The state of care in independent acute hospitals

Published: 10 April 2018 Page last updated: 12 May 2022

This publication presents findings from our programme of inspections of independent acute hospitals.

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Independent acute hospitals provide a range of services including surgery, diagnostics and medical care.

Many independent hospitals provide services that are funded partly or in full by the NHS. They are playing an increasingly important role in delivering healthcare services in England.

What we did

We introduced our new comprehensive inspection programme for independent acute hospitals in 2015.

This saw the start of expert led, specialist inspections that focused on what matters most to people using services – whether they are safe, caring, effective, responsive and well-led.

We also introduced performance ratings of ‘outstanding’, ‘good’, ‘requires improvement’ and ‘inadequate’ to help people make informed choices about their healthcare.

We inspected and rated 206 independent hospitals in England (at an overall level and for their core services) against these criteria.

What we found

CQC's actions are driving improvements in care for people. Providers have been quick to respond to inspection findings, addressing areas of further work to improve patient care.

Of the 13 hospitals that had been re-inspected:

  • seven had improved
  • four had improved from an initial rating of inadequate

As of 2 January 2018:

  • we rated 62% of independent hospitals as good
  • we rated 8% as outstanding

We found the greatest concerns in safety and leadership.

For safety:

  • 41% of hospitals required improvement
  • 1% were inadequate

For how well-led they are:

  • 30% of hospitals required improvement
  • 3% were inadequate

Our specific concerns included:

  • some surgeons were not following every step of the World Health Organisation surgical checklist
  • some hospitals failed to prepare for the possibility that a patient's condition could deteriorate

We will continue to hold these providers to account and will share the good practice we find in order to encourage further improvement.