Introduction

This is IHPN’s second in-depth report into the quality and safety of healthcare services provided by independent providers in the United Kingdom.

Our first report used data that was available towards the end of 2023. This report refreshes all that information, and in line with our commitment to look at the broader landscape, covers a range of new areas.

This is particularly timely because there has been considerable change in UK healthcare over the past year, not least as the new Government took office in July 2024.

A report that looks at quality and safety will inevitably be dominated by information published by the regulator, the Care Quality Commission (CQC), but we are also mindful of the recent changes in leadership at the CQC, and the recommendations of the report led by Dr Penny Dash focusing on how regulation needs to change. Our last report looked primarily at ratings published by the CQC. This year, we update those sections, and we also examine the proportion of services rated by the CQC as this was an area highlighted in the Dash review.

Even though there has been some progress in recent months bringing down the NHS elective waiting list, it remains stubbornly high despite heroic efforts and considerable resources to reduce patient waiting. Access to timely healthcare is an issue of quality and it has a profound impact on patients’ lives. We therefore examine the sector’s contribution to reducing waiting times, together with inequalities that develop when patients are unable to choose the most appropriate timely locally available care.

NHS England has been developing a new approach to outcomes, audits and registries through its Outcomes and Registries Programme (ORP), so we examine how that is affecting the sector, including recommendations about areas that must be addressed to enable progress in 2025:

• engagement on information governance issues
• incorporating the independent sector at the design stage of audits
• prioritising providing meaningful information back to providers to improve patient care

We explore how information about privately funded care is now more widely available than ever before, but despite this considerable progress, more needs to be achieved.

Listening to patients is crucially important, so we have included sections relating to Patient Reported Outcome Measures (PROMs) and patient experience. We have also covered a range of specialist areas including ophthalmology, orthopaedics, endoscopy, cosmetic surgery, cancer and diagnostics.

The information in this report demonstrates a high standard of care provided in the independent sector, with greater transparency, high-quality outcomes, and minimal complications. But there is always more to be done. That is why we are committed to supporting systems that link data to build our understanding of how patients move through healthcare from provider to provider (including the NHS). And it is why we commit ourselves again to working towards ever greater transparency across the whole of UK independent healthcare.