Quality and safety in the independent healthcare sector 2023
Core services
As well as looking at overall ratings, we can consider ratings awarded to core services, for example as per the CQC’s 2018 report.
The number of core services with ratings for organisations classed as independent by the CQC is shown below:
We can gain insights into the type and quality of care provided by the sector when focusing on those areas represented by IHPN3. The plot below shows the top core services by independent providers with ratings by the CQC.
The plot below shows how these ratings have improved, with the proportion of services rated good or outstanding rising from about 75% in 2018 to around 88% today:
Sector improvement case study
The previous section shows the scale by which the sector has improved over the past few years. These improvements have been achieved by learning from the findings of national inquiries and reports and by focusing on key areas such as medical governance, clinical audit and outcomes.
Medical Practitioners Assurance Framework (MPAF)
The MPAF, launched in 2019 and refreshed in 2022 was developed by IHPN, member organisations and key stakeholders to support improvement, consistency, and transparency in the oversight of medical practitioners working in the independent sector. It has since been adopted by CQC into its inspection methodology and used by the NHS through the 2022-23 Standard Contract.
Children and Young People
In 2018 CQC identified services to children and young people within acute hospitals as an area for improvement. 37 independent providers had ratings for this core service area at the beginning of that year. One was rated inadequate and 14 rated requires improvement (40% in total). By contrast, there are now 65 independent providers with ratings for this service area, 87% of which are good or outstanding, as shown below:
NB, there were four independent providers rated outstanding for children and young people’s services at the beginning of 2018 (i.e., 10.8% or 4 of 37 organisations). There are now seven organisations rated outstanding for this population group (10.7% or 7 of 65 organisations).
Outstanding locations for core services
Locations can receive outstanding ratings for quality domains (safe, effective, caring, responsive, well-led, and overall) for their overall service and for core services. It is therefore possible for a location to receive several outstanding ratings.
A total of 1,840 outstanding ratings have been awarded to 439 locations run by 311 independent sector provider groups for different aspects of care.
When we look at those groups that have the most locations with at least one outstanding rating, we see evidence of high-quality service spread across the group, not just concentrated in a small percentage of locations. For example, the top ten providers by number of locations with at least one outstanding rating have on average over 9 locations with outstanding ratings which is equivalent of 37% of those groups’ locations.
Of these, two organisations have over 70% of their estate with at least one outstanding rating. This suggests that with that the right approach, outstanding care is something that can be achieved with a significant degree of consistency.