our staff will then make sure that our Estates Department is aware of the issue. The Estates Department has staff to deal with any issues during normal working hours, and an emergency call‑out service for all other times.
How do we prevent infections at the hospital?
We are committed to providing a safe, clean environment that protects patients. This issue is especially important for us, as patients who are undergoing treatment for cancer may be more susceptible to developing an infection.
In order to minimise the risk to patients who come to The Royal Marsden, the Trust has a very strict policy for screening new patients for Meticillin Resistant Staphylococcus aureus (MRSA) and a Carbapenemase Producing Organism (CPO). MRSA is a bacteria that can be present on the skin without causing infection but can be a common cause of infections. A CPO is a bacteria that can be found living harmlessly in our guts however it can be a common cause of some infections like a urinary tract infection. A CPO bacteria is resistant to certain types of antibiotics. On registration or admission, this screening test ensures that we are aware of patients who carry MRSA and/or CPO before any admission so that they can be treated and reduce the risk of developing an infection.
The screening test is carried out by your clinic nurse and requires them to take a swab for MRSA from the inside of the nose, groin, armpit and throat. For a CPO test a swab is taken from inside the rectum, but a stool sample can also be supplied and that can be tested. If you have any concerns or questions about this test, or would like further details, please see the hospital information leaflet regarding MRSA or CPO or speak with your clinic nurse.
We have a dedicated team responsible for all aspects of infection prevention and control including:
- Providing infection prevention and control information, education and advice to patients, visitors and all healthcare workers
- Monitoring the cleanliness of equipment and the environment.
What you can do to help
- Keeping your hands clean is one of the most important things you can do to help prevent infection. Please wash your hands or use the hand rub regularly and encourage your visitors to do the same, particularly on arriving and leaving
- Always wash your hands after going to the toilet
- If you are being cared for in a single room, your visitors should always ask the nursing staff before entering about what precautions to take
- Ask visitors not to sit on the bed
- Ask your relatives and friends not to visit if they are suffering from a cold, flu, stomach upset, rash or if they have had recent contact with an infectious disease, for example, chicken pox or measles, and particularly if they have had diarrhoea or vomiting in the last 48 hours
- Supervise any children and do not allow them to touch any equipment
- Please report any concerns or issues, in particular cleaning, to the Private Care Matron, your ward sister or contact the Infection Prevention and Control Team on 020 8661 3248.
Information specific to outpatient appointments
What happens during the appointment?
Outpatients are people who do not need prolonged day care or an overnight stay in hospital.
Outpatient appointments will take place in the dedicated Private Care Outpatient Department on the Sutton or Chelsea site or in one of our diagnostic centres. If you are attending a clinic that is held in a different part of the hospital, we will notify you in advance and tell you how to get there. You may bring along a companion along to your appointment.
When you arrive
When you arrive, please report to the private outpatient reception desk. After registering, you can take a seat in the waiting area. Before you see your consultant, you might need to have blood tests or x‑rays. If so, we will let you know where to go.
On your first visit we will ask you to fill in a registration form; please allow about 20 minutes to do this.
Your medical consultation
Before you see the consultant, a nurse may weigh you. Please tell the nurse if you think your weight has changed during recent months. If an examination is necessary the nurse may also ask you to change into a clean examination gown. If you’re not sure how much clothing to remove, please ask the nurse.
As a private patient, you will see your chosen consultant at each outpatient attendance. If you need to be seen while your consultant is on leave, he or she will arrange for a consultant colleague or senior member of the team to see you.
Remembering important information
Your visit to the clinic is a good time to discuss things with your consultant. It can be hard to remember all the questions you want to ask and all the information the doctor gives you, but there are some things you can do to make it easier for yourself:
- Write down and prioritise the questions you want to ask and make a note of the answers
- Consider bringing a relative or friend to help you remember the conversation later
- Request written information if it is available and repeat back what you think you’ve heard to check that the information is correct
- If you haven’t understood what has been said, please ask your consultant or clinic nurse to repeat the answer or explain it again.
After your consultation
After your consultation, your consultant or clinic nurse will always be willing to answer any questions. Please ask if you haven’t understood what has been said.
What happens after my appointment?
Following each visit to the hospital, you will be given a card with the date and time of your next appointment if needed.
If you can’t keep an appointment, please phone your consultant’s medical secretary or the private ward or department you are due to attend to arrange another one. Please remember to tell staff if you have tests booked.
If you’re worried about anything between your appointments, please phone the contact number provided to you or our Central Referral and Information Line on 020 7811 8111 to arrange an earlier clinic visit or to get advice.
Royal Marsden patients, their carers and hospital and community-based doctors and nurses caring for Royal Marsden patients can also call The Royal Marsden Macmillan Hotline. This service provides specialist advice and support. You can call 24 hours a day, seven days a week on 020 8915 6899.
If you don’t need a follow‑up visit, remember to keep your appointment card safe in case you need it in the future.
If you change your address, GP or private medical insurer, please remember to notify us.
Information specific to day care appointments
What is day care?
Day care is for patients who need more prolonged treatment or investigations than outpatients, but who do not need to stay in the hospital overnight.
If you are a day care patient, you will need to spend part or all day at the hospital. This may be for surgery, where you will be looked after on the inpatient ward or in a surgical day care area or for non‑surgical, such as chemotherapy, on the Private Patient Medical Day Unit.
Day care endoscopy is provided at Chelsea
The ward or clinic you have been attending will book your day care appointment and will try to arrange a date and time that suits you.
Remember that you might need to visit more than one department on the same day.
About the Private Patient Medical Day Units (PPMDU)
The Royal Marsden’s dedicated Private Patient Medical Day Units (PPMDUs) provide day care services to patients in a comfortable and modern environment. You may attend a unit for a number of reasons, such as: chemotherapy, blood transfusions, blood tests, injections and other intravenous therapies.
The PPMDU has a dedicated team of doctors who are available throughout the day to give you medical support and advice. The unit also has an on‑site oncology‑trained pharmacist and technician, who can answer questions about your medication.
If your appointment is not on the PPMDU you will receive information from the relevant department on what to do before your arrival.
Other day care services, which are offered outside our PPMDU, include: radiotherapy, endoscopy and day surgery.
Before your first chemotherapy treatment
At the end of your initial outpatient consultation and before you begin chemotherapy treatment in the PPMDU, we will offer you a pre‑treatment appointment. This is a chance to meet the nursing staff and our ward pharmacist, view the unit and ask any questions you may have about your treatment. Many patients find this very helpful. We recommend it for any patient starting a new course of treatment.
During your visit
The length of time that you spend in the unit depends on the type of tests, assessment, treatment preparation and treatment you need.
On arrival at Sutton PPMDU
On the day of your treatment, please report to the reception at the PPMDU. This is on the first floor of the West Wing, Robert Tiffany ward.
On arrival at Chelsea PPMDU
On the day of your treatment please report to the reception at the PPMDU on the third floor of Wallace Wing. There is dedicated lift access to the private unit from the ground floor next to the Wallace Wing reception area.
When you arrive for treatment you will be greeted by your nurse for that day, who will give you a number of checks. You will have these checks each time you visit before your treatment begins. The nurse will:
- Take a blood test
- Measure your height and weight
- Carry out an assessment of your medical history (first visit) or your treatment progress (subsequent visits).
You will then be reviewed by a doctor who will confirm that you are well enough to receive your planned treatment.
If it is your first visit or if you are having a change of treatment, we will give you information about your treatment and ask you to sign a consent form.
The preparation of most chemotherapy treatments can take up to two to three hours from the time that your blood test results are confirmed.
If it’s likely to take longer we will keep you fully informed so you know how long you should expect to wait.
To help make your treatment as comfortable as possible, we recommend wearing loose‑fitting clothes with sleeves that can be easily rolled up.
Not all chemotherapy treatments cause hair loss, but for those patients who may lose hair there is scalp cooling treatment available to reduce this. Scalp cooling will add to the length of your visit and if you opt for this you will need to bring a mirror and comb so that you can style your hair afterwards.
If you prefer not to wait, it may be possible for you to have your blood test and review by the doctor, and then return the next day for treatment. Please discuss any queries with the nurse in charge.
Friends and family
You are welcome to bring a friend or family member with you on the day of your treatment. However, for the comfort and privacy of all patients, we ask that you bring only one companion per visit.
Food and drink
Our catering staff will provide you with a light lunch, together with refreshments and snacks throughout your stay. Hot drinks are available for your companion, but we cannot provide visitors with lunch. Food is available for visitors in designated areas around the hospital.
After your treatment
When your treatment has finished, your nurse will give you any medication you need to take home with you. To help your medical team monitor your medication, we will ask you to keep a record of any after‑effects in the days following each cycle of chemotherapy. You should bring this record with you to your next appointment.
Before you go home, please check with the ward clerk that your next appointment has been booked and that you have the details written in your appointment card.
We will also give you any information you need to know about the possible side‑effects of your treatment. This will include details of what to do and who to contact if you feel unwell.
Private Patient Medical Day Unit
If you feel unwell between visits, please call:
Sutton 020 8915 6670Monday to Friday: 8.30am to 8pm
Chelsea 020 7811 8092Monday to Friday: 8.30am to 8pmOut of hours switchboard 020 8642 6011
Information specific to inpatients
Inpatients are people whose treatment requires overnight stays in hospital. You might be admitted to hospital for planned treatment or if you have become unwell at home, you might need to be admitted to hospital as an emergency.
We aim to accommodate all our private patients in single en‑suite rooms. If for any reason this isn’t possible, we will make every effort to find you a comfortable alternative suitable for your medical requirements. If you need intensive care you will be accommodated in our state‑of-the‑art Critical Care Unit. To optimise your intensive nursing care, please note that you may be treated in a mixed sex area, where privacy and dignity will always be maintained.
When you arrive
We will send you a letter to confirm the date and time of your admission, and to let you know where to go when you arrive.
At Chelsea (Monday to Friday) If you are being admitted for surgery or the day surgery unit as advised in your admission letter, please report to the Private Care Surgical Unit on the first floor of the Chelsea Wing.
At Sutton (Monday to Friday) If you are being admitted for surgery that day, please come to Robert Tiffany Ward reception when you arrive at the hospital.
You will need to tell the nurse looking after you if any community services are being provided for you or someone you care for at home. These could include district nurses, Macmillan nurses or social services. It’s also important to tell your nurse if you think you need more help when you go home. Please let us know this as soon as you can because it can take some time to arrange services in the community for you.
What should I bring to hospital?
If you’re staying for any length of time at the hospital as an inpatient, there are certain things you need to bring with you and other things you might want to consider bringing.
If you are being admitted for a stay as an inpatient, please bring your own medicines from home. These may include:
- Medicines prescribed by your GP in their original packets
- Any over‑the‑counter medicines that you buy from a pharmacy or supermarket
- Any medicines or herbal remedies that you get from a health food shop or homeopathic practitioner.
As we are a specialist cancer hospital, we may not have all your medicines for other conditions in stock and it may take a day or two to order these. If you are using private medical insurance, this may not cover medicines relating to other conditions. Bringing your own medicines from home will ensure you can continue taking them without disruption during your stay and avoid the risk of personal cost to you.
Letting us know which medicines you take also means we can check that they are still suitable for you. Our pharmacists are on hand to offer advice about all of the medicines and remedies you are taking.
Toiletries and nightclothes
To help make your stay as comfortable as possible, please also bring:
- Dressing gown, slippers and a cardigan
- Nightclothes – pyjamas or a night dress
- Toothpaste and toothbrush, or denture cleaner and containers
- Razor or electric razor.
We also recommend bringing loose‑fitting clothes to wear during the day, and for when you leave.
As our storage space is limited, please travel light. Please don’t bring any valuables or large sums of money, as we cannot take responsibility for any loss.
Non‑essentials and things to pass the time
Your time at the hospital might involve long waiting periods when nothing much happens – for example, the waiting time between tests or treatments. Please do bring a book or a magazine, games or anything else that might help pass the time.
Although we provide food and drink, you can bring your own refreshments with you. We suggest light refreshments like cordial, fruit or biscuits.
What we provide
We will give you:
- A daily newspaper of your choice (other newspapers and magazines are available to buy)
- Fresh towels and bed linen every day.
In each of our single en‑suite rooms there is:
- A remote‑controlled flat screen digital TV and Patient Entertainment System (may be referred to as ‘PES’. See your room guide for more information)
- A direct dial telephone. Outgoing calls are free for private patients. Callers dialling in are advised to check the tariff with their landline or mobile provider.
During your stay
Can I bring someone with me?
You are welcome to bring a friend or a family member with you to the hospital. Many of our patients find it reassuring to bring a companion, especially if it is their first visit to the hospital.
Accommodation for relatives
Our accommodation for relatives is limited, but it may be available in some circumstances. The Facilities Office can give you details of hotels and serviced apartments in the area.
Ground floor, Wallace Wing
Telephone 020 7808 2011
Ground floor, West Wing
Telephone 020 8661 3395
Your meals will be made from fresh ingredients in our kitchen. Please let us know before your stay if you have any special dietary requirements.
How do I keep in touch with friends and family?
We know how important it can be to see your friends and family regularly when you’re staying in hospital.
We have no fixed visiting hours on the private wards, however we do ask that visitors understand that the mornings can be a very busy time for patients. Patients also need their rest at night and we settle patients down for bed at 9pm. We ask that visitors avoid these times where possible.
We may need to restrict visiting times when a patient is particularly unwell and needs to rest. It may also be necessary to restrict the number of visitors around a bed at any one time. We ask that you and your visitors are sensitive to the needs of other patients and respond to any requests made to you by ward staff.
Please ask a member of staff about other areas in the hospital where you can take your visitors.
To make sure that post reaches you, please ask your family and friends to include the following details on any letters or cards they send to you:
- Your full name with ‘patient’ in brackets
- The name of your ward
- The full postal address of the hospital.
If you wish to send letters, there are post‑boxes on the ground floor of each hospital. If you are unable to take letters to the post‑box yourself, a member of staff will be happy to post them for you. Stamps are available from the hospital shops.