Cancer patients experience concerning rates of psychosocial problems. The published literature has been dominated by attempts to detect and intervene with patients using individual or group counselling. This presentation will argue that we need to critically appraise the contribution of the treatment centre environment in contributing to gaps in the delivery of patient-centred care. Despite the difficulties with establishing high-level evidence, treatment centre factors have the potential to provide an effective approach in reducing the psychosocial burden of patients.