Quality and safety in the independent healthcare sector 2023


The Independent Healthcare Providers Network (IHPN) is the member organisation for independent healthcare in the United Kingdom. Our members span primary, secondary, diagnostic and community care services delivering care to patients who are funded by the NHS, by insurance or pay for their own care. 

In England, most healthcare services must be registered with the Care Quality Commission (CQC). Similarly, the independent regulator in Scotland is Healthcare Improvement Scotland (HIS), in Wales it is the Healthcare Inspectorate Wales (HIW) and in Northern Ireland it is the Regulation and Quality Improvement Authority (RQIA). IHPN membership covers all four nations. This report focuses on services in England, as it is where most IHPN provision takes place, and most data is currently available. Our ambition is to produce similar reports for all four counties that IHPN represents. 

The contribution of independent providers to England’s health system has never been more important or more varied. 

In 2022 around 2 ¼ million acute patient journeys took place across the sector, including more than 830,000 private patient journeys and over 1.4m acute NHS patient journeys. Beyond hospitals, IHPN members alone provide over 300 community services, many of which are commissioned by ICBs or local authorities. Over 3.5 million scans and tests were delivered by the sector last year to NHS patients. Some were directly commissioned diagnostic services, and others were provided by independent providers that run NHS trusts’ inhouse services. The sector employs over 150,000 people and contributes to the training of a wide range of clinical staff. 

To give context, we have shown comparative information about NHS providers where sufficient information is available, but we have done this cautiously, aware that there are differences between sectors, geographies and individual circumstances that should be considered before drawing wider conclusions. Where reasonably comparative information is unavailable, we have provided a narrative. 

We intend that the report should provide opportunities to share good practice and learning. Our work is informed by reports such as those by the CQC2 which highlight comparisons, identify where improvements in the sector have been made, where gaps or challenges remain and illustrate best practice for others to use. 

There are areas where comparative information is not available for a variety of reasons. For example, there are restrictions that prevent independent providers from submitting to some of the audits that form part of the National Clinical Audits and Outcomes Programme (NCAOP). In other areas, definitions of harm used in the Duty of Candour regulations differ between NHS and independent sector providers. 

Despite these challenges, we see progress across a range of national projects. The Acute Data Alignment Project (ADAPt) is on track to support analysis of private activity alongside care for NHS patients. More datasets than ever before are now published by the Private Healthcare Information Network (PHIN). Increasing numbers of independent providers are submitting data to Learning from Patient Safety Events (LFPSE) and the opportunity for the sector to directly report to this system is a welcome step in the right direction that follows years of work. 

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