Scotland, Wales and Northern Ireland

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.

There is less independent sector activity in Scotland, Wales and Northern Ireland than there is in England and the regulators publish considerably less data compared to the CQC and their reports are more narrative in nature. However, we have collected information about our members’ provision in Scotland and Wales which gives some insight into independent sector provision in those nations.

Scotland

Workforce

• Over 3,750 staff were employed or contracted across IHPN Scotland member organisations in 2025, reflecting steady workforce growth to meet increasing demand.
• Training was provided in nursing, optometry, radiography, physiotherapy, operating department practitioners, psychology, occupational therapy, art and music therapy.

Patient Activity

• 400,000 patients were treated in IHPN Scotland member facilities during 2025.
• Over 88,000 scans and X-rays were carried out, with imaging capacity and diagnostics optimised to meet demand.
• 269 acute beds are available across Scotland-based IHPN members, providing self-pay, insured and NHS-funded activity.
• 123 registered mental health inpatient beds are operated by IHPN Scotland members, including placements for complex and long-term mental health rehabilitation.

Safety and quality

• 96% of acute patients said they would recommend their independent hospital to friends and family — maintaining consistently high satisfaction levels.
• 100% of IHPN Scotland members have a Freedom to Speak Up guardian or equivalent role in place, ensuring accessible channels for staff to raise concerns.

Regulation

Acute Hospitals

• During 2025, Healthcare Improvement Scotland (HIS) continued its programme of regulatory assurance across independent hospitals and specialist services in Scotland. Within the IHPN Scotland membership, three acute members received a HIS inspection in 2025.

Specialist services and mental health hospitals

• Mental health members had their most recent HIS inspections in 2019–2024, with no new inspection reports published in 2025 for this group at the time of writing. One specialist services provider received a HIS inspection in 2025.

Overall Performance

Four IHPN Scotland member organisations were inspected by HIS in 2025, spanning acute surgical, day-surgery and specialist neuro-rehabilitation services.

HIS highlighted strong multidisciplinary teamwork and positive patient engagement supported by staff who reported feeling well-led and well-supported. The services also demonstrated active quality improvement processes, with regular audits, good staff training systems and a safe, well-maintained care environment. However, some inspections resulted in improvement plans with clearly defined requirements and recommendations, reflecting routine regulatory follow-up and ongoing quality enhancement.

The pattern of inspections – combining unannounced and announced visits – continues to illustrate HIS’s risk-based, proportionate approach to independent healthcare regulation in Scotland.

Collectively, these findings indicate a sector that is:

• Engaged with HIS inspection and assurance processes
• Responsive to identified areas for improvement
• Committed to maintaining strong safety, quality and governance standards, aligned with national expectations for independent healthcare in Scotland.

Wales

Workforce

• 4,000 staff were employed or contracted across IHPN Wales member organisations in 2025 — reflecting steady workforce growth to meet increasing demand.
• 70% of acute and mental health providers continue to offer nurse training placements or professional development programmes in partnership with higher education institutions in Wales.

Patient Activity

• 315,000 patients were treated in IHPN Wales member facilities during 2025 — a 15% increase on the previous year.
• 59,000 scans and X-rays were carried out, as imaging capacity and diagnostics expanded to meet demand.
• 164 acute beds are available across Wales-based IHPN members, providing self-pay, insured and NHS-funded activity.
• 313 mental health inpatient beds are operated by IHPN Wales members, including placements for complex and long-term mental health rehabilitation.
• The sector continues to play an important partnership role in supporting NHS Wales through planned elective procedures and mental health capacity provision.

Safety and quality

• 97% of acute patients said they would recommend their independent hospital to friends and family – maintaining consistently high satisfaction levels.
• 100% of IHPN Wales members have a Freedom to Speak Up guardian or equivalent role in place, ensuring accessible channels for staff to raise concerns.

Regulation

• During 2025, Healthcare Inspectorate Wales (HIW) provided a reduced programme of inspections across acute providers, while mental health independent healthcare providers saw an increase in inspection activity across 2025.

Acute Hospitals

• HIW conducted no full on-site inspections of independent acute hospitals or IR(ME)R inspections during 2025.
• One registered acute provider (registered in 2022) remains scheduled for its first full inspection under HIW’s rolling programme.

Mental Health Services

• HIW carried out four inspections of IHPN Wales member mental health hospitals during 2025.
• HIW’s findings across all four sites demonstrated strengthened governance, safe staffing levels, improved documentation, and greater patient participation in care planning.
• One non-compliance notice concerning governance documentation was identified. HIW received prompt and satisfactory assurance, and the provider was de-escalated following rapid improvement.

Overall Performance

Across all IHPN Wales member organisations — including acute, mental health, learning disability, and hospice services — no active enforcement actions or regulatory escalations remained in place at the time of reporting.

These outcomes reflect a mature, learning-driven sector that responds rapidly to inspection feedback, maintains strong compliance, and upholds a consistent focus on safety, openness and improvement.

IHPN Northern Ireland – Regulation & Quality Improvement Authority (RQIA) 

No regulatory inspection reports for IHPN Northern Ireland member facilities were published in 2025.