Sector improvements

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)

Working with our member organisations and key stakeholders, we developed the MPAF to support improvement, consistency and transparency in the oversight of medical practitioners working in the independent sector. It was launched in 2019 and refreshed in 2022 and has been adopted into the CQC’s inspection methodology and used by the NHS in its Standard Contract, following its adoption in 2024/25.

We plan to carry out a full review of the MPAF during 2026. This will be led by Professor Sir Stephen Powis, who was the National Medical Director of NHS England between 2018 and 2025.

We support good governance across the sector by running regular update sessions for registered managers. In February 2026, we supported this through the publication of a Registered Managers’ handbook.

Children and young people

In 2018, the CQC identified services for 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 were rated requires improvement (40% in total). By contrast, at the end of 2025 there were 63 independent providers with ratings for this service area, 86% of which were good or outstanding, as shown below: