Ratings principles: independent healthcare services

Page last updated: 12 May 2022
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Organisations we regulate

We follow these principles to determine how we aggregate and combine ratings, and in some circumstances, how we put a limit on ratings.

Reflecting enforcement action in our ratings

Where we are taking enforcement action, we will reflect this in the ratings at the lowest level (key question at service level).

1. Where we have identified a breach of a regulation and we issue a Requirement Notice, the rating linked to the area of the breach will normally be limited to ‘requires improvement’ at best.

2. Where we have identified a breach of a regulation and we take action under our enforcement powers, such as issuing a Warning Notice or imposing a condition of registration, the rating linked to the area of the breach will normally be ‘inadequate’.

Overarching aggregation principles

The following principles apply when we are aggregating ratings.

3. The five key questions are all equally important and should be weighted equally when aggregating.

4. The services are all equally important and should be weighted equally, except where they are significantly small.

5. All ratings will be treated equally when aggregating unless one of the other principles below applies.

Note: We can adjust the following principles for combinations where it is not appropriate to treat ratings equally.

Aggregating ratings

We use the following principles as the basis of the aggregation and use our professional judgement to apply them to the specific combination of underlying ratings.

6. The aggregated rating will normally be ‘outstanding’ where at least X number of the underlying ratings are ‘outstanding’ and the other underlying ratings are ‘good’.

Number of underlying ratings

Number (X) of underlying outstanding ratings

1 - 3

1 or more

4 - 8

2 or more

9+

3 or more

7. The aggregated rating will normally be limited to ‘requires improvement’ where at least X number of the underlying ratings are ‘requires improvement’.

Number of underlying ratings

Number (X) of underlying requires improvement ratings

1 - 3

1 or more

4 - 8

2 or more

9+

3 or more

8. The aggregated rating will normally be limited to ‘requires improvement’ at best where X number of the underlying ratings are ‘inadequate’.

9. The aggregated rating will normally be limited to ‘inadequate’ where at least Y number of the underlying ratings are ‘inadequate’.

Number of underlying ratings

Principle 8

Principle 9

 

Limited to requires improvement where there are (X) number of underlying inadequate ratings

Limited to inadequate where there are (Y) number of underlying inadequate ratings

1 - 3

Not applicable

1 or more

4 - 8

1

2 or more

9+

2

3 or more