Levels of ratings: independent healthcare services

Page last updated: 12 May 2022
Organisations we regulate

We rate independent healthcare providers in the same way that we rate other services.

This includes awarding a rating for the five key questions: are services safe, effective, caring, responsive and well-led, and then aggregating these up to an overall rating at service and/or location level. Where an independent healthcare provider delivers a number of services we will also aggregate the ratings for these services to an overall location level rating.

We rate at these levels on our four-point scale: outstanding, good, requires improvement and inadequate.

We decide all ratings using a combination of aggregating the ratings for the key questions and the professional judgement of inspection teams. We use the same set of ratings principles to help us to determine the final ratings that we use for all other services, which are published on our website.

Ratings will be based on our assessment of the evidence we gather against the key lines of enquiry in the assessment framework for healthcare services. Inspectors will refer to the corresponding ratings characteristics for the key lines of enquiry and use their professional judgement to decide on a rating.

Sometimes, we won’t be able to award a rating. This could be because:

  • the service is new
  • we don’t have enough evidence
  • the service has recently been reconfigured, such as being taken over by a new provider

In these cases, we will use the term ‘inspected but not rated’ when we publish an inspection report. We may also suspend a rating at any level. For example, we may have identified significant concerns which, after reviewing but before a full assessment, lead us to re-consider our previous rating. In this case, we would suspend our rating and then investigate the concerns.

We will rate at different levels according to the type of provider and the number of services they provide (where relevant). For all types of independent healthcare services we will rate at the following levels:

  • Level 1: A rating for each of the key questions for the service
  • Level 2: An overall rating for the service. This will be an aggregated rating informed by our findings at level 1

Rating example 1

Rating example 1 shows how the two levels work together for a single specialty service:

Table showing how the two levels work together for a single specialty service.

Rating example 2

Rating example 2 shows how the four levels work together for a provider that delivers more than one service. For example, for each independent acute hospital location, we would rate the quality of care at four levels:

  • Level 1: A rating for every service inspected against every key question
  • Level 2: An aggregated rating for each service
  • Level 3: An aggregated rating for each key question, except for providers with one location (hospital)
  • Level 4: An aggregated overall rating for the location as a whole

Table showing how the four levels work together for a provider that delivers more than one service.